Digestive Surgery最新文献

{"title":"Treatment of EGJ Cancer within or outside Clinical Trials: Does the Setting Matter? A Monocentric Prospective Observational Study.","authors":"Simone Giacopuzzi,&nbsp;Lorena Torroni,&nbsp;Maria Bencivenga,&nbsp;Jacopo Weindelmayer,&nbsp;Maria Clelia Gervasi,&nbsp;Giuseppe Verlato,&nbsp;Michele Pavarana,&nbsp;Gabriella Rossi,&nbsp;Giovanni de Manzoni","doi":"10.1159/000529199","DOIUrl":"https://doi.org/10.1159/000529199","url":null,"abstract":"<p><strong>Introduction: </strong>RCTs support neoadjuvant chemoradiotherapy (nCRT) followed by surgery in locally advanced esophago-gastric junction (LA-EGJ) adenocarcinoma. However, RCTs are performed in highly controlled settings with limited representativeness of real-life patients (RLS). The aim of the study was to compare the outcomes in RLS and clinical trial settings.</p><p><strong>Methods: </strong>The outcomes of RLS, which comprised 125 patients consequently treated for LA-EGJ adenocarcinoma between 2012 and 2017, were compared with the phase II trial (PIIS), performed on 65 patients from 2003 to 2011.</p><p><strong>Results: </strong>About half of RLS (51.2%) were treated with nCRT according to VR protocol, 20.8% with standard CRT according to CROSS/Al-Sarraf, 20% with chemotherapy (CT) alone. pCR was 36.8%, 28.6%, and 9.1% after VR protocol, standard CRT, and CT, respectively (p = 0.082), while 3-year overall survival (OS) was 58.6% (95% CI 43.2-71.1%), 32.8% (14.6-52.4%), and 44.8% (21.3-65.9%), respectively (p = 0.030). With respect to PIIS, RLS had a higher proportion of cN+ (94% vs. 54%; p < 0.001) and a lower proportion of pCR after CT/CRT (23% vs. 39%; p = 0.041). Three-year OS was slightly higher, although not significantly, in PIIS (58.9%, 45.1-70.2%) than RLS (47.9%, 37.4-57.7%) and nearly identical to 3-year OS in RLS treated with VR protocol.</p><p><strong>Conclusion: </strong>Real-life patients with EGJ adenocarcinoma have more advanced cancer at baseline, lower pathologic response to neoadjuvant treatment than patients enrolled in clinical trials, but similar survival.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"21-30"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9819886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologic Complete Response after Chemotherapy with Atezolizumab plus Bevacizumab for Hepatocellular Carcinoma with Tumor Thrombus in the Main Portal Trunk.","authors":"Ken Kurisaki,&nbsp;Akihiko Soyama,&nbsp;Takanobu Hara,&nbsp;Hajime Matsushima,&nbsp;Hajime Imamura,&nbsp;Takayuki Tanaka,&nbsp;Tomohiko Adachi,&nbsp;Shinichiro Ito,&nbsp;Kengo Kanetaka,&nbsp;Masaaki Hidaka,&nbsp;Shinji Okano,&nbsp;Susumu Eguchi","doi":"10.1159/000529405","DOIUrl":"https://doi.org/10.1159/000529405","url":null,"abstract":"<p><p>We report a case of pathologic complete response after successful treatment for advanced hepatocellular carcinoma (HCC) complicated with portal venous tumor thrombus with atezolizumab and bevacizumab followed by radical resection. The patient was a male in his 60s. During follow-up for chronic hepatitis B, abdominal ultrasonography revealed a huge tumor located in the right lobe of the liver with the portal vein thrombosed by the tumor. The tumor thrombus extended to the proximal side of the left branch of the portal vein. The patient's tumor marker levels were elevated (alpha-phetoprotein, 14,696 ng/mL; PIVKA-II, 2,141 mAU/mL). Liver biopsy revealed poorly differentiated HCC. The lesion was categorized as advanced stage according to the BCLC staging system. As systemic therapy, atezolizumab plus bevacizumab was administered. Imaging showed marked shrinkage of the tumor and portal venous thrombus with a remarkable decrease of tumor marker levels after 2 courses of chemotherapy. After 3 additional courses of chemotherapy, radical resection was considered possible. The patient underwent right hemihepatectomy and portal venous thrombectomy. A pathological examination revealed a complete response. In conclusion, we experienced a case in which advanced HCC was curatively treated with atezolizumab plus bevacizumab, which was administered as systemic therapy with a view to conversion surgery.