Urolithiasis and sleeve gastrectomy: a prospective assessment of urinary biochemical variables

ABSTRACT Introduction: to evaluate urinary biochemical alterations related to urolithogenesis processes after sleeve gastrectomy (SG). Materials and methods : prospective study with 32 individuals without previous diagnosis of urolithiasis who underwent SG. A 24-h urine test was collected seven days prior to surgery and at 6-month follow-up. The studied variables were urine volume, urinary pH, oxalate, calcium, citrate, and magnesium and calcium oxalate super saturation (CaOx SS). Results: patients were mainly women (81.2%), with mean age of 40.6 years. Mean pre- and postoperative BMI were 47.1 ± 8.3 Kg/m2 and 35.5 ± 6.1 Kg/m2, respectively (p<0.001). Urine volume was significantly lower at the postoperative evaluation in absolute values (2,242.50 ± 798.26 mL x 1,240.94 ± 352.39 mL, p<0.001) and adjusted to body weight (18.58 ± 6.92 mL/kg x 13.92 ± 4.65 mL/kg, p<0.001). CaOx SS increased significantly after SG (0.11 ± 0.10 x 0.24 ± 0.18, p<0.001). Moreover, uric acid levels were significantly lower at the postoperative evaluation (482.34 ± 195.80 mg x 434.75 ± 158.38 mg, p=0.027). Urinary pH, oxalate, calcium, citrate, and magnesium did not present significant variations between the pre- and postoperative periods. Conclusion: SG may lead to important alterations in the urinary profile. However, it occurs in a much milder way than that of RYGB.

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Sleeve Gastrectomy Is Associated with a Greater Reduction in Plasma Liver Enzymes Than Bypass Surgeries—A Registry-Based Two-Year Follow-Up Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10051144 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1144

Author(s):

Shira Azulai ◽

Ronit Grinbaum ◽

Nahum Beglaibter ◽

Shai Meron Eldar ◽

Moshe Rubin ◽

...

Keyword(s):

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Fatty Liver Disease ◽

Laboratory Tests ◽

Liver Enzymes ◽

Liver Pathology ◽

Hepatic Enzyme ◽

Demographic Information ◽

Post Surgery

Bariatric surgeries may lead to an improvement in metabolic fatty liver disease, and a reduction in the levels of the hepatic enzyme Alanine Aminotransferase (ALT). We compared the effects of Sleeve Gastrectomy (SG), Roux en Y Gastric Bypass (RYGB) and One Anastomosis Gastric Bypass (OAGB) on the levels of ALT by analysis of two-year follow-up data from 4980 patients in the Israeli Bariatric Registry that included laboratory tests and demographic information. Pre-operative characteristics of patients, and particularly levels of liver enzymes, were similar across surgery types. Regression modeling and retrospective matching showed that SG was superior to RYGB and OAGB in reducing ALT levels, and in reducing the fraction of patients with abnormally high ALT levels. Two-year post-surgery, an increase in ALT levels from normal to abnormal levels was observed in 5% of SG patients, and in 18% and 23% of RYGB and OAGB patients. In conclusion, SG leads to a greater reduction in ALT levels compared with bypass surgeries and a lower incidence of post-surgical elevation of ALT levels. Further studies are required to identify the cause for the rise in liver enzymes, and to determine whether ALT levels correlate with liver pathology especially following bariatric surgery.

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Polyglandular Autoimmune Syndrome Triggered after CTLA-4 and PD-1L Immunotherapy Treatment

Reports ◽

10.3390/reports4010001 ◽

2021 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Juan Luis Fernández-Morera ◽

Alfredo Renilla González ◽

Carmen Elena Calvo Rodríguez ◽

Judit Romano-García

Keyword(s):

Immune Response ◽

Side Effects ◽

Autoimmune Diseases ◽

Autoimmune Diabetes ◽

Hashimoto Thyroiditis ◽

Polyglandular Autoimmune Syndrome ◽

Autoimmune Syndrome ◽

Previous Diagnosis ◽

Optimal Approach

Background: CTLA-4 and PD-1L are novel immune checkpoint targets for cancer treatment with specific side effects such as autoimmune diseases. Less frequently, the presence of several autoimmune diseases in the same patient has been described. In this communication, we illustrate the case of a 45-year-old patient with a previous diagnosis of advanced cancer that, after starting treatment with this immunotherapy, developed in the following months autoimmune diabetes, lymphocytic hypophysitis, and a Hashimoto thyroiditis in an abrupt and intense manner that would correspond to an autoimmune polyglandular disease. Discussion: The activation of autoimmunity and associated diseases is increasing in parallel with augmented indication of these immunotherapeutic treatments in cancer patients. A closer follow-up of these patients could be necessary for an optimal approach to this type of pathology. Conclusions: Different autoimmune diseases can converge in the same patient when immunotherapy for cancer is indicated to boost immune response against tumor, caused by altering immune tolerance.

