排序方式: 共有17条查询结果,搜索用时 15 毫秒
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Pauline Faucher Christine Poitou Claire Carette Sophie Tezenas du Montcel Charles Barsamian Eliabelle Touati Jean-Luc Bouillot Adriana Torcivia Sébastien Czernichow Jean-Michel Oppert Cécile Ciangura 《Obesity surgery》2016,26(10):2370-2378
Background
Type 1 diabetes patients, although typically lean, experience an increased prevalence of obesity, and bariatric surgery is considered in severe cases. Bariatric surgery in such patients leads to significant weight loss and decreased insulin requirements; however, effects on glycemic control remain discussed. We assessed, in obese patients with type 1 diabetes, the effects of bariatric surgery upon body weight, body composition, and glycemic control, including the occurrence of hypoglycemic events.Methods
Thirteen obese patients with type 1 diabetes who underwent bariatric surgery (Roux-en-Y gastric bypass n?=?6, sleeve gastrectomy n?=?7) were matched with obese patients without diabetes and with type 2 diabetes patients during 12 months of follow-up. Outcomes included body weight, DXA-assessed body composition, HbA1c, and incidence of hypoglycemia.Results
At 12 months, median surgery-induced weight loss was 27.9 % (21.1–33.3), 26.1 % (24.8–29.7), and 27.5 % (21.8–32.1) in patients with type 1 diabetes, type 2 diabetes, and without diabetes, respectively, with no significant differences across the groups. Similar findings were observed for body fat changes. At 12 months, median HbA1c decreased from 8.3 to 7.6 % in type 1 diabetes patients versus 8.0 to 5.9 % in type 2 diabetes patients (P?=?0.04 between the groups). In type 1 diabetes patients, the number of reported minor hypoglycemia increased transiently only at 6 months. Two patients reported severe hypoglycemia (one episode each).Conclusions
Type 1 diabetes patients benefit from bariatric surgery in terms of weight loss and glycemic control. Close monitoring of insulin therapy appears warranted to prevent minor hypoglycemia in the first months post-surgery.3.
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Grassi N Cipolla C Torcivia A Mandala S Graceffa G Bottino A Latteri F 《World journal of gastroenterology : WJG》2008,14(8):1302-1304
Gastrointestinal stromal tumour (GIST) is a rare tumour of the gastrointestinal tract which does not generally originate in the rectum. The authors describe a case of a 70-year-old man who underwent an anterior resection of the rectum for a low-risk GIST. The patient was not given adjuvant chemotherapy with imatinib and is still disease-free 30 mo after surgery. The authors conclude that although rectal GIST is extremely uncommon, it should be included in differential diagnosis when a tumour in the rectum is detected. Biopsy of the tumour is essential, since this makes it possible to reach a sure preoperative diagnosis based on the immunohistological features of the CDl17 and CD34. Although complete surgical resection with negative tumour margins is the principal curative procedure for primary and nonmetastatic tumours, further studies are still needed for the determination of the most effective treatment strategy for patients with rectal GIST. 相似文献
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Elie Chouillard Arnaud Dache Adriana Torcivia Nada Helmy Ivan Ruseykin Andrew Gumbs 《Surgical endoscopy》2010,24(8):1861-1865
Background
Natural orifice translumenal endoscopic surgery (NOTES) is a major conceptual change in the field of modern surgery. However, corresponding technological refinements are not yet available to fill the gap separating the current laparoscopy from the NOTES of the future. Meanwhile, “hybrid” NOTES techniques, including single-port procedures, have been increasingly reported. This report describes a technique of single-incision laparoscopic appendectomy (SILA) for selected patients with acute appendicitis. 相似文献7.
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Lazzati A Polliand C Porta M Torcivia A Paolino LA Champault G Barrat C 《Obesity surgery》2011,21(12):1859-1863
Anterior fixation via a gastro-gastric suture in laparoscopic adjustable gastric banding (LAGB) is commonly performed to prevent
band-related complications. However, the necessity of this common technique has never been proven. Not fixing the band would
be time sparing and would reduce adhesions on the stomach and probably make revisional surgery easier. This study was conceived
as a 3-year randomised clinical trial to test the safety and efficacy of the non-fixation technique. From December 2006 to
December 2007, 81 patients undergoing LAGB were randomly distributed into two groups: group A, with gastro-gastric sutures
(n = 41) and group B, without gastro-gastric fixation (n = 40). The two groups were equivalent regarding initial body mass index (BMI), age and sex ratio. The main outcome was postoperative
complications and secondary outcomes were operative time and weight loss expressed by the percentage of excess BMI loss (%EBMIL).
All patients were prospectively followed up for 2 years. The mean preoperative BMI was 42.5 kg/m2 (35–56). All patients were
available for follow-up at 2 years. The mean overall preoperative time was 82 ± 20 min for the fixation group and 72 ± 20 min
for the non-fixation group (p = 0.13). The mean hospital stay was 4.1 ± 1.5 days (no significant difference between the two groups). The 2-year %EBMIL
was 35.9 for group A and 39.4 for group B (p = NS). The mean BMI at 2 years was 36.3 and 36.1, respectively, with no statistical difference. We observed three early band
slippages in the non-fixation group and none in the fixation group. Three bands were removed during the second year of follow-up
for causes other than band slippage (no significant difference between the two groups). This study was interrupted before
a statistical significance could be reached, under the general agreement of all participating surgeons, because of the three
unexpected early band slippages. For the patients who did not suffer from this complication, we did not observe any differences
between the two groups in terms of late complications and weight loss. The operative time was shorter in the non-fixation
group. This randomised clinical trial suggests that care should be taken when not fixating the LAGB because of the risk of
early postoperative band slippage. We suggest that fixing the LAGB by gastro-gastric sutures should remain common practice. 相似文献
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Adriana Torcivia Corinne Vons Christophe Barrat Fanny Dufour Gerard Champault 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2011,396(2):173-178
Background
Early post-operative pain after inguinal hernia repair delays management in ambulatory setting. The type of mesh used for repair appears to influence their incidence. 相似文献10.
Benzadón MN Ortega DF Thierer JM Torcivia RA Aldunate L de Lima AE Navia D Dorsa A Rossi A Trivi M 《The American journal of cardiology》2006,98(7):978-981
Recognition of the P wave is important for the correct characterization of atrial and ventricular arrhythmias. When the P wave is difficult to identify on standard electrocardiography (SECG), either esophageal electrocardiography (EECG) or intracardiac electrocardiography (IC-ECG), central venous catheter may be used. The feasibility of these methods has already been demonstrated, but there is no published study comparing them. This study compared the amplitude of the P wave obtained by IC-ECG with those of the P waves obtained by EECG and SECG. SECG, EECG, and IC-ECG were performed on each patient. IC-ECG and EECG made it possible to register P waves larger than registered by SECG (p <0.00001). The difference between the largest P waves obtained with IC-ECG (5.93 +/- 3.56 mm) and EECG (4.67 +/- 2.16 mm) was not statistically significant (p = 0.1953). In conclusion, IC-ECG is easy to perform and magnifies the P wave at least as effectively as EECG. 相似文献