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2.
Obes Surg ; 30(10): 3982-3987, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32557390

ABSTRACT

PURPOSE: In France, laparoscopic gastric plication (GP) has rarely been utilized as a weight loss procedure. Although relatively safe and efficient, its long-term results are still controversial. The goal of this study is to assess the indications and outcomes of revisional surgery post-GP. MATERIALS AND METHODS: Between February 2010 and September 2017, patient characteristics undergoing GP were prospectively collected from our database. Failure of conservative treatment or presence of anatomical anomaly explaining weight loss insufficiency was an indication for revisional surgery (RS). RESULTS: A total of 300 patients were included, 41 patients were lost to follow-up (13.7%), 124 patients (41.3%) had total weight loss (TWL) > 30%, and 116 patients (38.7%) underwent RS. Revisional procedures were laparoscopic Roux-en-Y gastric bypass (RYGB) in 72 patients (62.1%) and sleeve gastrectomy (SG) in 44 patients (37.9%). The median interval to RS was 29 months. The mean operative time was 60 min for the SG and 125 min for the RYGB (p < 0.0001). Mortality was nil. Significant morbidity occurred in eight patients (6.9%) including 4 non-abdominal complications, 1 gastric leak, 1 case of hemorrhage, 1 case of hematoma, and 1 intra-abdominal abscess. The mean length of hospital stay (LOS) was 2.9 days (range, 1-11) for the SG group vs 3.2 days (range, 2-8) for the RYGB group (p = 0.608). CONCLUSION: GP is associated with a relatively high rate of weight regain or insufficient weight loss. When compared to SG, RYGB seems to be the safer revisional procedure with fewer surgical complications.


Subject(s)
Gastric Bypass , Laparoscopy , Obesity, Morbid , France/epidemiology , Gastrectomy , Humans , Obesity, Morbid/surgery , Reoperation , Retrospective Studies , Treatment Outcome , Weight Gain
3.
Nanoscale ; 11(32): 15339-15346, 2019 Aug 15.
Article in English | MEDLINE | ID: mdl-31386742

ABSTRACT

Advances in nanotechnology are introducing the exciting possibility of cancer identification at early stages via analysis of the personalized biomolecular corona (BC), i.e. the dynamic "halo" of proteins that adsorbs onto NPs following exposure to patients' plasma. In this study, we develop a blood test for early cancer detection based on the characterization of the BC that forms around Graphene Oxide (GO) nanoflakes. Among its elective properties, GO binds low amounts of albumin, the most abundant protein in the blood and one of the most enriched proteins in the BC of many nanomaterials. This unique property of GO allows strong adsorption of poorly concentrated plasma proteins without abundant protein depletion. In our study, GO nanometric flakes have been used to analyze BCs from 50 subjects, half of them diagnosed with pancreatic cancer and half of them being healthy volunteers. Pancreatic cancer was chosen as the model of a high mortality disease with poor survival rates due to its delayed diagnosis. The receiver operating characteristic (ROC) curve analysis was applied to measure the diagnostic accuracy of the BC-based test. We obtained an area under the curve (AUC) of 0.96 and the test discriminated cancer patients from healthy subjects with a sensitivity of 92%. Finally, a double-blind validation was made using a second test dataset (10 healthy subjects + 10 pancreatic cancer patients) and it confirmed the results obtained on the first training dataset. Being highly accurate, fast, inexpensive and easy to perform, we believe that the BC-enabled blood test has the potential to become a turning point in early detection of cancer and other diseases.


Subject(s)
Early Detection of Cancer/methods , Graphite/chemistry , Nanostructures/chemistry , Pancreatic Neoplasms/diagnosis , Protein Corona/analysis , Area Under Curve , Biomarkers, Tumor/blood , CA-19-9 Antigen/blood , Case-Control Studies , Double-Blind Method , High-Throughput Screening Assays , Humans , Pancreatic Neoplasms/pathology , ROC Curve , Sensitivity and Specificity
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