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3. Esophageal and gastric malignancies after bariatric surgery: a retrospective global study

Author

Chetan Parmar, Roxanna Zakeri, Mohamed Abouelazayem, Thomas H. Shin, Ali Aminian, Tala Mahmoud, Barham K. Abu Dayyeh, Melissa Y. Wee, Laura Fischer, Freek Daams, Kamal Mahawar, Carlos Sosa Gallardo, Cataldo Agustin, Fernando Wright, Ignacio Fuente, Miguel Carbajo, Patricio Cal, Jacob Chisholm, Lilian Kow, Michael H.L. Tan, Philip Gan, Sivakumar Gananadha, Daniel M. Felsenreich, Gerhard Prager, Chris Matthys, Jacques M. Himpens, Marc A.M.R.M. Focquet, Almino Ramos, Manoel Galvano Nato, Thiago Vidal, Amin Andalib, Aya Siblini, Lorenzo Ferri, Lina Abdarabo, Yehonatan Nevo, Radu Pescarus, Wah Yang, Hosam Hamed, Arnaud Liagre, Damien Bergeat, De Montrichard Marie, Francesco Martini, François Regis, Laurent Genser, Mehdi Skalli, Marius Nedelcu, Milan Smejkal, Radwan Kassir, Regenet Nicolas, Christine Stier, Dan-Sebastian Nedelcut, Grigorios Christodoulidis, Amar Vennapusa, Mohammad Kermansaravi, Asnat Raziel, Nasser Sakran, Alberto Oldani, Cristian Eugeniu Boru, Fouzia Mécheri, Francesca Ciccarese, Giovanni Carlo Cesana, Mario Musella, Matteo Uccelli, Mirto Foletto, Pasquale Auricchio, Stefano Olmi, Yosuke Seki, Anne Kasteleijn, Gerhard Van 'T Hof, Jan A. Apers, Judith W.H. Hart, Justin S.L. Van De Sande, Marijn Takkenberg, Pierre B.G.M. Feskens, Rob Snoekx, Victor D. Plat, Jorunn Sandvik, Piotr Kalinowski, Celso Nabais, Ahmed Z. Al-Bahrani, Mohammad Al Zoubi, Carla Bettonica, Javier Osorio, Javier Tejedor-Tejada, Lourdes M. Sanz, Marta Cuadrado, Rajesh Gianchandani Moorjani, Fringeli Yannick, Michel Suter, Yves Borbély, Zehetner Joerg, Juan S. Barajas-Gamboa, Matthew Kroh, Aaron P. Kisiel, Anna Kamocka, Arul Immanuel, Bruno Sgromo, Bussa Gopinath, David Khoo, Samrat Mukherjee, Dimitrios Pournaras, Tim Underwood, Ewen A. Griffiths, Glenn V. Miller, Helen Jaretzke, Jan Dmitrewski, Martin S. Wadley, Ragad Al-Housni, Richard S. Gillies, Rishi Singhal, Shaun R. Preston, Steven John Robinson, William J. Hawkins, Marco Adamo, Mohamed El Kalaawy, James Gossage, Christopher B. Crawford, Veeravich Jaruvongvanich, Parmar, C., Zakeri, R., Abouelazayem, M., Shin, T. H., Aminian, A., Mahmoud, T., Abu Dayyeh, B. K., Wee, M. Y., Fischer, L., Daams, F., Mahawar, K., Gallardo, C. S., Agustin, C., Wright, F., Fuente, I., Carbajo, M., Cal, P., Chisholm, J., Kow, L., Tan, M. H. L., Gan, P., Gananadha, S., Felsenreich, D. M., Prager, G., Matthys, C., Himpens, J. M., Focquet, M. A. M. R. M., Ramos, A., Nato, M. G., Vidal, T., Andalib, A., Siblini, A., Ferri, L., Abdarabo, L., Nevo, Y., Pescarus, R., Yang, W., Hamed, H., Liagre, A., Bergeat, D., Marie, D. M., Martini, F., Regis, F., Genser, L., Skalli, M., Nedelcu, M., Smejkal, M., Kassir, R., Nicolas, R., Stier, C., Nedelcut, D. -S., Christodoulidis, G., Vennapusa, A., Kermansaravi, M., Raziel, A., Sakran, N., Oldani, A., Boru, C. E., Mecheri, F., Ciccarese, F., Cesana, G. C., Musella, M., Uccelli, M., Foletto, M., Auricchio, P., Olmi, S., Seki, Y., Kasteleijn, A., Van 'T Hof, G., Apers, J. A., Hart, J. W. H., Van De Sande, J. S. L., Takkenberg, M., Feskens, P. B. G. M., Snoekx, R., Plat, V. D., Sandvik, J., Kalinowski, P., Nabais, C., Al-Bahrani, A. Z., Al Zoubi, M., Bettonica, C., Osorio, J., Tejedor-Tejada, J., Sanz, L. M., Cuadrado, M., Moorjani, R. G., Yannick, F., Suter, M., Borbely, Y., Joerg, Z., Barajas-Gamboa, J. S., Kroh, M., Kisiel, A. P., Kamocka, A., Immanuel, A., Sgromo, B., Gopinath, B., Khoo, D., Mukherjee, S., Pournaras, D., Underwood, T., Griffiths, E. A., Miller, G. V., Jaretzke, H., Dmitrewski, J., Wadley, M. S., Al-Housni, R., Gillies, R. S., Singhal, R., Preston, S. R., Robinson, S. J., Hawkins, W. J., Adamo, M., El Kalaawy, M., Gossage, J., Crawford, C. B., Jaruvongvanich, V., Surgery, CCA - Cancer Treatment and quality of life, Amsterdam Gastroenterology Endocrinology Metabolism, and Plastic, Reconstructive and Hand Surgery