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Longitudinal Follow‐up and Performance Validation of a mRNA‐based Urine Test (Xpert® Bladder Cancer Monitor) for surveillance in Non‐Muscle Invasive Bladder Cancer Patients

BJU International ◽

10.1111/bju.15418 ◽

2021 ◽

Author(s):

Barrett Cowan ◽

Eric Klein ◽

Ken Jansz ◽

Karl Westenfelder ◽

Timothy Bradford ◽

...

Keyword(s):

Bladder Cancer ◽

Cancer Patients ◽

Invasive Bladder Cancer ◽

Urine Test ◽

Muscle Invasive Bladder Cancer ◽

And Performance ◽

Muscle Invasive ◽

Performance Validation

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Holmium laser enucleation of the prostate with Virtual Basket mode: faster and better control on bleeding

BMC Urology ◽

10.1186/s12894-021-00797-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Giorgio Bozzini ◽

Matteo Maltagliati ◽

Umberto Besana ◽

Lorenzo Berti ◽

Albert Calori ◽

...

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Operative Time ◽

Randomized Study ◽

Urine Volume ◽

Holmium Laser ◽

Laser Enucleation ◽

Holmium Laser Enucleation ◽

Irrigation Volume

Abstract Background To compare clinical intra and early postoperative outcomes between conventional Holmium laser enucleation of the prostate (HoLEP) and Holmium laser enucleation of the prostate using the Virtual Basket tool (VB-HoLEP) to treat benign prostatic hyperplasia (BPH). Methods This prospective randomized study enrolled consecutive patients with BPH, who were assigned to undergo either HoLEP (n = 100), or VB-HoLEP (n = 100). All patients were evaluated preoperatively and postoperatively, with particular attention to catheterization time, operative time, blood loss, irrigation volume and hospital stay. We also evaluated the patients at 3 and 6 months after surgery and assessed maximum flow rate (Qmax), postvoid residual urine volume (PVR), the International Prostate Symptom Score (IPSS) and the Quality of Life score (QOLS). Results No significant differences in preoperative parameters between patients in each study arm were found. Compared to HoLEP, VB-HoLEP resulted in less hemoglobin decrease (2.54 vs. 1.12 g/dl, P = 0.03) and reduced operative time (57.33 ± 29.71 vs. 42.99 ± 18.51 min, P = 0.04). HoLEP and VB-HoLEP detrmined similar catheterization time (2.2 vs. 1.9 days, P = 0.45), irrigation volume (33.3 vs. 31.7 l, P = 0.69), and hospital stay (2.8 vs. 2.7 days, P = 0.21). During the 6-month follow-up no significant differences in IPSS, Qmax, PVR, and QOLS were demonstrated. Conclusions HoLEP and VB-HoLEP are both efficient and safe procedures for relieving lower urinary tract symptoms. VB-HoLEP was statistically superior to HoLEP in blood loss and operative time. However, procedures did not differ significantly in catheterization time, hospital stay, and irrigation volume. No significant differences were demonstrated in QOLS, IPSS, Qmax and PVR throughout the 6-month follow-up. Trial Registration: Current Controlled Trials ISRCTN72879639; date of registration: June 25th, 2015. Retrospectively registred.

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Laparoscopic sleeve gastrectomy for morbid obesity and Klinefelter syndrome: clinical report on two patients, with long-term follow-up

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-020-00951-2 ◽

2020 ◽

Cited By ~ 2

Author(s):

Emanuela Bianciardi ◽

Paolo Orsaria ◽

Cinzia Niolu ◽

Alberto Siracusano ◽

Paolo Gentileschi

Keyword(s):

Morbid Obesity ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Klinefelter Syndrome ◽

Clinical Report ◽

Long Term Follow Up

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Prevalence of the metabolic syndrome in women with a previous diagnosis of polycystic ovary syndrome: long-term follow-up

Fertility and Sterility ◽

10.1016/j.fertnstert.2011.08.006 ◽

2011 ◽

Vol 96 (5) ◽

pp. 1271-1274 ◽

Cited By ~ 26

Author(s):

Miriam Hudecova ◽

Jan Holte ◽

Matts Olovsson ◽

Anders Larsson ◽

Christian Berne ◽

...

