scholarly journals EXPERIENCE OF THE SUCCESSFUL USING OF VACUUM THERAPY IN THE TREATMENT OF GASTRIC LEAK AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY: CASE REPORT

2018 ◽  
Vol 25 (2) ◽  
pp. 69-74
Author(s):  
K. A. Anisimova ◽  
D. I. Vasilevskii ◽  
A. Ju. Korolkov ◽  
S. G. Balandov ◽  
A. S. Lapshin ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Treatment Option ◽  
Treatment Options ◽  
Gastric Leak ◽  
Vacuum Therapy ◽  
Effective Treatment Option ◽  
Co Morbidity ◽  
Initial Body Mass Index ◽  
Effective Drainage

Gastric leak is the most dangerous postoperative complication of laparoscopic sleeve gastrectomy. Traditional surgical treatment options and endoscopic stent placement are not always successful. Negative Pressure Wound Therapy (NPWT) has shown itself like a new successful and feasible treatment option for leaks of different etiology after gastro-esophageal surgery.The initial body mass index (BMI) of the patient was 46 and co-morbidity was represented: arterial hypertension, type 2 diabetes and dyslipidemia. NPWT was initiated in 14 days after laparoscopic sleeve gastrectomy. The abdominal part of the system were changed 3 times for14 days. The patient was discharged from the hospital in 14 days after the secondary sutures to the wound. No relevant complications related to the procedure were observed during the course of the vacuum therapy. It combines defect closure, effective drainage and allows doing a periodic inspection of the wound cavity. NPWT is a successful, safety and effective treatment option for the leaks after laparoscopic sleeve gastrectomy 

scholarly journals Management of Post-operative Leakage after Sleeve Gastrectomy (A Systematic Review)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A I Khalil ◽  
M A Lasheen ◽  
I M Elzayyat ◽  
O R K Hammad
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Treatment Options ◽  
World Health ◽  
Gastric Leak ◽  
Multiple Treatment ◽  
Obesity And Overweight ◽  
Pubmed Database ◽  
Prevalence Of Obesity ◽  
Health Organization

Abstract Background the prevalence of obesity and overweight have reached epidemic proportions in the last decades, with estimates by the World Health Organization (WHO) pointing that about 2 billion people are at least overweight worldwide. Aim of the Work to establish, through the available literature, what is the current management of leakage after sleeve gastrectomy in relation to each patient’s condition through the range of interventions available and their effectiveness. Materials and Methods the search is carried out using the electronic national library of medicine’s PubMed database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications focusing on post-operative leakage. Electronic results were screened by title to exclude duplicate studies. Articles were identified by keywords: “laparoscopic sleeve gastrectomy” “leakage after sleeve” “gastric leak” and “management of leakage” and will be limited to research papers of all designed on human patients in English languish. Articles with no focus on leakage after sleeve gastrectomy were excluded from eligibility in this review. Results through this study, it is found that: 1- Early detection and management are very important to control the leak. 2- The early unstable patient should be operated for lavage and drainage and re-suturing of leak site if the tissue still healthy. 3- Management of the leakage after LSG still non-standardized and there are multiple treatment options, so it is important to carefully choose the best treatment options for each patient. Conclusion early diagnosis and deciding the best treatment option is important to reach a complete resolution of the leak. From this study, we concluded that treatment of gastric leak after LSG mainly depend on three factors; time of the leak, clinical presentation of the patient and site of the leak.

scholarly journals Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic greater curve plication: do they differ at 2 years?

Endoscopy ◽  
2020 ◽  
Author(s):  
Gontrand Lopez-Nava ◽  
Ravishankar Asokkumar ◽  
Inmaculada Bautista-Castaño ◽  
Janese Laster ◽  
Anuradha Negi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Effective Treatment Option ◽  
Endoscopic Sleeve Gastroplasty ◽  
Sleeve Gastroplasty ◽  
Laparoscopic Greater Curve Plication

