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Cabrera A, Vives M, Molina A, París M, Raga E, Sánchez A, Sabench F, Del Castillo D. Gastric Plication and Sleeve Gastrectomy in an Experimental Model of Obesity: New Insights into Weight Loss, Intake and Metabolic Results. Obes Surg 2018; 28:3259-3267. [PMID: 29961179 DOI: 10.1007/s11695-018-3340-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/26/2022]
Abstract
AIM Laparoscopic gastric plication (LGP) is a bariatric surgical technique based on the anatomical principles of laparoscopic sleeve gastrectomy (LSG), but its effects on the metabolic profile are still uncertain. The aim of our study is to compare the changes in weight, metabolic parameters and gastric histology following intervention by gastric plication (GP) and sleeve gastrectomy (SG) in an experimental model of obesity. METHODS To conduct the study, 32 8-week-old male Sprague-Dawley rats (Charles River®) were fattened by means of a cafeteria diet and randomly assigned to the following experimental groups: group 1: GP (n = 12); group 2: SG (n = 12) and group 3: sham (n = 8). RESULTS Unlike the SG group, the GP group attained the weight of the sham group at the end of the experiment (week 16). The GP group continued to eat more cafeteria diet than the SG group. In addition, the SG group achieved better glycaemic control than the GP group. Significantly higher plasma ghrelin levels were observed at week 16 in the GP group than in the SG group (2.29 ± 0.5 vs 1.07 ± 0.4, p < 0.05), which also occurred for the glucagon plasmatic levels (62.71 ± 36.2 vs 24.63 ± 9.3, p < 0.05). CONCLUSIONS GP is not as effective as SG and cannot be considered a metabolic surgery due to observed hormonal variations. The animals subjected to a GP continued to have a high appetite for the cafeteria diet unlike the animals submitted to an SG. Hormonal mechanisms possibly related to glucagon and ghrelin may be involved in this metabolic response.
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Affiliation(s)
- A Cabrera
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - M Vives
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - A Molina
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - M París
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - E Raga
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - A Sánchez
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - F Sabench
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain.
| | - D Del Castillo
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain.
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Vives M, Molina A, Danús M, Rebenaque E, Blanco S, París M, Sánchez A, Sabench F, Del Castillo D. Analysis of Gastric Physiology After Laparoscopic Sleeve Gastrectomy (LSG) With or Without Antral Preservation in Relation to Metabolic Response: a Randomised Study. Obes Surg 2018; 27:2836-2844. [PMID: 28478583 DOI: 10.1007/s11695-017-2700-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy is one of the most common techniques in bariatric surgery, but there is no consensus on the optimal distance from the pylorus to start the gastric transection. The aim of this study is to determine the differences in gastric emptying, gastric distension and metabolic response between two starting distances. MATERIAL AND METHODS This is a prospective randomised study of 60 patients (30 patients with the section at 3 cm and 30 patients at 8 cm from the pylorus). We calculate at 6 and 12 months from surgery gastric emptying by scintigraphy (T1/2 min), gastric volume by CT scan (cc) and metabolic response by blood sample analysis (glucose, HbA1c, insulin, HOMA-IR, GLP-1, GIP and C-peptide). RESULTS Gastric emptying increases the speed significantly in both groups but is greater in the 3-cm group (p < 0.05). Dividing groups into type 2 diabetic patients and non-diabetic patients, the speed in non-diabetic patients is significantly higher for the 3-cm group. Residual volume increases significantly in both groups, and there are no differences between them. One year after surgery, there are significant improvements in the hyperinsulinaemia in the patients of the 3-cm group with respect to the 8-cm group, but only in diabetic patients. No differences between groups are found regarding changes in GLP-1 or GIP. CONCLUSIONS Gastric emptying is faster in patients with antrum resection. The distance does not influence the gastric emptying of diabetic patients. Other mechanisms may explain metabolic response besides GLP-1 and its association with improvements in diabetes via gastric emptying.
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Affiliation(s)
- M Vives
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - A Molina
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - M Danús
- Nuclear Medicine Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - E Rebenaque
- Radiology Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - S Blanco
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - M París
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - A Sánchez
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain
| | - F Sabench
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain.
| | - D Del Castillo
- Surgery Service, University Hospital of Sant Joan, Faculty of Medicine, IISPV, "Rovira i Virgili" University, Reus, Tarragona, Spain.
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Jiménez AI, Cativiela C, Gómez-Catalán J, Pérez JJ, Aubry A, París M, Marraud M. Influence of Side Chain Restriction and NH···π Interaction on the β-Turn Folding Modes of Dipeptides Incorporating Phenylalanine Cyclohexane Derivatives. J Am Chem Soc 2000. [DOI: 10.1021/ja993568k] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ana I. Jiménez
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
| | - Carlos Cativiela
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
| | - Jesús Gómez-Catalán
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
| | - Juan J. Pérez
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
| | - André Aubry
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
| | - Miguel París
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
| | - Michel Marraud
- Contribution from the Department of Organic Chemistry, ICMA, CSIC−University of Zaragoza, 50009 Zaragoza, Spain, Department of Chemical Engineering, Technical University of Catalonia, 08028 Barcelona, Spain, Laboratory of Crystallography and Modeling of Mineral and Biological Materials, ESA-7036, University Henri Poincaré of Nancy, BP 236, 54509 Vandoeuvre, France, and Laboratory of Macromolecular Physical Chemistry, UMR-7568 CNRS-INPL, ENSIC, BP 451, 54001 Nancy, France
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Abstract
Since 1970 we have stabilized the ribs to correct paradoxical movement of the chest wall in chest injuries, using an original technique, in order to avoid as far as possible the need for long-term chest wall stabilization by intermittent positive pressure respiration (IPPR). The technical details of surgical stabilization are described, and the different types of stainless steel struts are shown. Type I was originally used either as an intramedullary nail or as an external brace. Types II and III were designed for external fixation of the strut to the rib. Treatment of 29 patients with severe flail chest, classified into four groups is shown: group I was treated by IPPR, group II by IPPR plus surgical stabilization, group III by surgical stabilization only, and group IV by surgical stabilization after exploratory thoracotomy. The clinical results are discussed. We conclude that surgical stabilization of the paradoxial movement of the chest wall can avoid the use of the respirator or at least reduce the interval of IPPR to a short period during the initial recovery from trauma. Using type III struts, we have obtained stabilization of the flail chest in all cases even in patients with severe anterior paradoxical movement. The patients' tolerance of surgical stainless steel struts was good.
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