MGBReviewCorp

01/09/2022

Vitamin tablets versus vitamins and healthy food.

It's okay your doctor tells you to take your pills, I understand. But maybe the most important thing you can do is not the pills but it's food that contains healthy vitamins.

Want to be healthy job one eat healthy food. And of course follow your doctor's orders.

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12/08/2020

Dietary fiber may modify microbiota abundance, diversity, and metabolism including short-chain fatty acid production.

09/28/2020

Laparoscopic gastric plication for the treatment of morbid obesity by using real-time imaging of the stomach pouch

excess weight loss of 55% at six month and 65% over a 12-month

Ann Ital Chir 2017;6:392-398.

Laparoscopic gastric plication for the treatment of morbid obesity by using real-time imaging of the stomach pouch

Cristian Borz, Tivadar Jr Bara, Tivadar Bara, Andras Suciu, Marton Denes, Bogdan Borz, Dorin Marian, Simona Muresan,

Anca Bacarea, Mircea Muresan, Gabriela Jimborean
PMID: 29197192

Abstract

Background: Bariatric surgery is a continuously evolving field. Laparoscopic greater curvature plication is a new investigational procedure used to treat patients with morbid obesity.

The demand for this operation from the obese patients is also rising. The problem is that during gastric plication the exact dimensions and volume of the pouch are not known so frequently it is too large or too tight thus compromising the results. The aim of the study was to identify the parameters that can improve the outcomes after this procedure.

Methods:

We performed laparoscopic greater curvature plication in 75 obese patients during 2013-2015.

The last 25 patients underwent surgery with a modified surgical technique using real-time imaging of the stomach pouch. The inclusion criteria for the 25 patients enrolled in this case series were the usual, body mass index higher than 40 or higher than 35 but with comorbidities along with the option of the patients for laparoscopic gastric plication. The operative technique was enhanced by using a computerized device and special intragastric catheters during the procedure that permitted real-time imaging of the gastric geometry. With this new operative approach we obtained the desired volume of the gastric remnant and we avoided strictures, obstruction or irregular shape of the pouch, problems that otherwise could have compromised the outcomes.

Results: We found an increased excess weight loss of 55% at six month and 65% over a 12-month follow-up period with alleviation of comorbidities. There were no major complications (gastric outlet obstructions or leaks) and less minor complications (nausea and vomiting) than in the patients operated with classic gastric plication procedure.

Conclusions: This study shows that in case of laparoscopic gastric plication the use of our modified operative technique has better outcomes than in the classical setting. This is a new operative approach in the bariatric literature which can lead to greater acceptance of gastric plication among bariatric surgeons. The target population is represented by the obese patients who want to obtain similar results to those after gastric bypass and sleeve gastrectomy but are concerned about removing a part of their stomach and the postoperative complications that may occur, especially leaks and nutritional complications.

Gastric geometry, Laparoscopic gastric plication, Morbid obesity, Real-time imaging.

09/28/2020

The size of the remnant stomach showed no positive impact on nutritional outcomes.

Abstract
Investigate the adaptation process of the alimentary tract after

distal gastrectomy and
understand the impact of
Remnant Stomach Volume (RSV) on recovery.

One year after gastrectomy,

Patients’ oral intake had increased,

the Remnant Stomach Volume (RSV) was decreased and

small bowel motility was INCREASED.

Patients with a larger Remnant Stomach Volume (RSV)
=> showed
=> no additional benefits regarding nutritional outcomes.

prospectively enrolled patients who underwent distal gastrectomy with

=> Billroth II reconstruction to treat gastric cancer

at a tertiary hospital cancer center between September 2009 and February 2012. Demographic data, diet questionnaires, computed tomography (CT), and contrast

fluoroscopy findings were collected.

Patients were divided into 2 groups according to the

RSV calculated using CT
=> gastric volume measurements
(large vs small).

=> The size of the remnant stomach showed no positive impact on nutritional outcomes.

Dietary habits and nutritional status were compared between the groups.

=================================
3.5 Changes in the remnant stomach volume after gastrectomy
From the CT volumetry, the mean baseline gastric volume was 605 ± 276 mL. Six months after surgery, the mean gastric volume was 139 ± 81 mL, which decreased to 111 ± 64 mL 1 year after surgery (P < .01) and to 96 ± 54 mL 2 years after surgery (P = .07). This decrease was maintained until the 3rd year after surgery (96 ± 55 mL, P = .79) (Fig. 2E).

=================================
3.6 Small vs large remnant stomach volume: diet configuration and nutrition status

According to the CT volumetric database,
=> patients were divided into 2 groups
(S group ≤110 mL vs
L group >110 mL)
based on the median value of the RSV (110 mL).

After allocation, the mean RSV was larger in the L group than in the S group
(LARGE = 195 mL vs SMALL = 90 mL, P < .01) (Fig. 6).

=================================
Between the groups, there were
=> no differences regarding nutritional outcomes
=> (body weight change,
=> hemoglobin,
=> albumin,
=> cholesterol) or
diet configuration
=> (diet volume,
=> diet frequency,
=> time consumption per meal).
=================================

Discussion:

identify the influence of

gastric volume on nutritional outcomes.

We compared each step of the alimentary tract at different time intervals in regard to anatomical and functional aspects and included a patient-oriented survey.

=> In our study,
=> remnant gastric volume **decreased over time**
and
=> small bowel motility **increased after gastrectomy.

Patients with a larger remnant gastric volume showed no additional benefits regarding nutritional outcomes. Based on these results, after gastrectomy, diet volume is recovered by the acceleration of small bowel motility, while the

=> Remnant Stomach Volume (RSV) has a **limited effect.** gastric emptying rate is associated with a decreased transit time of the small intestine

https://pubmed.ncbi.nlm.nih.gov/31593134/

09/14/2020

https://www.slideshare.net/DrRRMD/errors-medical-decision-making-mgboagb-different-and-better?qid=7dec3023-8aca-437e-a515-b6ec39eb6f67&v=&b=&from_search=10

MGB-OAGB, Different and Better!