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1.
Chinese Journal of Gastrointestinal Surgery ; (12): 36-38, 2012.
Artículo en Chino | WPRIM | ID: wpr-290858

RESUMEN

<p><b>OBJECTIVE</b>To investigate the efficacy and feasibility of duodenojejunal bypass(DJB)on non-severe obese patients with type 2 diabetes mellitus(T2DM).</p><p><b>METHODS</b>The body mass index (BMI), fasting plasma glucose(FPG), 2h-postprandial plasma glucose(2hPG), fasting insulin(F-ins), fasting c-peptide(F-CP), glycated hemoglobin and hypoglycemic agents dose changes were tested in 7 patients with non-severe obese T2DM undergoing DJB, preoperatively and within 24 weeks after surgery during the follow-up. Data were collected and the clinical outcomes of T2DM were analyzed.</p><p><b>RESULTS</b>In 7 cases of non-obese T2DM who underwent DJB, one patient was weaned off hypoglycemic agents with normal FPG, 2hPG and HbA1c postoperatively. Five required significantly lower dosage. No significant improvement in 1 case. Complete remission rate of hyperglycemia was 1/7, effective rate was 6/7, and effective rate of HbA1c was 5/7. No significant changes in BMI were observed between the preoperative and postoperative phases.</p><p><b>CONCLUSION</b>Plasma glucose level can be markedly reduced by duodenojejunal bypass in non-obese T2DM, independent of weight loss, and the mechanism remains unclear.</p>


Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cirugía Bariátrica , Métodos , Diabetes Mellitus Tipo 2 , Cirugía General , Duodeno , Cirugía General , Estudios de Seguimiento , Yeyuno , Cirugía General , Obesidad , Resultado del Tratamiento
2.
Chinese Journal of Gastrointestinal Surgery ; (12): 440-442, 2011.
Artículo en Chino | WPRIM | ID: wpr-237101

RESUMEN

<p><b>OBJECTIVE</b>To evaluate clinical outcomes after laparoscopic total mesorectal excision (TME) combined with intersphincteric resection (ISR) for ultra-low rectal tumors.</p><p><b>METHODS</b>Clinical data of 36 patients with ultra-low rectal tumor undergoing laparoscopic TME combined with ISR were analyzed retrospectively.</p><p><b>RESULTS</b>The median distance from the inferior margin of the tumor to the anal verge was 3.4 (2.0-5.0) cm. There were 33 cases of well/moderately differentiated adenocarcinoma and 3 rectal malignant villous adenoma. There were 16 patients with stage I disease, 15 with stage II A, 3 with stage III A, and 1 with III B. Postoperatively, one patient developed stenosis at the end ileostomy and 3 anastomotic leakage. After a median follow-up of 16(4-49) months, one patient developed local recurrence at the anastomosis and one case died of liver metastasis. In the 19 patients who had a minimum follow-up of one year, the bowel movements frequency ranged from 1-4 times per day, and these patients were able to withhold defecation for more than 5 minutes.</p><p><b>CONCLUSIONS</b>Laparoscopic TME combined with ISR can achieve oncologic clearance, sphincter preservation, and minimal invasiveness for ultra-lower rectal cancer. However, patients selection should be cautious.</p>


Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Canal Anal , Cirugía General , Estudios de Seguimiento , Laparoscopía , Mesenterio , Cirugía General , Neoplasias del Recto , Cirugía General , Recto , Cirugía General , Estudios Retrospectivos , Resultado del Tratamiento
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