Subjects
Adult, obesity, Sleeve gastrectomy, medicine.medical_specialty, Palliative treatment, bariatric surgery, esophageal cancer, esophagogastric cancer, gtastric cancer, metabolic surgery, adult, female, gastrectomy, humans, middle aged, retrospective studies, treatment outcome, gastric bypass, morbid, stomach neoplasms, medicine.medical_treatment, Esophageal cancer, Esophagogastric cancer, Population, Gastric Bypass, Bariatric Surgery, Gastrectomy, Stomach Neoplasms, medicine, Humans, In patient, Adjustable gastric band, education, Retrospective Studies, Bariatric surgery, education.field_of_study, business.industry, Cancer, Middle Aged, medicine.disease, Obesity, Obesity, Morbid, Surgery, Treatment Outcome, Adenocarcinoma, Female, Metabolic surgery, Gastric cancer, business
Abstract

Background Bariatric surgery can influence the presentation, diagnosis, and management of gastrointestinal cancers. Oesophago-Gastric (OG) malignancies in patients who have had a prior bariatric procedure have not been fully characterised. Objective To characterise OG malignancies after bariatric procedures. Setting University Hospital, United Kingdom. Methods We performed a retrospective, multi-centre observational study of patients with OG malignancies after bariatric surgery to characterise this condition. Results This study includes 170 patients from 75 centres in 25 countries who underwent bariatric procedures between 1985 and 2020. At the time of the bariatric procedure, the mean age was 50.2 ± 10 years and the mean weight 128.8 ± 28.9 kg. Females comprised 57.3% (n=98) of the population. Most (n=64) patients underwent a Roux-en-Y Gastric Bypass (RYGB) followed by Adjustable Gastric Band (AGB) (n = 46) and Sleeve Gastrectomy (SG) (n = 43). Time to cancer diagnosis after bariatric surgery was 9.5 ± 7.4 years and mean weight at diagnosis was 87.4 ± 21.9 kg. The time lag was 5.9 ± 4.1 years after SG compared to 9.4 ± 7.1 years after RYGB and 10.5 ± 5.7 years after AGB. One-third of patients presented with metastatic disease. The majority of tumours were adenocarcinoma (82.9%). Approximately 1 in 5 patients underwent palliative treatment from the outset. Time from diagnosis to mortality was under one year for most patients who died over the intervening period. Conclusions The OGMOS (Oesophago-Gastric Malignancies after Obesity/ Bariatric Surgery) study presents the largest series to date of patients developing OG malignancies after bariatric surgery and attempts to characterise this condition.

Published
2022

5. Laparoscopic sleeve gastrectomy with Rossetti fundoplication: long-term (5-year) follow-up

Author

Matteo Uccelli, Giovanni Carlo Cesana, Francesca Ciccarese, Alberto Oldani, Riccardo Giorgi, Stefano Maria De Carli, Roberta Villa, Adelinda Angela Giulia Zanoni, Ayman Ismail, Francesco Di Capua, Marta Bonaldi, Carolina Rubicondo, Davide Moioli, and Stefano Olmi

Subjects
Adult, Fundoplication, Middle Aged, Obesity, Morbid, Barrett Esophagus, Gastrectomy, Weight Loss, Gastroesophageal Reflux, Esophagitis, Humans, Surgery, Laparoscopy, Prospective Studies, Follow-Up Studies
Abstract

Gastroesophageal reflux disease (GERD), including erosive esophagitis, is highly prevalent in the obese population. Barrett's esophagus is the consequence of untreated GERD. Laparoscopic sleeve gastrectomy is one of the most frequently performed bariatric procedures. This study presents results after 5 years of follow-up of combined LSG and Rossetti fundoplication for the treatment of GERD, esophagitis, and Barrett's esophagus in patients with morbid obesity.To evaluate long-term results after sleeve gastrectomy with Rossetti fundoplication.Public university hospital in Italy.Since January 2015, more than 450 patients with obesity underwent sleeve gastrectomy with a Rossetti fundoplication procedure as part of prospective studies underway at our center performed by 4 different expert bariatric surgeons. Currently, 127 patients have a follow-up of 5 years or more.Mean patient age was 42.9 ± 10.3 years, and mean body mass index was 42.4 ± 6.1 kg/mLaparoscopic sleeve gastrectomy with Rossetti fundoplication is well tolerated, feasible, and safe in patients with obesity, providing adequate weight loss results and complete resolution of clinical signs of GERD. We have recorded an improvement in esophagitis lesions present at preoperative gastroscopy and complete resolution of Barrett's esophagus within 5 years of follow-up.

