Laparoscopic Resection of Gastrointestinal Stromal Tumors (Gist)

Loureiro, Marcelo de Paula; Almeida, Rômulo Augusto Andrade de; Claus, Christiano Marlo Paggi; Bonin, Eduardo A.; Cury-Filho, Antônio Moris; Costa, Marco Aurélio Raeder da; Vital, Marcílio Lisboa

doi:10.1590/0102-6720201600010001

Cited by 16 publications

(12 citation statements)

References 28 publications

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“…However, when GIST is histologically proven the European and Japanese guidelines recommend resection regardless of its size. Lately, several endoscopic and combined endoscopic and laparoscopic resections techniques have been proposed 2 , 11 , 15 , 19 , 21 , 24 , 26 , 29 , 31 , 32 . However, these types of treatments exhibit some complications 1 , 14 .…”

Section: Discussionmentioning

confidence: 99%

Full-Thickness Endoscopic Gastric Resection Using a Stapler and Gastrostomy: A Feasibility Study

Wada

Hashiba

Otoch

et al. 2018

ABCD, arq. bras. cir. dig.

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Background: Laparoscopic sleeve gastrectomy (LSG) is currently the most frequently performed bariatric procedure in Turkey. The goal of weight reduction surgery is not only to decrease excess weight, but also to improve obesity related comorbidities and quality of life (QoL). Aim: To evaluate the impact of LSG on patient quality of life, weight loss, and comorbidities associated with morbid obesity according to the updated BAROS criteria. Methods: Eleven hundred thirty-eight adult patients were undergone to LSG by our bariatric surgery team between January 2013 and January 2016. A questionnaire (The Bariatric Analysis and Reporting Outcome System - BAROS) was published on social media. The data on postoperative complications were collected from hospital database. Results: Number of respondants was 562 (49.4%). Six of 1138 patients(0.5%) had leakage. All patients who had leakage were respondants. The overall complication rate was 7.7%. After a mean period of 7.4±5.3 months(1-30), mean excess weight loss was 71.3±27.1% (10.2-155.4). The respondants reported 772 comorbidities. Of these, 162 (30%) were improved, and 420 (54.4%) were resolved. The mean scores for QoL were significantly increased after LSG (range, p<0.05 to <0.001). Of the 562 patients, 26 (4.6%) were classified as failures; 86 (15.3%) fair; 196 (34.9%) good; 144 (25.6%) very good, and 110 (19.6%) excellent results according to the updated BAROS scoring system. Conclusion: LSG is a highly effective bariatric procedure in the manner of weight control, improvement in comorbidities and increasing of QoL in short- and mid-term.

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Section: Discussionmentioning

confidence: 99%

Full-Thickness Endoscopic Gastric Resection Using a Stapler and Gastrostomy: A Feasibility Study

Wada

Hashiba

Otoch

et al. 2018

ABCD, arq. bras. cir. dig.

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“…Therefore, Brazil emerges as the second country in the world, behind only the USA, to have a high number of bariatric surgery (BS), with more than 95,000 operations performed per year. In the last 10 years, the number of BS increased by 300%, and the risk of this procedure is currently equivalent to a medium-sized abdominal surgery [ 8 ].…”

Section: Introduction/purposementioning

confidence: 99%

Systemic Inflammation in Severe Obese Patients Undergoing Surgery for Obesity and Weight-Related Diseases

et al. 2018

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BackgroundObesity is a worldwide disease related to genetic, environmental, and behavioral factors, and it is associated with high rates of morbidity and mortality. Recently, obesity has been characterized by a low-grade inflammatory state known as inflammome indicated by chronic increases in circulating concentrations of inflammatory markers. The purpose of this study was to evaluate the effect of weight loss induced by surgery for obesity and weight-related diseases on pro-inflammatory cytokine (TNF-α) and anti-inflammatory adipokine (adiponectin) levels, and on an adipose-derived hormone (leptin) in severely obese subjects.MethodsThis randomized, controlled trial involved 55 severe obese patients (50 women, age 18–63 years, and body mass index of 35.7–63 kg/m2) who underwent bariatric surgery (BS). Patients with a BMI > 65 kg/m2 and clinical and mental instability, or significant and unrealistic expectations of surgery were excluded. Blood samples were collected during the fasting period to analyze tumor necrosis factor alpha (TNF-α), adiponectin, and leptin levels by enzyme-linked immunosorbent assay.ResultsAt baseline, no significant difference was observed in the anthropometric, demographic, clinical characteristics and biochemistry and inflammatory markers between the control group (CG) and bariatric surgery group (BSG). The same finding was also observed when we compared the baseline variables to those at the 6-month follow-up in the CG. However, the same variables in the BSG group were significantly different between baseline and the 6-month follow-up after BS.ConclusionsWeight loss induced by surgery for obesity and weight-related diseases reduced the inflammome state in severely obese patients.

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“…This study is subject to the limitations inherent to its retrospective design, and the experience of a single endosonographer in solely a referral center. Furthermore, the diagnoses obtained by means of EUS-FNA were not compared to surgery 15 . However, as most patients were asymptomatic and their median lesion size was 16 mm, it would not be possible to submit all GISTs to resection.…”

Section: Discussionmentioning

confidence: 99%

Eus-Fna With 19 or 22 Gauges Needles for Gastric Subepithelial Lesions of the Muscle Layer

Lopes¹,

Hartmann

Artifon

2018

ABCD, arq. bras. cir. dig.

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Background: Tissue diagnosis is required for gastric subepithelial lesions for differential diagnosis of GISTs. However, there has not been consensus about the best needle for EUS-guided sampling of these lesions. Aim: To evaluate the diagnostic yield of EUS-FNA for gastric subepithelial lesions of the proper muscle layer with large-bore 19 gauge needles. Methods: A prospectively maintained database was retrospectively reviewed to identify consecutive patients who underwent EUS-FNA with 19 and 22 gauge needles for gastric subepithelial lesions of the fourth endosonographic layer in a tertiary care referral center. EUS-FNA was performed by the same endosonographer, using the fanning technique, without on-site cytopathologist. Specimens were analysed through cell blocks by the same pathologist. Procedure results were categorized into diagnostic, defined as enough material for histopathology and immunohistochemistry, or nondiagnostic. Results: Eighty-nine patients (mean age: 59 years, 77% women) underwent 92 EUS-FNA with 19 (75) or 22 (17) gauge needles. Mean lesion size was 22.6 mm. Overall diagnostic yield was 88%. The diagnostic yield of 19 gauge was higher than that of 22 gauge needle (92%x70.6%; p=0.0410), and similar for lesions >2 cm and <2 cm (93.7%x90.7%; p=0.9563). The best performance for 19 gauge needles was obtained performing <3 needle passes. Complication rate was 2.8%. Conclusions: Diagnostic yield of EUS-FNA with 19 gauge needles is 92% for gastric subepithelial lesions of the proper muscle layer. It is safe and highly valuable for differentiation between GIST and leiomyoma, no matter the size of the lesion.

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Laparoscopic Resection of Gastrointestinal Stromal Tumors (Gist)

Cited by 16 publications

References 28 publications

Full-Thickness Endoscopic Gastric Resection Using a Stapler and Gastrostomy: A Feasibility Study

Full-Thickness Endoscopic Gastric Resection Using a Stapler and Gastrostomy: A Feasibility Study

Systemic Inflammation in Severe Obese Patients Undergoing Surgery for Obesity and Weight-Related Diseases

Eus-Fna With 19 or 22 Gauges Needles for Gastric Subepithelial Lesions of the Muscle Layer

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