Abstract Background Endoscopic sleeve gastroplasty (ESG) is an effective treatment option for obesity. However, data comparing its efficacy to bariatric surgery are scarce. We aimed to compare the effectiveness and safety of ESG with laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curve plication (LGCP) at 2 years. Methods We reviewed 353 patient records and identified 296 patients who underwent ESG (n = 199), LSG (n = 61), and LGCP (n = 36) at four centers in Spain between 2014 and 2016. We compared their total body weight loss (%TBWL) and safety over 2 years. A linear mixed model (LMM) was used to analyze repeated measures of weight loss outcomes at 6, 12, 18, and 24 months to compare the three procedures. Results Among the 296 patients, 210 (ESG 135, LSG 43, LGCP 32) completed 1 year of follow-up and 102 (ESG 46, LSG 34, LGCP 22) reached 2 years. Their mean (standard deviation [SD]) body mass index (BMI) was 39.6 (4.8) kg/m2. There were no differences in age, sex, or BMI between the groups. In LMM analysis, adjusting for age, sex, and initial BMI, we found ESG had a significantly lower TBWL, %TBWL, and BMI decline compared with LSG and LGCP at all time points (P = 0.001). The adjusted mean %TBWL at 2 years for ESG, LSG, and LGCP were 18.5 %, 28.3 %, and 26.9 %, respectively. However, ESG, when compared with LSG and LGCP, had a shorter inpatient stay (1 vs. 3 vs. 3 days; P < 0.001) and lower complication rate (0.5 % vs. 4.9 % vs. 8.3 %; P = 0.006). Conclusion All three procedures induced significant weight loss in obese patients. Although the weight loss was lower with ESG compared with other techniques, it displayed a better safety profile and shorter hospital stay.

Reflux, Barrett’s Esophagus, and Esophageal Adenocarcinoma After Bariatric Surgery

2022 ◽  
pp. 263451612110683
Author(s):  
Benjamin Medina ◽  
Daniela Molena
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Gastroesophageal Reflux ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Treatment Options ◽  
Effective Treatment Option ◽  
Management Options

We present the case of a patient who developed esophageal adenocarcinoma after a previous laparoscopic sleeve gastrectomy. Bariatric surgery has emerged as the most effective treatment option for weight loss and obesity-related diseases; however, sleeve gastrectomy promotes gastroesophageal reflux and leads to Barrett’s esophagus in a substantial portion of patients. The natural history of Barrett’s esophagus in these patients is unknown, and active surveillance is recommended until the incidence of dysplasia and adenocarcinoma in this population is clarified. Management options for these patients include conversion to Roux-en-Y gastric bypass. Although esophagectomy in patients who have previously undergone sleeve gastrectomy may require an alternative conduit, the remnant stomach can be used in carefully selected patients. Here, we review the different weight loss procedures, their effect on gastroesophageal reflux disease and Barrett’s esophagus, and the treatment options for patients with esophageal cancer after sleeve gastrectomy. We report the use of preoperative coil embolization as a means of vascular preconditioning before successful use of a gastric conduit.

scholarly journals Evaluation of laparoscopic sleeve gastrectomy on weight loss and co-morbidity

2010 ◽  
Vol 8 (4) ◽  
pp. 302-304 ◽  
Author(s):  
S.W. Nienhuijs ◽  
J.P. de Zoete ◽  
C.A.S. Berende ◽  
I.H.J.T. de Hingh ◽  
J.F. Smulders
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Co Morbidity

scholarly journals In VitroActivity of the New Fluoroketolide Solithromycin (CEM-101) against a Large Collection of Clinical Neisseria gonorrhoeae Isolates and International Reference Strains, Including Those with High-Level Antimicrobial Resistance: Potential Treatment Option for Gonorrhea?

2012 ◽  
Vol 56 (5) ◽  
pp. 2739-2742 ◽  
Author(s):  
Daniel Golparian ◽  
Prabhavathi Fernandes ◽  
Makoto Ohnishi ◽  
Jörgen S. Jensen ◽  
Magnus Unemo
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Treatment Option ◽  
Treatment Options ◽  
Effective Treatment Option ◽  
Content Type ◽  
New Treatment ◽  
High Level ◽  
Drug Resistant Strains ◽  
Reference Strains

ABSTRACTGonorrhea may become untreatable, and new treatment options are essential. We investigated thein vitroactivity of the first fluoroketolide, solithromycin. ClinicalNeisseria gonorrhoeaeisolates and reference strains (n= 246), including the two extensively drug-resistant strains H041 and F89 and additional isolates with clinical cephalosporin resistance and multidrug resistance, were examined. The activity of solithromycin was mainly superior to that of other antimicrobials (n= 10) currently or previously recommended for gonorrhea treatment. Solithromycin might be an effective treatment option for gonorrhea.