Published
2022

6. Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Author

Rishi Singhal, Islam Omar, Brijesh Madhok, Christian Ludwig, Abd A. Tahrani, Kamal Mahawar, Michał Pędziwiatr, Piotr Major, Piotr Zarzycki, Athanasios Pantelis, Dimitris P. Lapatsanis, Georgios Stravodimos, Chris Matthys, Marc Focquet, Wouter Vleeschouwers, Antonio G. Spaventa, Carlos Zerrweck, Antonio Vitiello, Giovanna Berardi, Mario Musella, Alberto Sanchez-Meza, Felipe J. Cantu, Fernando Mora, Marco A. Cantu, Abhishek Katakwar, D. Nageshwar Reddy, Haitham Elmaleh, Mohammad Hassan, Abdelrahman Elghandour, Mohey Elbanna, Ahmed Osman, Athar Khan, Laurent Layani, Nalini Kiran, Andrey Velikorechin, Maria Solovyeva, Hamid Melali, Shahab Shahabi, Ashish Agrawal, Apoorv Shrivastava, Ankur Sharma, Bhavya Narwaria, Mahendra Narwaria, Asnat Raziel, Nasser Sakran, Sergio Susmallian, Levent Karagöz, Murat Akbaba, Salih Zeki Pişkin, Ahmet Ziya Balta, Zafer Senol, Emilio Manno, Michele Giuseppe Iovino, Mohamed Qassem, Sebastián Arana-Garza, Heitor P. Povoas, Marcos Leão Vilas-Boas, Alan Li, Basil J. Ammori, Hany Balamoun, Mohammed Salman, Amrit Manik Nasta, Ramen Goel, Hugo Sánchez-Aguilar, Miguel F. Herrera, Adel Abou-Mrad, Lucie Cloix, Guilherme Silva Mazzini, Leonardo Kristem, Andre Lazaro, Jose Campos, Joaquín Bernardo, Jesús González, Carlos Trindade, Octávio Viveiros, Rui Ribeiro, David Goitein, David Hazzan, Lior Segev, Tamar Beck, Hernán Reyes, Jerónimo Monterrubio, Paulina García, Marine Benois, Radwan Kassir, Alessandro Contine, Moustafa Elshafei, Sueleyman Aktas, Sylvia Weiner, Till Heidsieck, Luis Level, Silvia Pinango, Patricia Martinez Ortega, Rafael Moncada, Victor Valenti, Ivan Vlahović, Zdenko Boras, Arnaud Liagre, Francesco Martini, Gildas Juglard, Manish Motwani, Sukhvinder Singh Saggu, Hazem Al Momani, Luis Adolfo Aceves López, María Angelina Contreras Cortez, Rodrigo Aceves Zavala, Christine D'Haese, Ivo Kempeneers, Jacques Himpens, Andrea Lazzati, Luca Paolino, Sarah Bathaei, Abdulkadir Bedirli, Aydın Yavuz, Çağrı Büyükkasap, Safa Özaydın, Andrzej Kwiatkowski, Katarzyna Bartosiak, Maciej Walędziak, Antonella Santonicola, Luigi Angrisani, Paola Iovino, Rossella Palma, Angelo Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Gianfranco Silecchia, Abdulzahra Hussain, Srivinasan Balchandra, Izaskun Balciscueta Coltell, Javier Lorenzo Pérez, Ashok Bohra, Altaf K. Awan, Paul C. Leeder, Sherif Awad, Waleed Al-Khyatt, Ashraf Shoma, Hosam Elghadban, Sameh Ghareeb, Bryan Mathews, Marina Kurian, Andreas Larentzakis, Gavriella Zoi Vrakopoulou, Konstantinos Albanopoulos, Ahemt Bozdag, Azmi Lale, Cuneyt Kirkil, Mursid Dincer, Ahmad Bashir, Ashraf Haddad, Leen Abu Hijleh, Bruno Zilberstein, Danilo Dallago de Marchi, Willy Petrini Souza, Carl Magnus Brodén, Hjörtur Gislason, Kamran Shah, Antonio Ambrosi, Giovanna Pavone, Nicola Tartaglia, S. Lakshmi Kumari Kona, K. Kalyan, Cesar Ernesto Guevara Perez, Miguel Alberto Forero Botero, Adrian Covic, Daniel Timofte, Madalina Maxim, Dashti Faraj, Larissa Tseng, Ronald Liem, Gürdal Ören, Evren Dilektasli, Ilker Yalcin, Hudhaifa AlMukhtar, Mohammed Al Hadad, Rasmi Mohan, Naresh Arora, Digvijaysingh Bedi, Claire Rives-Lange, Jean-Marc Chevallier, Tigran Poghosyan, Hugues Sebbag, Lamia Zinaï, Saadi Khaldi, Charles Mauchien, Davide Mazza, Georgiana Dinescu, Bernardo Rea, Fernando Pérez-Galaz, Luis Zavala, Anais Besa, Anna Curell, Jose M. Balibrea, Carlos Vaz, Luis Galindo, Nelson Silva, José Luis Estrada Caballero, Sergio Ortiz Sebastian, João Caetano Dallegrave Marchesini, Ricardo Arcanjo da Fonseca Pereira, Wagner Herbert Sobottka, Felipe Eduardo Fiolo, Matias Turchi, Antonio Claudio Jamel Coelho, Andre Luis Zacaron, André Barbosa, Reynaldo Quinino, Gabriel Menaldi, Nicolás Paleari, Pedro Martinez-Duartez, Gabriel Martínez de Aragon