Risk of Gastric Cancer After Roux-en-Y Gastric Bypass

Inoue, Hiromo; Rubino, Francesco; Shimada, Yutaka; Lindner, Véronique; Inoue, Masako; Riegel, Philippe; Marescaux, Jacques

doi:10.1001/archsurg.142.10.947

Cited by 37 publications

(22 citation statements)

References 24 publications

(25 reference statements)

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“…Gastrointestinal reflux was determined by the relative concentration of bilirubin in the stomach of ABTtreated and vehicle-treated rats. Gastric bilirubin is a validated natural marker to assess enterogastric reflux and is routinely used in clinical studies (Fein et al, 2002) and in preclinical studies in rats (Inoue et al, 2007). Groups of male nonfasted Sprague-Dawley rats (n = 6, weight range 200-250 g) were dosed with either 50 mg/kg ABT or vehicle (0.5% methyl cellulose and 0.5% Tween 80 (v/v) in saline via the s.c. route at a dose volume of 2 ml/kg.…”

Section: Methodsmentioning

confidence: 99%

1-Aminobenzotriazole Modulates Oral Drug Pharmacokinetics through Cytochrome P450 Inhibition and Delay of Gastric Emptying in Rats

et al. 2014

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The simultaneous effects of the cytochrome P450 inhibitor 1-aminobenzotriazole (ABT) on inhibition of in vivo metabolism and gastric emptying were evaluated with the test compound 7-(3,5-dimethyl-1H-1,2,4-triazol-1-yl)-3-(4-methoxy-2-methylphenyl)-2,6-dimethylpyrazolo [5,1-b]oxazole(NVS-CRF38), a novel corticotropin releasing factor receptor 1 (CRF 1 ) antagonist with low water solubility, and the reference compound midazolam with high water solubility in rats. Pretreatment of rats with 100 mg/kg oral ABT administered 2 hours before a semisolid caloric test meal markedly delayed gastric emptying. ABT increased stomach weights by 2-fold; this is likely attributable to a prosecretory effect because stomach concentrations of bilirubin were comparable in ABT and control groups. ABT administration decreased the initial systemic exposure of orally administered NVS-CRF38 and increased T max 40-fold, suggesting gastric retention and delayed oral absorption. ABT increased the initial systemic exposure of midazolam, however for orally (but not subcutaneously) administered midazolam, extensive variability in plasma-concentration time profiles was apparent. Careful selection of administration routes is recommended for ABT use in vivo, variable oral absorption of coadministered compounds can be expected due to a disturbance of gastrointestinal transit.

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Section: Methodsmentioning

confidence: 99%

1-Aminobenzotriazole Modulates Oral Drug Pharmacokinetics through Cytochrome P450 Inhibition and Delay of Gastric Emptying in Rats

et al. 2014

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“…The Roux-en-Y gastrojejunostomy is the best reconstruction method that prevents reflux gastritis, esophagitis, and carcinogenesis of the gastric remnant [3]. However, the Roux-en-Y method is relatively complicated and lengthy.…”

Section: Introductionmentioning

confidence: 99%

Roux-en-Y Gastrojejunostomy Using Modified Hemi-Double Stapling

Kim¹,

Jeon²,

Kim³

et al. 2009

Dig Surg

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For reconstruction after distal gastrectomy, the Roux-en-Y gastrojejunostomy is superior to the Billroth II gastrojejunostomy in terms of bile reflux. Roux-en-Y gastrojejunostomy prevents reflux gastritis, esophagitis, and carcinogenesis of the gastric remnant. However, the Roux-en-Y gastrojejunostomy is relatively complicated and lengthy. The authors perform a simple, safe Roux-en-Y gastrojejunostomy using modified hemi-double stapling. We applied this technique to 42 patients with gastric cancer. The average operating and reconstruction times were 172.6 ± 42.0 and 26.2 ± 4.8 min, respectively. The postoperative courses were uneventful and the patients were discharged 11.2 ± 2.4 days postoperatively. Neither leakage nor bleeding from the gastrojejunostomy has occurred postoperatively. The postoperative follow-up was 7–24 months and no local recurrence or stricture at the gastrojejunostomy site occurred. Roux-en-Y gastrojejunostomy using the modified hemi-double stapling technique can achieve reconstruction more simply, safely and quickly, and may provide an alternative reconstruction method for distal gastrectomy.