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"84-89"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9829306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significantly Lower Physical Activity Participation in Individuals with Chronic Pancreatitis Compared to Controls: An Exploratory Study of Objectively Assessed Physical Activity Levels.","authors":"Brenda Monaghan,&nbsp;Ann Monaghan,&nbsp;Qurat Ul Ain,&nbsp;Sinead N Duggan,&nbsp;Kevin C Conlon,&nbsp;John Gormley","doi":"10.1159/000530543","DOIUrl":"https://doi.org/10.1159/000530543","url":null,"abstract":"<p><strong>Introduction: </strong>The beneficial effects of exercise and physical activity (PA) have been demonstrated in many chronic inflammatory diseases. Knowledge on PA levels is unknown in the chronic pancreatitis population, and there are currently no specific PA recommendations for this condition.</p><p><strong>Methods: </strong>PA was measured objectively over a 7-day period in 17 individuals with chronic pancreatitis using an accelerometer (ActiGraph) and in 15 controls, matched for age, sex, and body mass index.</p><p><strong>Results: </strong>Participants with chronic pancreatitis spent a significantly lower amount of time in moderate, light, and moderate/vigorous activity compared to the healthy control group. Mean time in light activity in the chronic pancreatitis group was 825.4 ± 972 (standard deviation [SD]) compared to 1,500 ± 958 (SD) in the healthy control group. Moderate activity mean minutes were 61.6 ± 85 in the chronic pancreatitis group compared to 161.4 ± 131.2 in the healthy control group. Moderate/vigorous mean minutes were 62.1 ± 86 (SD) in the chronic pancreatitis group compared to 164.3 ± 132 (SD) in the healthy control group. There was no significant difference found between the groups for either vigorous activity or time spent sedentary.</p><p><strong>Conclusion: </strong>This exploratory study offers early objective evidence that activity levels in the chronic pancreatic group are not meeting current international recommendations. Further investigation of this chronic illness population is strongly recommended.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"69-75"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9832617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Hepatobiliary Scintigraphy as the Initial Investigative Modality for Significant Bile Leak following Laparoscopic Cholecystectomy.","authors":"Amitai Bickel, Ron Lagrissi, Jacqueline Jerushalmi, Wisam Sbeit, Michael Weiss, Moshe Shiller, Samer Ganam, Eli Kakiashvili","doi":"10.1159/000533794","DOIUrl":"10.1159/000533794","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, the rate of bile duct injury and leak following laparoscopic cholecystectomy (LC) is still higher than for open surgery. Diverse investigative algorithms were suggested for bile leak, shifting from hepatobiliary scintigraphy (HBS) toward invasive and more sophisticated means. We aimed to analyze the use of biliary scan as the initial modality to investigate significant bile leak in the drain following LC, attempting to avoid potential unnecessary invasive means when the scan demonstrate fair passage of nuclear substance to the intestine, without leak.</p><p><strong>Methods: </strong>We have conducted a prospective non-randomized study, mandating hepatobiliary scintigraphy first, for asymptomatic patients harboring drain in the gallbladder fossa, leaking more than 50 mL/day following LC. Analysis was done based on medical data from the surgical, gastroenterology, and the nuclear medicine departments.</p><p><strong>Results: </strong>Among 3,124 patients undergoing LC, significant bile leak in the drain was seen in 67 subjects, of whom we started with HBS in 50 patients, presenting our study group. In 27 of whom, biliary scan was the only investigative modality, showing fair passage of the nuclear isotope to the duodenum and absence of leak in the majority. The leak stopped spontaneously within a mean of 3.6 days, and convalescence as well as outpatient clinic follow-up was uneventful. In 23 patients, biliary scan that was interpreted as abnormal was followed by endoscopic retrograde cholangio-pancreatography (ERCP). However, ERCP did not demonstrate any bile leak in 13 subjects. In 17 patients, ERCP was used initially, without biliary scan, suggesting the possibility of avoiding invasive modalities in 7 patients.