Ramírez de Esparza, Valentin Sierra Esteban, Antonio Torres, Jose Luis Garcia-Galocha, Miguel Josa, Jose Manuel Pacheco-Garcia, Maria Angeles Mayo-Ossorio, Pradeep Chowbey, Vandana Soni, Hercio Azevedo de Vasconcelos Cunha, Michel Victor Castilho, Rafael Meneguzzi Alves Ferreira, Thiago Alvim Barreiro, Alexandros Charalabopoulos, Elias Sdralis, Spyridon Davakis, Benoit Bomans, Giovanni Dapri, Koenraad Van Belle, Mazen Takieddine, Pol Vaneukem, Esma Seda Akalın Karaca, Fatih Can Karaca, Aziz Sumer, Caghan Peksen, Osman Anil Savas, Elias Chousleb, Fahad Elmokayed, Islam Fakhereldin, Hany Mohamed Aboshanab, Talal Swelium, Ahmad Gudal, Lamees Gamloo, Ayushka Ugale, Surendra Ugale, Clara Boeker, Christian Reetz, Ibrahim Ali Hakami, Julian Mall, Andreas Alexandrou, Efstratia Baili, Zsolt Bodnar, Almantas Maleckas, Rita Gudaityte, Cem Emir Guldogan, Emre Gundogdu, Mehmet Mahir Ozmen, Deepti Thakkar, Nandakishore Dukkipati, Poonam Shashank Shah, Shashank Subhashchandra Shah, Simran Shashank Shah, Md Tanveer Adil, Periyathambi Jambulingam, Ravikrishna Mamidanna, Douglas Whitelaw, Vigyan Jain, Deepa Kizhakke Veetil, Randeep Wadhawan, Max Torres, Tabata Tinoco, Wouter Leclercq, Marleen Romeijn, Kelly van de Pas, Ali K. Alkhazraji, Safwan A. Taha, Murat Ustun, Taner Yigit, Aatif Inam, Muhammad Burhanulhaq, Abdolreza Pazouki, Foolad Eghbali, Mohammad Kermansaravi, Amir Hosein Davarpanah Jazi, Mohsen Mahmoudieh, Neda Mogharehabed, Gregory Tsiotos, Konstantinos Stamou, Francisco J Barrera Rodriguez, Marco A. Rojas Navarro, Omar MOhamed Torres, Sergio Lopez Martinez, Elda Rocio Maltos Tamez, Gustavo A. Millan Cornejo, Jose Eduardo Garcia Flores, Diya Aldeen Mohammed, Mohamad Hayssam Elfawal, Asim Shabbir, Kim Guowei, Jimmy By So, Elif Tuğçe Kaplan, Mehmet Kaplan, Tuğba Kaplan, DangTuan Pham, Gurteshwar Rana, Mojdeh Kappus, Riddish Gadani, Manish Kahitan, Koshish Pokharel, Alan Osborne, Dimitri Pournaras, James Hewes, Errichetta Napolitano, Sonja Chiappetta, Vincenzo Bottino, Evelyn Dorado, Axel Schoettler, Daniel Gaertner, Katharina Fedtke, Francisco Aguilar-Espinosa, Saul Aceves-Lozano, Alessandro Balani, Carlo Nagliati, Damiano Pennisi, Andrea Rizzi, Francesco Frattini, Diego Foschi, Laura Benuzzi, Chirag Parikh, Harshil Shah, Enrico Pinotti, Mauro Montuori, Vincenzo Borrelli, Jerome Dargent, Catalin A Copaescu, Ionut Hutopila, Bogdan Smeu, Bart Witteman, Eric Hazebroek, Laura Deden, Laura Heusschen, Sietske Okkema, Theo Aufenacker, Willem den Hengst, Wouter Vening, Yonta van der Burgh, Ahmad Ghazal, Hamza Ibrahim, Mourad Niazi, Bilal Alkhaffaf, Mohammad Altarawni, Giovanni Carlo Cesana, Marco Anselmino, Matteo Uccelli, Stefano Olmi, Christine Stier, Tahsin Akmanlar, Thomas Sonnenberg, Uwe Schieferbein, Alejandro Marcolini, Diego Awruch, Marco Vicentin, Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio, Anmol Ahuja, Tarun Mittal, Roel Bolckmans, Tom Wiggins, Clément Baratte, Judith Aron Wisnewsky, Laurent Genser, Lynn Chong, Lillian Taylor, Salena Ward, Michael W. Hi, Helen Heneghan, Naomi Fearon, Andreas Plamper, Karl Rheinwalt, Justin Geoghegan, Kin Cheung Ng, Krzysztof Kaseja, Maciej Kotowski, Tarig A. Samarkandy, Adolfo Leyva-Alvizo, Lourdes Corzo-Culebro, Cunchuan Wang, Wah Yang, Zhiyong Dong, Manel Riera, Rajesh Jain, Hosam Hamed, Mohammed Said, Katia Zarzar, Manuel Garcia, Ahmet Gökhan Türkçapar, Ozan Şen, Edoardo Baldini, Luigi Conti, Cacio Wietzycoski, Eduardo Lopes, Tadeja Pintar, Jure Salobir, Cengiz Aydin, Semra Demirli Atici, Anıl Ergin, Huseyin Ciyiltepe, Mehmet Abdussamet Bozkurt, Mehmet Celal Kizilkaya, Nezihe Berrin Dodur Onalan, Mariana Nabila Binti Ahmad Zuber, Wei Jin Wong, Amador Garcia, Laura Vidal, Marc Beisani, Jorge Pasquier, Ramon Vilallonga, Sharad Sharma, Chetan Parmar, Lyndcie Lee, Pratik Sufi, Hüseyin Sinan, and Mehmet Saydam

