P1-9 Retrospective analysis of the efficacy and safety of FOLFOX in patients with esophageal cancer

IntroductionOne anastomosis gastric bypass (OAGB) has become a widespread technique over the last few years in France, without any prior assessment and despite existing controversies among bariatric surgeons. An older bypass technique for treating obesity, the Roux-en-Y gastric bypass (RYGB), is available and reimbursed, having been assessed and approved for use in 2005. In 2019, the French Haute Autorité de Santé (HAS) assessed OAGB for the treatment of severe and massive obesity. This assessment, the first in the world, was undertaken for OAGBs carried out with a 200- or 150-centimeter biliopancreatic-limb (BP-limb) length.MethodsA systematic review (SR) of the literature and consultation of a working group consisting of both healthcare professionals (clinician and surgeons) and patients were carried out. The primary aim of our assessment was to determine whether the OAGB technique can replace RYGB. The efficacy and safety profile of OAGB was compared with RYGB in adult patients with massive, severe obesity. Complications and postoperative follow up specific to OAGB were identified.ResultsThe three selected randomized controlled trials (RCTs) could not confirm the superiority or the non-inferiority of OAGB, compared with RYGB, on the selected efficacy endpoints of weight loss, resolution of comorbidities, and quality of life. Adverse events reported for OAGB included severe nutritional complications and bile reflux that could potentially lead to lower esophageal cancer. In one RCT, the frequency of serious adverse events in the OAGB group was almost two times higher than in the RYGB group.ConclusionsHAS considered that OAGB carried out with a longer (200 centimeter) BP-limb is not a validated technique for the surgical treatment of massive, severe obesity. Thus, it cannot be considered an alternative to RYGB. There were insufficient data available on OAGB performed with a 150-centimeter BP-limb. Thus, HAS recommended undertaking a multicenter RCT to assess the efficacy and safety of OAGB. Patients who have already undergone OAGB should receive the same follow up as patients who have received RYGB, including close monitoring for nutritional complications and lower esophageal cancer and an endoscopic examination five years after surgery.

Download Full-text

Modified percutaneous radiologic gastrostomy technique without endoscopic or nasogastric access

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0086-8 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Reda Tabashy ◽

Amira Darwish ◽

Ashraf Ibrahim ◽

Mohamed Gad El-Mola

Keyword(s):

Esophageal Cancer ◽

Success Rate ◽

Nasogastric Tube ◽

Conventional Technique ◽

Fluoroscopic Guidance ◽

Efficacy And Safety ◽

Technical Success ◽

Technical Success Rate ◽

Major Complications ◽

Percutaneous Radiologic Gastrostomy

Abstract Background The aim of this study is to evaluate the efficacy and safety of a modified percutaneous radiologic gastrostomy (MPRG) technique under ultrasound and fluoroscopic guidance without endoscopic or nasogastric access. Results The study included 24 patients: 10 males and 14 females whose ages ranged from 44 to 80 years old. Ten patients had esophageal cancer and 14 patients had neck cancer. Technical success was achieved in 23 out of the 25 procedures (92%). Two procedures failed (8%) and were converted to the conventional technique by using the nasogastric tube. No major complications were reported. Minor complications were observed in 5 patients (20%): intraperitoneal air and contrast leakage in 4 patients and focal mucosal dissection by the contrast in 1 patient. Conclusion The MPRG has high technical success rate, is safe with no major complications, and is most feasible when endoscopic or nasogastric access cannot be performed.

Download Full-text