</p><p><strong>Conclusions: </strong>Based on a negative predictive value of 91%, we suggest that in cases of asymptomatic significant bile leak through a drain following LC, a normal HBS as the initial modality can safely decrease the rate of using invasive modalities.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"178-186"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41119121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Anastomosis in Robotic-Assisted Pancreaticoduodenectomy: Different Surgical Techniques.","authors":"Matteo De Pastena,&nbsp;Elisa Bannone,&nbsp;Elena Andreotti,&nbsp;Chiara Filippini,&nbsp;Marco Ramera,&nbsp;Alessandro Esposito,&nbsp;Roberto Salvia","doi":"10.1159/000528646","DOIUrl":"https://doi.org/10.1159/000528646","url":null,"abstract":"<p><p>Robot-assisted pancreatoduodenectomy (R-PD) may provide challenges but potential benefits for pancreatic-enteric anastomosis fashioning. Despite numerous trials comparing different pancreatic-enteric anastomosis techniques, an ideal method is still missing. This study aims to describe different management strategies and surgical techniques of standardized pancreatic-enteric anastomoses during an R-PD. This study reported the robotic technical steps of the modified end-to-side Blumgart pancreaticojejunostomy, the Cattel-Warren duct-to-mucosa pancreatojejunostomy, with internal or external pancreatic duct stent, and the modified end-to-side, double-layer pancreogastrostomy. A dual-console da Vinci Xi Surgical System® (Intuitive Surgical Xi, Sunnyvale, CA) was used to perform all the R-PD. Different robotic pancreatic-enteric anastomosis techniques can be used during the reconstruction phase, possibly reproducing the open technique. The type of anastomosis and applied mitigation strategies should balance surgical strategy adaptability and operative technique standardization. R-PD should be performed in high-volume centers by surgeons with extensive experience in pancreatic and advanced MI surgery, enabling different but standardized anastomotic techniques based on patients' risk factors and intraoperative findings. Future studies on robotic pancreatic anastomosis should focus on personalized approaches after adequate risk stratification.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"1-8"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9832161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"Weekday Effect\" on Enhanced Recovery after Surgery Protocol for Gastrectomy.","authors":"Jacopo Weindelmayer,&nbsp;Valentina Mengardo,&nbsp;Lorena Torroni,&nbsp;Maria Clelia Gervasi,&nbsp;Selma Hetoja,&nbsp;Carlo Alberto De Pasqual,&nbsp;Davide Simion,&nbsp;Simone Giacopuzzi","doi":"10.1159/000531022","DOIUrl":"https://doi.org/10.1159/000531022","url":null,"abstract":"<p><strong>Introduction: </strong>While enhanced recovery after surgery (ERAS) protocol demonstrated to improve outcomes after gastrectomy, some papers evidenced a detrimental effect on postoperative morbidity related to the \"weekday effect.\" We aimed to understand whether the day of gastrectomy could affect postoperative outcomes and compliance with ERAS items.</p><p><strong>Methods: </strong>We included all patients that underwent gastrectomy for cancer between January 2017 and September 2021. Cohort was divided considering the day of surgery: Early group (Monday-Wednesday) and Late group (Thursday-Friday). Compliance with protocol and postoperative outcomes were compared.</p><p><strong>Results: </strong>Two hundred twenty-seven patients were included in Early group, while 154 were in Late group. The groups were comparable in preoperative characteristics. No significant difference in pre/intraoperative and postoperative ERAS items' compliance was apparent between Early and Late groups, with most items exceeding the 70% threshold. Median length of stay was 6.5 days and 6 days in Early and Late groups (p = 0.616), respectively. Morbidity was 50% in both groups, with severe complications that occurred in 13% of Early patients and 15% of Late patients. Ninety-day mortality was 2%, and it was similar between the two groups.