Subjects
obesity, Endocrinology, Diabetes and Metabolism, bariatric surgery, resuming elective surgery, laparoscopy, body mass index, BMI, covid-19, metabolic surgery, obesity surgery, pandemic, Sars-Cov-2, female, gastrectomy, humans, male, pandemics, retrospective studies, treatment outcome, weight loss, gastric bypass, Resuming Elective surgery, Obesity, Morbid, Bariatric surgery, Nutrition and Dietetics, Pandemic, Manchester Cancer Research Centre, SARS-CoV-2, ResearchInstitutes_Networks_Beacons/mcrc, COVID-19, Obesity, Morbid, Obesity surgery, Metabolic surgery, Body Mass Index, Female, Gastrectomy, Humans, Male, Pandemics, Retrospective Studies, Treatment Outcome, Weight Loss, Bariatric Surgery, Gastric Bypass, Laparoscopy
Abstract

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI - Group I (BMI60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 ± 24.4 Kgs and 43.03 ± 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively. The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection.

Published
2022

7. Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Author

Singhal, Rishi, Omar, Islam, Madhok, Brijesh, Rajeev, Yashasvi, Graham, Yitka, Tahrani, Abd A, Ludwig, Christian, Wiggins, Tom, Mahawar, Kamal, Michał, Pędziwiatr, Piotr, Major, Piotr, Zarzycki, Athanasios, Pantelis, Dimitris, P Lapatsanis, Georgios, Stravodimos, Chris, Matthys, Marc, Focquet, Wouter, Vleeschouwers, Antonio, G Spaventa, Carlos, Zerrweck, Antonio, Vitiello, Giovanna, Berardi, Mario, Musella, Alberto, Sanchez-Meza, Felipe, J Cantu Jr, Fernando, Mora, Marco, A Cantu, Abhishek, Katakwar, D Nageshwar Reddy, Haitham, Elmaleh, Mohammad, Hassan, Abdelrahman, Elghandour, Mohey, Elbanna, Ahmed, Osman, Athar, Khan, Laurent, Layani, Nalini, Kiran, Andrey, Velikorechin, Maria, Solovyeva, Hamid, Melali, Shahab, Shahabi, Ashish, Agrawal, Apoorv, Shrivastava, Ankur, Sharma, Bhavya, Narwaria, Mahendra, Narwaria, Asnat, Raziel, Nasser, Sakran, Sergio, Susmallian, Levent, Karagöz, Murat, Akbaba, Salih Zeki Pişkin, Ahmet Ziya Balta, Zafer, Senol, Emilio, Manno, Michele Giuseppe Iovino, Mohamed, Qassem, Sebastián, Arana-Garza, Heitor, P Povoas, Marcos Leão Vilas-Boas, Alan, Li, Basil, J Ammori, Hany, Balamoun, Mohammed, Salman, Amrit Manik Nasta, Ramen, Goel, Hugo, Sánchez-Aguilar, Miguel, F Herrera, Adel, Abou-Mrad, Lucie, Cloix, Guilherme Silva Mazzini, Leonardo, Kristem, Andre, Lazaro, Jose, Campos, Joaquín, Bernardo, Jesús, González, Carlos, Trindade, Octávio, Viveiros, Rui, Ribeiro, David, Goitein, David, Hazzan, Lior, Segev, Tamar, Beck, Hernán, Reyes, Jerónimo, Monterrubio, Paulina, García, Marine, Benois, Radwan, Kassir, Alessandro, Contine, Moustafa, Elshafei, Sueleyman, Aktas, Sylvia, Weiner, Till, Heidsieck, Luis, Level, Silvia, Pinango, Patricia Martinez Ortega, Rafael, Moncada, Victor, Valenti, Ivan, Vlahović, Zdenko, Boras, Arnaud, Liagre, Francesco, Martini, Gildas, Juglard, Manish, Motwani, Sukhvinder Singh Saggu, Hazem Al Momani, Luis Adolfo Aceves López, María Angelina