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Drai C, Chierici A, Pavone G, Benamran D, Alromayan M, Alamri A, Anty R, Liddo G, Iannelli A. Remission of nonalcoholic steatohepatitis after bariatric surgery: a single referral center cohort study. Surg Obes Relat Dis 2024; 20:482-489. [PMID: 38195314 DOI: 10.1016/j.soard.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/09/2023] [Accepted: 10/29/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Obesity is associated with nonalcoholic steatohepatitis (NASH), which leads to an increased rate of primary liver cancers, cirrhosis, and decreased life expectancy. Metabolic/bariatric surgery (MBS) determines long-term weight loss and the resolution of obesity-related medical problems. OBJECTIVE The aim of this study was to evaluate the impact of MBS on liver histologic features in individuals with obesity. SETTING Tertiary referral university hospital. METHODS We retrospectively analyzed data on 37 patients undergoing MBS from a prospectively held database. All patients had a liver biopsy at the time of MBS and a second liver biopsy in case of further surgery or for NASH follow-up. Eighteen patients had NASH on the first liver biopsy. The primary endpoint was the resolution of steatohepatitis without worsening of fibrosis on the second liver biopsy. Secondary endpoints were the evolution of liver steatosis, hepatocyte ballooning, nonalcoholic fatty liver disease activity score, and biochemical parameters from the time of the first to the second liver biopsy. RESULTS Fifteen (83.3%) patients had significant resolution of steatohepatitis (P < .001) without fibrosis worsening. There was a statistically significant improvement of all blood tests except for low-density lipoprotein, alkaline phosphatases, and bilirubinemia. The Homeostatic Model Assessment (HOMA) index was significantly improved after MBS (P < .001), and circulating insulin and leptin concentrations were significantly reduced. Mean weight loss was 47 kg, with a 16.6 kg/m2 body mass index reduction and a % of total weight loss (%TWL) of 40.3 ±14% from the moment of MBS to the last follow-up. CONCLUSION MBS is effective in determining NASH regression without fibrosis worsening and in reducing HOMA index and leptin and insulin concentrations.
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Affiliation(s)
- Céline Drai
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Andrea Chierici
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Giovanna Pavone
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Dorith Benamran
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Mohamed Alromayan
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France; Security Forces Medical City, Riyadh, Saudi Arabia
| | - Abdulrhamane Alamri
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France; Department of Surgery, Medical College, Najran University. Najran, Saudi Arabia
| | - Rodolphe Anty
- Department of Gastroenterology, Digestive Center, Université Côte d'Azur, Centre Hospitalier Universitaire, Nice, France; Université Côte d'Azur, Nice, France
| | - Guido Liddo
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Antonio Iannelli
- Digestive Surgery and Liver Transplantation Unit, Centre Hospitalier Universitaire de Nice, Nice, France; Université Côte d'Azur, Nice, France; Team 8 "Hepatic complications of obesity and alcohol," Inserm U1065, Nice, France.
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Amor IB, Triantafyllou E, Temime V, Chenaitia H, Benamran D, Vanbiervliet G, Dagher I, Gugenheim J, Lainas P. Endoscopic Administration of Combined Autologous Mesenchymal Stem Cells and Platelet-Rich Plasma for the Treatment of Gastric Staple Line Leaks After Sleeve Gastrectomy. Obes Surg 2024; 34:106-113. [PMID: 38017329 DOI: 10.1007/s11695-023-06942-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/25/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Gastric staple line leak treatment after laparoscopic sleeve gastrectomy (LSG) remains challenging. Regenerative medicine is gaining place in the accelerated treatment of damaged tissues. This study presents the first series of gastric leak treatment after LSG using endoscopic intragastric administration of combined autologous mesenchymal stem cells (MSC) and platelet-rich plasma (PRP). METHODS MSC-PRP harvesting and endoscopic administration techniques are described in detail. Data were prospectively gathered and analyzed. Primary endpoints were morbidity/mortality rates and fistula closure time. RESULTS Twelve patients (9 women, 3 men) were included. Median age was 41.5 years, median weight 105.5 kg and median BMI 38.9 kg/m2. Median time to gastric staple line leak detection was 10 days post-LSG. Median time between re-laparoscopy and MSC-PRP administration was 5 days. MSC-PRP endoscopic administration was successfully performed and tolerated by all patients, with median procedure duration of 27 min and minimal blood loss. Four postoperative complications were noted: two patients with increased tibial pain at tibial puncture site, one with tibial hematoma, and one with epigastric pain/dysphagia. Median length of hospital stay was 1 day. Gastric leak healing occurred after a median of 14 days, only two patients requiring a second MSC-PRP endoscopic injection. Median follow-up was 19 months, all patients being in good health at last contact. CONCLUSION Endoscopic administration of combined autologous MSC-PRP seems to be a good option for treatment of gastric leaks after sleeve gastrectomy. It is a challenging procedure that should be performed in specialized bariatric centers by expert bariatric surgeons and endoscopists after meticulous patient selection.