</p><p><strong>Conclusions: </strong>In a center with a standardized ERAS protocol, the weekday of gastrectomy has no significant impact on the success of each ERAS item and on postoperative surgical and oncological outcomes.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 3-4","pages":"100-107"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of Two Scoring Tools to Predict the Operative Duration and Open Conversion of Elective Laparoscopic Cholecystectomy in a Mexican Population.","authors":"Gustavo Martínez-Mier,&nbsp;Daniel Mendez-Rico,&nbsp;José Manuel Reyes-Ruiz,&nbsp;Pedro Ivan Moreno-Ley,&nbsp;Victor Bernal-Dolores,&nbsp;Octavio Avila-Mercado","doi":"10.1159/000531087","DOIUrl":"https://doi.org/10.1159/000531087","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the use of laparoscopic cholecystectomy (LC) operative time (CholeS score) and conversion to an open procedure (CLOC score) outside their validation dataset in Mexican population.</p><p><strong>Methods: </strong>Patients &gt;18 years who underwent elective LC were analyzed in a single-center retrospective chart review study. Association between scores (CholeS and CLOC) with operative time and conversion to open procedures was assessed with Spearman correlation. The predictive accuracy of the CholeS score and CLOC score was evaluated by receiver operator characteristic.</p><p><strong>Results: </strong>200 patients were included in the study (33 excluded for emergency case or missing data). Spearman coefficient correlations between CholeS or CLOC score and operative time were 0.456 (p &lt; 0.0001) and 0.356 (p &lt; 0.0001), respectively. Area under the curve (AUC) for operative prediction time (&gt;90 min) by CholeS score was 0.786 with a 3.5-point cutoff (80% sensitivity and 63.2% specificity). AUC for open conversion (CLOC score) was 0.78 with a 5-point cutoff (60% sensitivity and 91% specificity). The CLOC score had a 0.740 AUC (64% sensitivity and 72.8% specificity) for operative time &gt;90 min.</p><p><strong>Conclusions: </strong>The CholeS and the CLOC scores predicted LC long operative time and risk for conversion to an open procedure, respectively, outside their original validation set.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 3-4","pages":"108-113"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Other Pathologies Were Rarely Reported after Laparoscopic Surgery for Suspected Appendicitis: A Systematic Review and Meta-Analysis.","authors":"Siri Rønholdt Henriksen,&nbsp;Jacob Rosenberg,&nbsp;Siv Fonnes","doi":"10.1159/000531283","DOIUrl":"https://doi.org/10.1159/000531283","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic laparoscopy is often used when a patient is suspected of having acute appendicitis. The aim of this study was to assess the rate of other pathologies found during diagnostic laparoscopy for suspected acute appendicitis.</p><p><strong>Methods: </strong>This systematic search included studies with ≥100 patients who received laparoscopy for suspected acute appendicitis and reported on the histopathologic and other intra-abdominal findings. We performed a meta-analysis estimating the rate of other pathologies, and a sensitivity analysis excluding smaller cohorts (≤500 patients). Age groups, sex, specific findings, and geographic regions were investigated. Certainty of evidence was assessed with GRADE.</p><p><strong>Results: </strong>A total of 27 studies were included covering 25,547 patients and of these 793 had an unexpected pathology. The findings were benign pathology in the appendix (34%), malignancy (30%), gynecologic pathology (5%), gastrointestinal pathology (4%), or unspecified (27%). Meta-analysis showed an overall rate of unexpected findings of 3.5% (95% CI 2.7-4.3; moderate certainty), and the sensitivity analysis showed similar results. Malignancy found in the appendix when treating suspected acute appendicitis was 1.0% (95% CI 0.8-1.3%; high certainty).</p><p><strong>Conclusion: </strong>The rate of other histopathological findings in patients with suspected acute appendicitis was low and a malignancy in appendix was found in 1% of patients.