Contreras Cortez, Rodrigo Aceves Zavala, Christine, D'Haese, Ivo, Kempeneers, Jacques, Himpens, Andrea, Lazzati, Luca, Paolino, Sarah, Bathaei, Abdulkadir, Bedirli, Aydın, Yavuz, Çağrı, Büyükkasap, Safa, Özaydın, Andrzej, Kwiatkowski, Katarzyna, Bartosiak, Maciej, Walędziak, Santonicola, Antonella, Luigi, Angrisani, Iovino, Paola, Rossella, Palma, Angelo, Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Gianfranco, Silecchia, Abdulzahra, Hussain, Srivinasan, Balchandra, Izaskun Balciscueta Coltell, Javier Lorenzo Pérez, Ashok, Bohra, Altaf, K Awan, Brijesh, Madhok, Paul, C Leeder, Sherif, Awad, Waleed, Al-Khyatt, Ashraf, Shoma, Hosam, Elghadban, Sameh, Ghareeb, Bryan, Mathews, Marina, Kurian, Andreas, Larentzakis, Gavriella Zoi Vrakopoulou, Konstantinos, Albanopoulos, Ahemt, Bozdag, Azmi, Lale, Cuneyt, Kirkil, Mursid, Dincer, Ahmad, Bashir, Ashraf, Haddad, Leen Abu Hijleh, Bruno, Zilberstein, Danilo Dallago de Marchi, Willy Petrini Souza, Carl Magnus Brodén, Hjörtur, Gislason, Kamran, Shah, Antonio, Ambrosi, Giovanna, Pavone, Nicola, Tartaglia, S Lakshmi Kumari Kona, Kalyan, K, Cesar Ernesto Guevara Perez, Miguel Alberto Forero Botero, Adrian, Covic, Daniel, Timofte, Madalina, Maxim, Dashti, Faraj, Larissa, Tseng, Ronald, Liem, Gürdal, Ören, Evren, Dilektasli, Ilker, Yalcin, Hudhaifa, Almukhtar, Mohammed Al Hadad, Rasmi, Mohan, Naresh, Arora, Digvijaysingh, Bedi, Claire, Rives-Lange, Jean-Marc, Chevallier, Tigran, Poghosyan, Hugues, Sebbag, Lamia, Zinaï, Saadi, Khaldi, Charles, Mauchien, Davide, Mazza, Georgiana, Dinescu, Bernardo, Rea, Fernando, Pérez-Galaz, Luis, Zavala, Anais, Besa, Anna, Curell, Jose, M Balibrea, Carlos, Vaz, Luis, Galindo, Nelson, Silva, José Luis Estrada Caballero, Sergio Ortiz Sebastian, João Caetano Dallegrave Marchesini, Ricardo Arcanjo da Fonseca Pereira, Wagner Herbert Sobottka, Felipe Eduardo Fiolo, Matias, Turchi, Antonio Claudio Jamel Coelho, Andre Luis Zacaron, André, Barbosa, Reynaldo, Quinino, Gabriel, Menaldi, Nicolás, Paleari, Pedro, Martinez-Duartez, Gabriel Martínez de Aragon Ramírez de Esparza, Valentin Sierra Esteban, Antonio, Torres, Jose Luis Garcia-Galocha, Miguel, Josa, Jose Manuel Pacheco-Garcia, Maria Angeles Mayo-Ossorio, Pradeep, Chowbey, Vandana, Soni, Hercio Azevedo de Vasconcelos Cunha, Michel Victor Castilho, Rafael Meneguzzi Alves Ferreira, Thiago Alvim Barreiro, Alexandros, Charalabopoulos, Elias, Sdralis, Spyridon, Davakis, Benoit, Bomans, Giovanni, Dapri, Koenraad Van Belle, Mazentakieddine, Pol, Vaneukem, Esma Seda Akalın Karaca, Fatih Can Karaca, Aziz, Sumer, Caghan, Peksen, Osman Anil Savas, Elias, Chousleb, Fahad, Elmokayed, Islam, Fakhereldin, Hany Mohamed Aboshanab, Talal, Swelium, Ahmad, Gudal, Lamees, Gamloo, Ayushka, Ugale, Surendra, Ugale, Clara, Boeker, Christian, Reetz, Ibrahim Ali Hakami, Julian, Mall, Andreas, Alexandrou, Efstratia, Baili, Zsolt, Bodnar, Almantas, Maleckas, Rita, Gudaityte, Cem Emir Guldogan, Emre, Gundogdu, Mehmet Mahir Ozmen, Deepti, Thakkar, Nandakishore, Dukkipati, Poonam