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“…36,37 The operation was, therefore, modified to include the Roux-en-Y anastomotic technique, 38 which has the added advantage of decreasing biliary reflux and preventing subsequent gastric cancer risk. 39,40 The vast majority of procedures are performed laparoscopically 41 and demonstrate low postoperative adverse outcomes. A recent multicenter, prospective, observational study 42 revealed an overall operative 30-day mortality to be 0.3%.…”

mentioning

confidence: 99%

Metabolic surgery and cancer

Ashrafian

Ahmed

Rowland

et al. 2010

Cancer

135

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The worldwide epidemic of obesity and the global incidence of cancer are both increasing. There is now epidemiological evidence to support a correlation between obesity, weight gain, and some cancers. Metabolic or bariatric surgery can provide sustained weight loss and reduced obesity-related mortality. These procedures can also improve the metabolic profile to decrease cardiovascular risk and resolve diabetes in morbidly obese patients. The operations offer several physiological steps, the so-called BRAVE effects: 1) bile flow alteration, 2) reduction of gastric size, 3) anatomical gut rearrangement and altered flow of nutrients, 4) vagal manipulation and 5) enteric gut hormone modulation. Metabolic operations are also associated with a significant reduction of cancer incidence and mortality. The cancer-protective role of metabolic surgery is strongest for female obesity-related tumors; however, the underlying mechanisms may involve both weight-dependent and weight-independent effects. These include the improvement of insulin resistance with attenuation of the metabolic syndrome as well as decreased oxidative stress and inflammation in addition to the beneficial modulation of sex steroids, gut hormones, cellular energetics, immune system, and adipokines. Elucidating the precise metabolic mechanisms of cancer prevention by metabolic surgery can increase our understanding of how obesity, diabetes, and metabolic syndrome are associated with cancer. It may also offer novel treatment strategies in the management of tumor generation and growth. Cancer 2011;117:1788-99. V C 2010 American Cancer Society.KEYWORDS: metabolic surgery, bariatric surgery, cancer, oncology.The worldwide epidemic of obesity and the global incidence of cancer are both increasing. According to the World Health Organization (WHO), obesity is rising by 30 million cases per year, 1 whereas the overall number of new cancer cases will increase by 300,000 cases per year.2 Both obesity and cancer contribute to increased worldwide mortality and healthcare costs. They are now both recognized as global healthcare concerns and have been the subject of worldwide calls to action. 3,4Several treatment strategies have been developed to decrease obesity; these include prevention, lifestyle, behavioral modification, and pharmacotherapy. The weight-loss effects of these strategies have only been marginally successful, 5 and, therefore, a surgical solution has been developed to provide consistent weight loss in severely obese patients. The operations initially titled ''bariatric procedures'' have demonstrated long-term weight loss at more than 15 years after surgery 6,7 ; however in addition, they achieve pronounced metabolic effects including diabetes resolution in the majority of morbidly obese patients. [8][9][10] As a result, these procedures are now considered as ''metabolic'' operations. 10-14The epidemiological association between obesity rates and cancer rates has come under increased scrutiny as there is now evidence to establish obesity as a significant...

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Risk of Gastric Cancer After Roux-en-Y Gastric Bypass

Cited by 37 publications

References 24 publications

1-Aminobenzotriazole Modulates Oral Drug Pharmacokinetics through Cytochrome P450 Inhibition and Delay of Gastric Emptying in Rats

1-Aminobenzotriazole Modulates Oral Drug Pharmacokinetics through Cytochrome P450 Inhibition and Delay of Gastric Emptying in Rats

Roux-en-Y Gastrojejunostomy Using Modified Hemi-Double Stapling

Metabolic surgery and cancer

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