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 3-4","pages":"91-99"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sarcopenic Obesity on Severe Postoperative Complications in Patients with Gastric Cancer Undergoing Gastrectomy.","authors":"Shunsuke Yamagishi, Yukiyasu Okamura, Woodae Kang, Masataka Shindate, Mitsugu Kochi, Yusuke Mitsuka, Megumu Watabe, Nao Yoshida, Masahito Ikarashi, Shintaro Yamazaki, Osamu Aramaki, Hisashi Nakayama, Masamichi Moriguchi, Tokio Higaki, Hiroharu Yamashita","doi":"10.1159/000531797","DOIUrl":"10.1159/000531797","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have indicated that sarcopenia affects the short- and long-term outcomes of cancer patients, including those with gastric cancer. In recent years, sarcopenic obesity and its effects have been reported in cancer patients. This study aimed to evaluate the impact of sarcopenic obesity on postoperative complications in patients with gastric cancer undergoing gastrectomy.</p><p><strong>Methods: </strong>This single-center, retrospective study included 155 patients who underwent curative gastrectomy for gastric cancer from January 2015 to July 2021. Sarcopenia was defined by the psoas muscle index (&lt;6.36 cm2/m2 in men and &lt;3.92 cm2/m2 in women), which measures the iliopsoas muscle area at the lumbar L3 level using computed tomography. Obesity was defined by body mass index (≥25). Patients with both sarcopenia and obesity were defined as the sarcopenic obesity group and others as the non-sarcopenic obesity group. Severe postoperative complications were defined as Clavien-Dindo classification grade IIIa or higher.</p><p><strong>Results: </strong>Of the 155 patients, 26 (16.8%) had sarcopenic obesity. The incidence of severe postoperative complications was significantly higher in the sarcopenic obesity group (30.8% vs. 10.9%; p = 0.014). Multivariate analysis indicated that sarcopenic obesity was an independent risk factor for severe postoperative complications (odds ratio, 3.950; 95% confidence interval, 1.390-11.200; p = 0.010).</p><p><strong>Conclusion: </strong>Sarcopenic obesity is an independent risk factor for severe postoperative complications.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"143-152"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Revision of Vertical Banded Gastroplasty to Roux-En-Y Gastric Bypass with 2 Years of Follow-Up].","authors":"Medhat Mohamed Helmy Khalil,&nbsp;Gad Behairy,&nbsp;Ahmed Farrag,&nbsp;Mohab G Elbarbary","doi":"10.1159/000529603","DOIUrl":"https://doi.org/10.1159/000529603","url":null,"abstract":"<p><strong>Background: </strong>Due to weight regain and GIT symptoms associated with vertical banded gastroplasty (VBG), revisional surgery is necessary. Roux-en-Y gastric bypass (RYGB) is one of the best options as a revision procedure but comes with a high complication rate.</p><p><strong>Methods: </strong>This prospective study included 80 patients undergoing RYGB surgery at Ain Shams University Hospitals after failed VBG surgery, with up to 2 years of follow-up.</p><p><strong>Results: </strong>Eighty patients underwent RYGB correction after VBG. The mean age was 42 ± 6.45 (39-58) years and the mean preoperative body mass index was 45.46 ± 4.135 (38-55) kg/m2. The median length of hospital stay for the patients was 4.78 ± 1.84 days. The early postoperative complication rate was 8.7% and the reoperation rate within 30 days was 3.75%, with no mortality. Leakage and bowel injury were detected in 2 patients. After an average follow-up of 2 years, the percentage of EWL was 64.47 ± 19.3, and complete resolution of VBG-related GIT symptoms was achieved in approximately all patients. Late complications occurred in 7.5% of patients, of whom 3.75% required surgery.</p><p><strong>Conclusion: </strong>Conversion to RYGB is feasible with a limited short-term complication and reoperation rate; long-term results show a nearly complete resolution of VBG-related symptoms and a statistically significant positive impact on weight loss.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"31-38"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9819899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}