Shashank Shah, Shashank Subhashchandra Shah, Simran Shashank Shah, Md Tanveer Adil, Periyathambi, Jambulingam, Ravikrishna, Mamidanna, Douglas, Whitelaw, Vigyan, Jain, Deepa Kizhakke Veetil, Randeep, Wadhawan, Max, Torres, Tabata, Tinoco, Wouter, Leclercq, Marleen, Romeijn, Kelly van de Pas, Ali, K Alkhazraji, Safwan, A Taha, Murat, Ustun, Taner, Yigit, Aatif, Inam, Muhammad, Burhanulhaq, Abdolreza, Pazouki, Foolad, Eghbali, Mohammad, Kermansaravi, Amir Hosein Davarpanah Jazi, Mohsen, Mahmoudieh, Neda, Mogharehabed, Gregory, Tsiotos, Konstantinos, Stamou, Francisco, J Barrera Rodriguez, Marco, A Rojas Navarro, Omar MOhamed Torres, Sergio Lopez Martinez, Elda Rocio Maltos Tamez, Gustavo, A Millan Cornejo, Jose Eduardo Garcia Flores, Diya Aldeen Mohammed, Mohamad Hayssam Elfawal, Asim, Shabbir, Kim, Guowei, Jimmy By So, Elif Tuğçe Kaplan, Mehmet, Kaplan, Tuğba, Kaplan, Dangtuan, Pham, Gurteshwar, Rana, Mojdeh, Kappus, Riddish, Gadani, Manish, Kahitan, Koshish, Pokharel, Alan, Osborne, Dimitri, Pournaras, James, Hewes, Errichetta, Napolitano, Sonja, Chiappetta, Vincenzo, Bottino, Evelyn, Dorado, Axel, Schoettler, Daniel, Gaertner, Katharina, Fedtke, Francisco, Aguilar-Espinosa, Saul, Aceves-Lozano, Alessandro, Balani, Carlo, Nagliati, Damiano, Pennisi, Andrea, Rizzi, Francesco, Frattini, Diego, Foschi, Laura, Benuzzi, Chirag, Parikh, Harshil, Shah, Enrico, Pinotti, Mauro, Montuori, Vincenzo, Borrelli, Jerome, Dargent, Catalin, A Copaescu, Ionut, Hutopila, Bogdan, Smeu, Bart, Witteman, Eric, Hazebroek, Laura, Deden, Laura, Heusschen, Sietske, Okkema, Theo, Aufenacker, Willem den Hengst, Wouter, Vening, Yonta van der Burgh, Ahmad, Ghazal, Hamza, Ibrahim, Mourad, Niazi, Bilal, Alkhaffaf, Mohammad, Altarawni, Giovanni Carlo Cesana, Marco, Anselmino, Matteo, Uccelli, Stefano, Olmi, Christine, Stier, Tahsin, Akmanlar, Thomas, Sonnenberg, Uwe, Schieferbein, Alejandro, Marcolini, Diego, Awruch, Marco, Vicentin, Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio, Anmol, Ahuja, Tarun, Mittal, Roel, Bolckmans, Tom, Wiggins, Clément, Baratte, Judith Aron Wisnewsky, Laurent, Genser, Lynn, Chong, Lillian, Taylor, Salena, Ward, Michael, W Hi, Helen, Heneghan, Naomi, Fearon, Andreas, Plamper, Karl, Rheinwalt, Justin, Geoghegan, Kin Cheung Ng, Krzysztof, Kaseja, Maciej, Kotowski, Tarig, A Samarkandy, Adolfo, Leyva-Alvizo, Lourdes, Corzo-Culebro, Cunchuan, Wang, Wah, Yang, Zhiyong, Dong, Manel, Riera, Rajesh, Jain, Hosam, Hamed, Mohammed, Said, Katia, Zarzar, Manuel, Garcia, Ahmet Gökhan Türkçapar, Ozan, Şen, Edoardo, Baldini, Luigi, Conti, Cacio, Wietzycoski, Eduardo, Lopes, Tadeja, Pintar, Jure, Salobir, Cengiz, Aydin, Semra Demirli Atici, Anıl, Ergin, Huseyin, Ciyiltepe, Mehmet Abdussamet Bozkurt, Mehmet Celal Kizilkaya, Nezihe Berrin Dodur Onalan, Mariana Nabila Binti Ahmad Zuber, Wei Jin Wong, Amador, Garcia, Laura, Vidal, Marc, Beisani, Jorge, Pasquier, Ramon, Vilallonga, Sharad, Sharma, Chetan, Parmar, Lyndcie, Lee, Pratik, Sufi, Hüseyin, Sinan, and Mehmet, Saydam

