Abstract:
OBJECTIVE:To study the relationship between the amount of surgery-induced gastric volume reduction and long-term weight loss and glucose tolerance. BACKGROUND DATA:Vertical sleeve gastrectomy (VSG) has recently surpassed gastric bypass to become the most popular surgical intervention to induce sustained weight loss. Besides inducing significant weight loss, VSG also improves glucose tolerance. Although no clear correlation has been observed between the size of the residual stomach and sustained weight loss, this begs the question whether less aggressive gastric volume reduction may provide sufficient efficacy when weight loss is not the major goal of the surgical intervention. METHODS:A series of strategies to reduce gastric volume were developed and tested in Long Evans male rats, namely: VSG, Fundal (F)-Resection, Gastric Sleeve Plication (GSP), Fundal-Plication, and Fundal-Constrained. RESULTS:All surgical interventions resulted in a reduction of gastric volume relative to sham, but none of the interventions were as effective as the VSG. Gastric volume was linearly correlated to increased gastric emptying rate as well as increased GLP-1 response. Overall, cumulative food intake was the strongest correlate to weight loss and was logarithmically related to gastric volume. Regression modeling revealed a nonlinear inverse relation between body weight reduction and gastric volume, confirming that VSG is the only effective long-term weight loss strategy among the experimental operations tested. CONCLUSIONS:The data suggest a minimum threshold volume of the residual stomach that is necessary to induce sustained weight loss. Although all gastric volume interventions increased the GLP-1 response, none of the interventions, except VSG, significantly improved glucose tolerance. In conclusion, if weight loss is the primary goal of surgical intervention, significant volume reduction is required, and this most likely requires excising gastric tissue.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Evers SS,Lewis AG,Tong C,Shao Y,Alvarez R,Ridelman E,Grant B,Seeley RJdoi
10.1097/SLA.0000000000003240subject
Has Abstractpub_date
2020-06-01 00:00:00pages
1102-1109issue
6eissn
0003-4932issn
1528-1140journal_volume
271pub_type
杂志文章abstract:OBJECTIVE:To prospectively evaluate the oncologic and functional outcomes of laparoscopic total mesorectal excision (TME) with colonic J-pouch reconstruction. BACKGROUND:TME is considered the established gold standard in rectal cancer surgery. However, data on laparoscopic sphincter-preserving TME are limited. METHOD...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000202180.16723.03
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To study the impact of LT experience on the outcome of CLR for locally advanced hepatobiliary malignancy SUMMARY OF BACKGROUND DATA:: Despite evolution in LT knowledge and surgical techniques in the past decades, there is yet data to evaluate the significance of LT experience in performing CLR. METHODS:Posto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004227
更新日期:2020-07-09 00:00:00
abstract::To determine if visceral blood flow was altered by thermal injury, effective renal blood flow (ERBF) was measured by para-aminohippurate clearance in five control subjects and 13 nonbacteremic burn patients (mean burn size: 50% total body surface, range: 24.5-83.5) 6-25 days after burn injury. Splanchnic blood flow (S...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198101000-00018
更新日期:1981-01-01 00:00:00
abstract::Repair of the pharynx after extirpation of malignancy may require the introduction of independently vascularized tissue either at the time of resection (primary reconstruction) or later for undesirable sequelae, such as fistula or stenosis. A ten-year retrospective study compares two methods of pharyngeal reconstructi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198905000-00007
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:This study aims to objectively define the criteria for assessing the presence of lymphedema and to report the prevalence of lymphedema after inguinal and ilio-inguinal (inguinal and pelvic) lymph node dissection for metastatic melanoma. SUMMARY BACKGROUND DATA:Lymphedema of the lower limb is a common problem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817ed7c3
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to characterize the patterns of first recurrence after curative-intent resection for pancreatic adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA:We evaluated the first site of recurrence after neoadjuvant treatment as locoregional (LR) or distant metastasis (DM). To validate our...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004585
更新日期:2020-10-19 00:00:00
abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197808000-00005
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:We have previously demonstrated that P. aeruginosa can have profound effects on the intestinal epithelial barrier via one of its virulence factors, the PA-I lectin/adhesin. The aims of the present study were to further characterize the interaction of P. aeruginosa and the intestinal epithelium using both in v...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000094551.88143.f8
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of early, routine antioxidant supplementation using alpha-tocopherol and ascorbic acid in reducing the rate of pulmonary morbidity and organ dysfunction in critically ill surgical patients. SUMMARY BACKGROUND DATA:Oxidative stress has been associated with the development of the...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200212000-00014
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To review the literature on current management of hepatocellular carcinoma (HCC). BACKGROUND:Hepatocellular carcinoma represents one of the most common malignancies worldwide with a rising incidence in western countries. There have been substantial advances in the surgical and medical treatment of HCC within...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e31820d944f
更新日期:2011-03-01 00:00:00
abstract::Nineteen patients with vascular deformities of the lower extremity were studied and were classified into three groups based on their clinical and angiographic findings. 1) The Klippel or Venous Dysplasia Group (n = 8) demonstrated: cutaneous nevi of metameric distribution, congenital varices (many of which were anomal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197702000-00005
更新日期:1977-02-01 00:00:00
abstract:OBJECTIVE:A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery in terms of overall survival was conducted, and short-term surgical outcomes are demonstrated. BACKGROUND:The efficacy and safety outcome of laparoscopic surgery for clinical stages II/III colon cancer underg...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000499