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Affiliation(s)
- Imed Ben Amor
- Department of Digestive Surgery, Archet II Hospital, Nice, France
- University of Nice-Sophia-Antipolis, Nice, France
- INSERM U1081, Nice, France
| | - Evangelia Triantafyllou
- Department of Minimally Invasive Digestive & Bariatric Surgery, Metropolitan Hospital, HEAL Academy, 9 Ethnarchou Makariou & 1 Venizelou Streets, Neo Faliro, 18547, Athens, Greece
| | - Victor Temime
- Department of Digestive Surgery, Archet II Hospital, Nice, France
| | - Hichem Chenaitia
- Department of Digestive Surgery, Archet II Hospital, Nice, France
| | - Dorith Benamran
- Department of Digestive Surgery, Archet II Hospital, Nice, France
| | | | - Ibrahim Dagher
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, AP-HP, Clamart, France
- Paris-Saclay University, Orsay, France
| | - Jean Gugenheim
- Department of Digestive Surgery, Archet II Hospital, Nice, France
- University of Nice-Sophia-Antipolis, Nice, France
- INSERM U1081, Nice, France
| | - Panagiotis Lainas
- Department of Minimally Invasive Digestive & Bariatric Surgery, Metropolitan Hospital, HEAL Academy, 9 Ethnarchou Makariou & 1 Venizelou Streets, Neo Faliro, 18547, Athens, Greece.
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, AP-HP, Clamart, France.
- Paris-Saclay University, Orsay, France.
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Baboudjian M, Gondran-Tellier B, Touzani A, Martini A, Diamand R, Roche JB, Lacetera V, Beauval JB, Roumeguere T, Simone G, Benamran D, Fourcade A, Fiard G, Van Den Bergh R, Peltier A, Ploussard G. MRI-based t-staging to predict biochemical recurrence after radical prostatectomy: A step towards the iTNM classification. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01278-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Baboudjian M, Breda A, Roumeguere T, Uleri A, Roche J, Touzani A, Lacetera V, Beauval J, Diamand R, Simone G, Windisch O, Benamran D, Fourcade A, Fiard G, Roumiguié M, Oderda M, Barret E, Fromont G, Dariane C, Gondran-Tellier B, Ruffion A, Van Den Bergh R, Peltier A, Ploussard G. Machine learning algorithm to define optimal candidates for active surveillance in intermediate-risk prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00997-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Mandoorah Q, Benamran D, Pinar U, Seisen T, Abdessater M, Iselin C, Rouprêt M. Biochemical relapse predictive factors in patients with lymph node metastases during radical prostatectomy. Prog Urol 2022; 32:1462-1468. [DOI: 10.1016/j.purol.2022.07.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 10/15/2022]
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Olivieri M, Vaccaro F, Tille J, Iselin C, Benamran D. Biopsies ciblées pour lésions PIRADS 3 lors de biopsies concomitantes pour lésions PIRADS 4/5 et biopsies systématiques : toujours obligatoire ? Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Oderda M, Albisinni S, Benamran D, Calleris G, Ciccariello M, Dematteis A, Diamand R, Descotes J, Fiard G, Forte V, Giacobbe A, Marquis A, Marra G, Messas A, Muto G, Peltier A, Rius L, Simone G, Roumeguere T, Gontero P. Improved cancer detection with targeted biopsies only: results from a multicenter series using Koelis fusion system. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00914-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Oderda M, Albisinni S, Benamran D, Calleris G, Ciccariello M, Dematteis A, Diamand R, Descotes J, Fiard G, Forte V, Giacobbe A, Marquis A, Marra G, Messas A, Muto G, Peltier A, Rius L, Simone G, Thierry R, Gontero P. Correlation between MRI and biopsy for cancer location definition: results from a multicentric study. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Oderda M, Albisinni S, Benamran D, Calleris G, Ciccariello M, Dematteis A, Diamand R, Descotes J, Fiard G, Forte V, Giacobbe A, Marquis A, Marra G, Messas A, Muto G, Peltier A, Rius L, Simone G, Roumeguere T, Gontero P. Accuracy of Koelis fusion biopsy: Improved cancer detection with targeted biopsies only. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01332-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Liernur T, Costa Dos Santos J, Benamran D, Iselin C. Robot-assisted laparoscopic ureteral reimplantation: Very often successful, which type of failures? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00742-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tabourin T, Sarfati J, Pinar U, Beaud N, Parra J, Vaessen C, Gomez F, Benamran D, Canlorbe G, Belghiti J, Chartier-Kastler E, Cussenot O, Seisen T, Roupret M. Évaluation du risque de contamination par le coronavirus après chirurgie robotique durant la pandémie COVID-19. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Diamand R, Ploussard G, Roumiguié M, Oderda M, Benamran D, Fiard G, Quackels T, Assenmacher G, Simone G, Van Damme J, Malavaud B, Iselin C, Descotes J, Roche J, Peltier A, Roumeguère T, Albisinni S. Validation externe du nomogramme basé sur l’imagerie par résonance magnétique prédisant le risque d’effraction extra-capsulaire et d’invasion des vésicules séminales chez des patients opérés de prostatectomie radicale. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Diamand R, Ploussard G, Roumiguié M, Oderda M, Benamran D, Fiard G, Peltier A, Simone G, Van Damme J, Malavaud B, Iselin C, Descotes J, Roche J, Quackels T, Roumeguère T, Albisinni S. Le délais pour une prostatectomie radicale n’influence pas le résultat ontologique : étude d’une large cohorte de patients européen. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Diamand R, Albisinni S, Fourcade A, Fournier G, Benamran D, Fiard G, Descotes J, Assenmacher G, Svistakov I, Peltier A, Simone G, Di Cosmo G, Roche J, Bonnal J, Van Damme J, Rossi M, Mandron E, Oderda M, Roumeguere T. External validation of the new Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer: Results from a multicentric European cohort. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33704-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Fenner V, Benamran D, Wirth G, Iselin C. Urétroplastie transpérinéale bulbo-prostatique par résection-anastomose pour les sténoses bulbaires proximales non associées à des traumatismes pelviens. Prog Urol 2015; 25:817. [DOI: 10.1016/j.purol.2015.08.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Fenner V, Benamran D, Venzi G, Delannoy J, Iselin C. Efficacité à long terme des uréthroplasties de substitution par greffon dorsal pour sténoses uréthrales bulbo-scrotales : suivi après 10ans. Prog Urol 2015; 25:817. [DOI: 10.1016/j.purol.2015.08.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Benamran D, Klein J, De Perrot T, Tille J, Iselin C. Efficacité de l’IRM multiparamétrique et des biopsies ciblées dans le diagnostic des foyers significatifs de cancer de prostate : corrélation avec les spécimens de prostatectomie. Prog Urol 2015; 25:831. [DOI: 10.1016/j.purol.2015.08.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Benamran D, Fenner V, Hauser J, Iselin C. Anastomoses urétérales donneur-receveur robot-assistées chez les patients greffés rénaux pour sténose ou maladie de reflux. Prog Urol 2014; 24:856. [DOI: 10.1016/j.purol.2014.08.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Amram M, Benamran D, Wirth G, Roth A, Huber O. Hyperthermic Intraperitoneal Chemoterapy (Hipec) and Cytoreductive Surgery for Synchronous Peritoneal Carcinomatosis (Pc) from Gastric Cancer (Gc) : Results from a Single Center Experience. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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