Subjects
Nutrition and Dietetics, Manchester Cancer Research Centre, SARS-CoV-2, ResearchInstitutes_Networks_Beacons/mcrc, Endocrinology, Diabetes and Metabolism, obesity, older patients, resuming elective surgery, metabolic surgery, Resuming elective surgery, Bariatric Surgery, COVID-19, Metabolic surgery, Obesity, Older patients, Aged, Humans, Pandemics, Postoperative Complications, Prospective Studies, Obesity, Morbid, Surgery, Morbid
Abstract

Background Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort. Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups — patients ≥ 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality. Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 ± 2.5 years, 119.5 ± 24.5 kg, and 43 ± 7 in Group I and 39.8 ± 11.3 years, 117.7±20.4 kg, and 43.7 ± 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I (11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups. Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those ≥ 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups. Graphical abstract

Published
2022

8. Low-dose interleukin-2 administered pre-operatively to patients with gastric cancer activates peripheral and peritumoral lymphocytes but does not affect prognosis

Author

Howard L. Kaufman, Marco Scotti, Fabrizio Romano, Franco Uggeri, Giacomo Aletti, Ambrogio Brenna, Gaia Piacentini, Massimo Vaghi, Giorgio Bovo, Giovanni Carlo Cesana, Roberto Caprotti, Cesana, G, Romano, F, Piacentini, M, Scotti, M, Brenna, A, Bovo, G, Vaghi, M, Aletti, G, Caprotti, R, Kaufman, H, and Uggeri, F

Subjects
Interleukin 2, Oncology, CD4-Positive T-Lymphocytes, Male, Pathology, medicine.medical_specialty, medicine.medical_treatment, T-Lymphocytes, Antineoplastic Agents, Adenocarcinoma, CD8-Positive T-Lymphocytes, Lymphocyte Activation, Preoperative care, Immune system, Lymphocytes, Tumor-Infiltrating, Surgical oncology, Stomach Neoplasms, Internal medicine, Preoperative Care, MED/18 - CHIRURGIA GENERALE, medicine, Humans, Lymphocyte Count, Neoadjuvant therapy, Aged, business.industry, Case-control study, IL-2, gastric cancer, survival, Cancer, Immunotherapy, medicine.disease, Prognosis, Neoadjuvant Therapy, Settore MAT/06 - Probabilita' e Statistica Matematica, Killer Cells, Natural, Case-Control Studies, Interleukin-2, Clinical trial - Gastric carcinoma - Interleukin-2 - Treatment, Surgery, Female, business, medicine.drug
Abstract

Background: There is evidence that cancer is immunogenic under certain situations. IL-2 is described to stimulate an effective antitumor immune response in vitro and in vivo. The ability of cancer patients to undergo surgical resection is still the most important prognostic factor for many solid tumors, including gastric adenocarcinoma. The host immune system may be further compromised by surgical procedures leading to a generalized state of immunodepression in the post-operative period. The aim of this randomized case-control study is to evaluate the effects of pre-operative low-dose IL-2 treatment on patients with gastric adenocarcinoma who undergo surgery. Methods: Sixty-eight patients with gastric adenocarcinoma were enrolled in the study and randomized in two groups: 36 patients were pre-treated with IL-2 and 32 underwent surgery without any treatment. Total peripheral WBC, neutrophils, CD3+ T, CD4+ T, CD8+ T and NK cells were obtained before and after surgery, at different times. Peritumoral infiltration was analyzed on all surgical specimens. Overall survival and relapse-free survival were studied with a median follow-up of 51 months. Results: Low-dose IL-2 treatment resulted in an increase peritumoral lymphocytic and eosinophilic infiltrations and in a minor decrease in CD3+ T and CD4+ T cells after surgery (P < 0.05). A stepwise multivariate analysis revealed that overall survival and relapse-free survival were affected only by stage of tumor and age of patients. Conclusions: According to our data low-doses of IL-2 administered pre-operatively to patients with gastric cancer activate peripheral and peri-tumoral lymphocytes but did not affect prognosis. © 2007 Society of Surgical Oncology.

Published
2006

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