Browsing by Author "Himpens, J"
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- Conversion of Adjustable Gastric Banding to Roux-en-Y Gastric Bypass in One or Two Steps: What Is the Best Approach? Analysis of a Multicenter Database Concerning 832 PatientsPublication . Pujol-Rafols, J; Abbas, A; Devriendt, S; Guerra, A; Herrera, M; Himpens, J; Pardina, E; Pouwels, S; Ramos, A; Ribeiro, R; Safadi, B; Sanchez-Aguilar, H; Vries, C; Wagensveld, BBackground: Roux-en-Y gastric bypass (RYGB) is often the preferred conversion procedure for laparoscopic adjustable gastric banding (LAGB) poor responders. However, there is controversy whether it is better to convert in one or two stages. This study aims to compare the outcomes of one and two-stage conversions of LAGB to RYGB. Methods: Retrospective review of a multicenter prospectively collected database. Data on conversion in one and two stages was compared. Results: Eight hundred thirty-two patients underwent LAGB conversion to RYGB in seven specialized bariatric centers. Six hundred seventy-three (81%) were converted in one-stage. Patients in the two-stage group were more likely to have experienced technical complications, such as slippage or erosions (86% vs. 37%, p = 0.0001) and to have had a higher body mass index (BMI) (41.6 vs. 39.9 Kg/m2, p = 0.005). There were no differences in postoperative complications and mortality rates between the one-stage and two-stage groups (13.5% vs. 10.8%, and 0.7% vs. 0.0% respectively, p = ns). Mean final BMI and %total weight loss (%TWL) for the one-stage and the two-stage groups were 31.6 vs. 32.4 Kg/m2 (p = ns) and 30.4 vs. 26.8 (p = 0.017) after a mean follow-up of 33 months. Follow-up at 1, 3, and 5 years was 98%, 75%, and 54%, respectively. Conclusions: One-stage conversion of LAGB to RYGB is safe and effective. Two-stage conversion carries low morbidity and mortality in the case of band slippage, erosion, or higher BMI patients. These findings suggest the importance of patient selection when choosing the appropriate conversion approach.
- Esophageal and Gastric Malignancies After Bariatric Surgery: a Retrospective Global StudyPublication . Parmar, C; Zakeri, R; Abouelazayem, M; Shin, T; Aminian, A; Mahmoud, T; Abu Dayyeh, B; Wee, M; Fischer, L; Daams, F; Mahawar, K; Gallardo, C; Agustin, C; Wright, F; Fuente, I; Carbajo, M; Cal, P; Chisholm, J; Kow, L; Tan, M; Gan, P; Gananadha, S; Felsenreich, D; Prager, G; Matthys, C; Himpens, J; Focquet, M; Ramos, A; Nato, M; Vidal, T; Andalib, A; Siblini, A; Ferri, L; Abdarabo, L; Nevo, Y; Pescarus, R; Yang, W; Hamed, H; Liagre, A; Bergeat, D; Marie, De M; Martini, F; Regis, F; Genser, L; Skalli, M; Nedelcu, M; Smejkal, M; Kassir, R; Nicolas, R; Stier, C; Nedelcut, DS; Christodoulidis, G; Vennapusa, A; Kermansaravi, M; Raziel, A; Sakran, N; Oldani, A; Boru, C; Mécheri, F; Ciccarese, F; Cesana, G; Musella, M; Uccelli, M; Foletto, M; Auricchio, P; Olmi, S; Seki, Y; Kasteleijn, A; Van 'T Hof, G; Apers, J; Hart, J; Van De Sande, J; Takkenberg, M; Feskens, P; Snoekx, R; Plat, V; Sandvik, J; Kalinowski, P; Nabais, C; Al-Bahrani, A; Al Zoubi, M; Bettonica, C; Osorio, J; Tejedor-Tejada, J; Sanz, L; Cuadrado, M; Moorjani, R; Yannick, F; Suter, M; Borbély, Y; Joerg, Z; Barajas-Gamboa, J; Kroh, M; Kisiel, A; Kamocka, A; Immanuel, A; Sgromo, B; Gopinath, B; Khoo, D; Mukherjee, S; Pournaras, D; Underwood, T; Griffiths, E; Miller, G; Jaretzke, H; Dmitrewski, J; Wadley, M; Al-Housni, R; Gillies, R; Singhal, R; Preston, S; Robinson, S; Hawkins, W; Adamo, M; El Kalaawy, M; Gossage, J; Crawford, C; Jaruvongvanich, VBackground: Bariatric surgery can influence the presentation, diagnosis, and management of gastrointestinal cancers. Esophagogastric (EG) malignancies in patients who have had a prior bariatric procedure have not been fully characterized. Objective: To characterize EG malignancies after bariatric procedures. Setting: University Hospital, United Kingdom. Methods: We performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition. Results: This study includes 170 patients from 75 centers 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. Women composed 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 tumors were adenocarcinoma (82.9%). Approximately 1 in 5 patients underwent palliative treatment from the outset. Time from diagnosis to mortality was under 1 year for most patients who died over the intervening period. Conclusion: The Oesophago-Gastric Malignancies After Obesity/Bariatric Surgery study presents the largest series to date of patients developing EG malignancies after bariatric surgery and attempts to characterize this condition.