Keyword(s):

Metabolic Syndrome ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

The Metabolic Syndrome ◽

Previous Diagnosis ◽

Long Term Follow Up

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Diverted sleeve gastrectomy with ileal transposition in overweight, obese, and morbidly obese patients with type 2 diabetes: results of 1-year follow-up

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2015.09.027 ◽

2016 ◽

Vol 12 (3) ◽

pp. 541-549 ◽

Cited By ~ 5

Author(s):

Alper Celik ◽

Eylem Cagiltay ◽

Surendra Ugale ◽

Muharrem Asci ◽

Bahri Onur Celik ◽

...

Keyword(s):

Type 2 Diabetes ◽

Sleeve Gastrectomy ◽

Morbidly Obese ◽

Obese Patients ◽

Ileal Transposition

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Short-Term Results of Single-Anastomosis Gastric Bypass After Failed Sleeve Gastrectomy

QJM ◽

10.1093/qjmed/hcab097.039 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Alaa Abbas Sabry ◽

Karim Sabry Abd-Elsamee ◽

Mohamed Ibrahim Mohamed ◽

Mohammed Mohamed Ahmed Abd-Elsalam

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Weight Regain ◽

Revisional Surgery ◽

One Anastomosis Gastric Bypass ◽

Short Term ◽

Multicenter Studies ◽

Metabolic Outcomes

Abstract Background It is already known that Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain is considered as a complication. Demand for secondary surgery is rising, partly for this reason, but through that study we try to discover the efficacy of conversion of failed sleeve gastrectomy to one anastomosis gastric bypass (OAGB) regarding weight loss and metabolic outcomes. Objective To asses the efficacy and safety of one anastomosis gastric bypass (OAGB) as a conversion surgery post Sleeve Gastrectomy failure as regard weight loss and metabolic outcomes. Patients and Methods This study is a retrospective cohort study which included 20 patients underwent one anastomosis gastric bypass at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt and specialized bariatric center, Cairo, Egypt From February 2019 to July 2019 with 6 months of postoperative follow up till January 2019. Results In this study, we reviewed and analyzed the outcomes from the revision of the SG due to either inadequate weight loss or weight regain to one anastomosis gastric bypass (OAGB) with %EBWL of 6.65% at 1 month, 13.61 % at 3 months and 20.86% at 6 months. Conclusion OAGB appears to be an effective and safe therapeutic technique as a revisional surgery for failed primary SG with good short-term results for treating morbid obesity and its associated comorbidities with a significantly low rate of complications. However the EBWL was less than what is reported after primary OAGB weight. Multicenter studies with larger series of patients and longer term follow up after SG revisions to OAGB are warranted.

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EP.WE.1048Weight Regain After Sleeve Gastrectomy More Common in Male and Less Common in Super-Obese Patients - Results of an 18-Month Follow-up Study

British Journal of Surgery ◽

10.1093/bjs/znab308.111 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Ahmed Salman Bodla ◽

Jenny Abraham ◽

Neha Shah ◽

Vinod Menon

Keyword(s):

Sleeve Gastrectomy ◽

Revisional Surgery ◽

Patient Specific ◽

Obese Patients ◽

Inclusion Criteria ◽

Super Obese ◽

Burn Out ◽

Single Centre Study ◽

Male Patients

Abstract Aims Long-term success of Sleeve Gastrectomy (SG) is undermined by weight regain (WR). Several procedure- and patient-specific factors have been proposed in previous studies. Here we look at 18-month follow-up post-SG to investigate WR and patient-specific variables influencing this. Methods A single-centre study involving retrospective analysis of a prospectively-maintained database. Inclusion criteria: Primary non-revisional SG patients with adequate follow-up data to assess WL/WR trends. Patients were divided into two subgroups based on their %EWL between 6-to-12 and 12-to-18 months: weight regainers (WR) and weight losers/maintainers (WL/M). Results Out of 338 SG cases between 2012-2017, 180 met inclusion criteria of which 18.3% were men and 45% were super-obese. All patients lost weight during first 6 months (mean %EWL 52.3%, P < 0.0001). Between 6-to-12 months, 87.6% patients continued WL with a further mean %EWL of 10.35% (P < 0.0001). Between 12-to-18 months, a drastic deceleration/reversal of WL progress was observed with an average of only 0.76% EWL (P = 0.84), with 42% of patients regaining weight in this period (mean EWG 6.8%). Male patients encountered significantly higher WR rate (OR 3.27, P = 0.003), whereas it was much less frequent in pre-operatively super-obese patients (OR 0.48, P = 0.036). Moreover, there was no difference in the 6-month %EWL between WR and WL/M subgroups (P = 0.62), thus negating the possibility of WL burn-out phenomenon. Conclusions Different rates of WR in men and super-obese patients may indicate underlying behavioural and biological differences. More research is needed to investigate them in detail, having implications for revisional surgery and follow-up support.

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