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817b65f2
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare the hand-sewn and stapled methods in esophagogastric anastomosis. SUMMARY BACKGROUND DATA:After esophageal resection for cancer, the relative merits of the hand-sewn and the stapled methods of esophagogastric anastomosis, especially regarding leakage and stricture r...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199708000-00008
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To summarize the current world position on laparoscopic liver surgery. SUMMARY BACKGROUND DATA:Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1097/sla.0b013e3181b3b2d8
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To determine the optimum excision margin and nodal management for patients with primary cutaneous melanomas 2.01- to 4.00-mm thick (T3 melanomas). BACKGROUND:Currently available evidence does not reliably define the minimum safe excision margin and best nodal management for patients with primary cutaneous T3...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000792
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Surgical resection provides the only possibility of cure for pancreas cancer. A standard adjuvant approach has not been established. We tested the safety and efficacy of a granulocyte-macrophage colony-stimulating factor (GM-CSF)-based immunotherapy administered in patients with resected pancreatic adenocarcino...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181fd271c
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To evaluate (1) levels of the host-defense/antimicrobial peptide LL-37 in patients with trauma and hemorrhagic shock (HS) and (2) the effects of a synthetic host-defense peptide; Pep19-4LF on multiple organ failure (MOF) associated with HS. BACKGROUND:HS is a common cause of death in severely injured patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002186
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:This study was conducted to evaluate those factors associated with popliteal artery injury that influence amputation, with emphasis placed on those that the surgeon can control. SUMMARY BACKGROUND DATA:Generally accepted factors impacting amputation after popliteal artery injury include blunt trauma, prolong...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199705000-00009
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:Evaluate current risk factors for mortality and morbidity in patients undergoing the Fontan procedure at a single institution in the current era. SUMMARY BACKGROUND DATA:An emphasis on early relief of volume and pressure overload culminating in the Fontan procedure has improved patient outcomes for patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181858286
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:To investigate the existence of a pathway between intraluminal products and the muscularis leukocytic infiltrate. SUMMARY BACKGROUND DATA:Mild intestinal manipulation or lipopolysaccharide initiates an intense inflammatory response within the intestinal muscularis, resulting in paralytic ileus. A major poten...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200201000-00005
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:This prospective observational study was designed to assess Pediatric Quality of Life (PedsQL) after surgical treatment for congenital diaphragmatic hernia (CDH), esophageal atresia/tracheoesophageal fistula (EA/TEF), Hirschsprung disease (HD), gastroschisis (GAS), omphalocele (OMP), and necrotizing enterocol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002918
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Resident duty hour restrictions were implemented in 2002-2003. This study examines changes in resident surgical experience since these restrictions were put into place. METHOD:Operative log data for 3 specialties were examined: general surgery, urology, and plastic surgery. The academic year immediately prec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e62299
更新日期:2010-08-01 00:00:00
abstract::Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198808000-00004
更新日期:1988-08-01 00:00:00
abstract::Small intestinal morphologic and biochemical changes were studied following jejuno-ileal bypass for obesity after body weight stabilization had occurred. Four patients underwent biopsy of in-continuity and bypassed jejunal and ileal segments of the small intestine 11 to 22 months after the bypass operation. Microscopi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197706000-00005
更新日期:1977-06-01 00:00:00
abstract:OBJECTIVE:To study the influence of esophageal cancer surgeon volume upon mortality from upper gastrointestinal emergencies. BACKGROUND:Volume-outcome relationships led to the centralization of esophageal cancer surgery. METHODS:Hospital Episode Statistics data were used to identify patients admitted to hospitals wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002387
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review of economic evaluations of enhanced recovery pathways (ERP) for colorectal surgery. BACKGROUND:Although there is extensive literature investigating the clinical effectiveness of ERP, little is known regarding its cost-effectiveness. METHODS:A systematic literature search ident...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e318295fef8
更新日期:2014-04-01 00:00:00
abstract::Reframing healthcare delivery in terms of the principles of complex adaptive systems has practical implications for addressing the challenges in improving surgical care. In an Integrated Practice Unit (IPU) - such as a surgical service line, a surgical in-patient floor, or an acute care unit - a diverse group of careg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001251
更新日期:2015-12-01 00:00:00
abstract::CLINICAL AND LABORATORY STUDIES OF AFP PRODUCING HEPATOMAS DEMONSTRATED THAT: 1) serum AFP levels correlated directly with tumor growth; 2) circulating AFP could be cleared by passive administration of an. excess of anti-AFP; and 3) highly specific anti-AFP functioned as a carrier to localize diagnostic and possibly t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00025
更新日期:1974-10-01 00:00:00
abstract:OBJECTIVE:To discuss the difficulties in dealing with infected or exposed ventral hernia mesh, and to illustrate one solution using an autogenous abdominal wall reconstruction technique. SUMMARY BACKGROUND DATA:The definitive treatment for any infected prosthetic material in the body is removal and substitution. When ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000055278.80458.D0
更新日期:2003-03-01 00:00:00