Gastric Leak After Laparoscopic Sleeve Gastrectomy

2010 ◽  
Vol 20 (9) ◽  
pp. 1306-1311 ◽  
Author(s):  
Manuel Ferrer Márquez ◽  
Manuel Ferrer Ayza ◽  
Ricardo Belda Lozano ◽  
María del Mar Rico Morales ◽  
Jose Miguel García Díez ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Gastric Leak

scholarly journals Laparoscopic Sleeve Gastrectomy with Omentopexy: Is It Really a Promising Method?—A Systematic Review with Meta-analysis

2021 ◽  
Author(s):  
Piotr Zarzycki ◽  
Jan Kulawik ◽  
Piotr Małczak ◽  
Mateusz Rubinkiewicz ◽  
Mateusz Wierdak ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Leakage Rate ◽  
Gastric Leak ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Gastric Leakage ◽  
Established Technique

Abstract Purpose Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedure worldwide. Omentopexy during LSG is a novel variation of this well-established technique. There are no clear conclusions on indications for this procedure, safeness, and effects of such a method. We aimed to compare the outcomes of laparoscopic sleeve gastrectomy (LSG) with omentopexy (OP) and without omentopexy. Materials and Methods We searched the Medline, EMBASE, and Scopus databases up-to June 2020. Full-text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines. Results Of initial 66 records, only 4 studies (N = 1396 patients) were included in the meta-analysis. Our findings showed that LSG with omentopexy had significantly lowered overall morbidity compared to LSG without omentopexy (RR = 0.38; 95% CI [0.15, 0.94]; p=0.04). Gastric leakage rate (RR = 0.17; 95% CI [0.04, 0.76]; p = 0.02) was also significantly lower in LSG with omentopexy. There were no significant differences between groups in length of hospital stay. Conclusions Our meta-analysis showed that LSG with omentopexy may be a feasible procedure for decreasing morbidity and gastric leak rate. However, despite promising results, the procedure needs to be researched more in randomized controlled studies to draw solid conclusions.

scholarly journals Gastrobronchial fistula post laparoscopic sleeve gastrectomy in immunocompromised patient

2019 ◽  
Vol 6 (12) ◽  
pp. 4530
Author(s):  
Omar Hasheesh Al-Bogami ◽  
Abdullah Saeed Al-Zahrani ◽  
Bandar Idrees Ali
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Immunocompromised Patient ◽  
Medical Community ◽  
Definitive Treatment ◽  
Gastric Leak ◽  
Productive Cough ◽  
Endoscopic Clip ◽  
Successful Approach ◽  
Very High

Bariatric surgery is evolving worldwide nowadays. Postoperative complications are mainly represented by gastric leak reported range between 1% to 3.3%. The worse scenario of the leak post laparoscopic sleeve gastrectomy is a fistula. Many types of fistula were prescribed and one of the theses is gastrobronchial one. It has a catastrophic sequela if not diagnosed and treated efficiently early. It is difficult to manage either radiologically, endoscopically or surgically. No clear consensus yet for the standard of treatment for such complication especially if these patients are immunocompromised was the mortality will be very high. Therefore, we aim to contribute our successful approach to treating our patient. We report a case of a 27-year-old female who is obese with systemic lupus erythematous controlled medically underwent laparoscopic sleeve gastrectomy. 6 months later she presented to the hospital with productive cough post-operative stenting and esophageal dilation was performed. 15 months post LSG patient presented with productive cough with green sputum, food particle, and left-sided chest pain. Endoscopic clip placement was attempted with no avail. The management of gastrobronchial fistulas involves a comprehensive clinical evaluation. In the absence of red flags, initial conservative management should be undertaken. When all else fail, surgery is the only route towards a permanent and definitive treatment. The need for further research and consensus is of utmost importance to guide future surgeons and to increase awareness among the medical community, due to its presentation under the facade of common symptoms.

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