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Browsing by Author "Parmar, C"

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  • Esophageal and Gastric Malignancies After Bariatric Surgery: a Retrospective Global Study
    Publication . 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, V
    Background: 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.
    2022-04Journal article Open access Show more
  • Outcomes of Long Pouch Gastric Bypass (LPGB): 4-Year Experience in Primary and Revision Cases
    Publication . Ribeiro, R; Pouwels, S; Parmar, C; Pereira, J; Manaças, L; Guerra, A; Borges, N; Ribeiro, J; Viveiros, O
    Background: One of the most important complications of the one anastomosis gastric bypass (OAGB) is enterobilio acid reflux (EBAR). We report the concept of the long pouch Roux-en-Y gastric bypass (LPRYGB) meaning a Roux-en-Y with a long pouch and a 100-cm alimentary limb to avoid EBAR, with a long biliopancreatic limb to increase metabolic effects. Methods: A total of 300 LPRYGB cases in a 4-year period, with a 90% follow-up rate, were analysed. Anthropometric, technical feasibility, morbidity, weight loss and comorbidity outcomes were analysed. Results: The percentage total weight loss (%TWL) was 30.5% at 4 years of follow-up (32.3% in primary and 28.3% in revisions). Six intra-operative (2%) and 28 postoperative complications (9.3%) were seen. Out of this 28 complications, 11 (3.6%) were late complications. Reoperations were performed in 15 patients (5.0%). Clinically relevant EBAR was present in 3 cases only (1%) 4 years after the operation. Conclusions: The LPRYGB combines the main advantages of the OAGB (light restriction and moderate malabsorption) with the anti-reflux effect from the Roux-en-Y diversion.
    2019Journal article Open access Show more