English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Tools annual

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Presents the access of premium content as premium feature

Premium Content

Global: Zendy Plus annual

Global: Zendy Free Plan

DOES NOT ACCURATELY IDENTIFY LEAKS OR PREDICT STRICTURES. Jonathan T Carter MD, Sepideh Tafreshian MD, Umesh Tiwari MD, Fernando Herbella MD, John P Cello MD, Marco G Patti MD, Guilherme M Campos MD, Stanley J Rogers MD, Andrew M Posselt MD Depts. of Surgery and Medicine, Univ. of California, San Francisco, USA. INTRODUCTION: Most centers performing Roux-en-Y gastric bypass for morbid obesity obtain a routine upper GI series (UGI) in the early postoperative period to evaluate for anastomotic leaks and delayed pouch emptying. We hypothesized that routine UGI does not accurately identify leaks or predict strictures. METHODS: From December, 1998 to April 2005, 569 gastric bypass procedures were performed at our center (60% laparoscopically). Routine UGI was obtained in 546 (96%) patients. We compared radiographic findings (leak or delayed emptying) with patient outcome (leak or stricture) to calculate the sensitivity and specificity of the study. Univariate modeling identified risk factors for anastomotic leak or stricture; the low number of events precluded multivariate modeling. RESULTS: Of 546 routine UGI studies, anastomotic leaks were reported in 5 (0.9%); 2 of these were later interpreted as artifact. UGI failed to identify 3 leaks, yielding an overall sensitivity of 50% and PPV of 60%. In univariate analysis, only institutional experience was associated with anastomotic leak (odds-ratio (OR) 6.5 for the first 100 cases, p=0.02). Delayed emptying of contrast was observed in 109 (19%) studies, was more frequent in laparoscopic cases (26.8% vs. open 9.0%, p<0.01) and when a GIA stapler was used for the gastrojejunostomy (31.7% vs. EEA 13.6%, hand-sewn 18.9%; p=0.01). Only 10 (1.7%) patients developed strictures requiring dilatation. The PPV of delayed contrast emptying for eventual stricture formation was 6%. Risk factors for stricture formation included stapled anastomosis (OR 9.4, p<0.01), long Roux length (>100cm OR 5.4, p=0.03), antecolic Roux (OR 10.2, p=0.03), and delayed contrast emptying (OR 6.3; p<0.01). CONCLUSIONS: Due to the overall low incidence of complications and low sensitivity/specificity, routine UGI does not accurately identify leaks or predict strictures after Roux-en-Y gastric bypass. A selective approach, reserved for patients with clinical evidence of leak or stricture, is more appropriate and cost-effective AN INITIAL EXPERIENCE USING THE LAPAROSCOPIC ADJUSTABLE GASTRIC BAND IN 54 US TEENAGERS G A Fielding MD, C J Ren MD, E Nadler MD, H A Youn RN Department of Surgery, NYU School of Medicine This is an analysis of an early US experience using the Laparoscopic Adjustable Gastric Band (LAGB) in US teenagers, assessing safety and efficacy.

surgical endoscopy/surgical endoscopy and other interventional techniques

2006 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Dallas, Texas, USA, 26–29 April 2006: Oral presentations