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Chinese Medical Journal 2022年第7期135卷 774-778页

作者： Vitor Ottoboni Brunaldi Manoel Galvao Neto Center for Digestive Endoscopy Surgery and Anatomy DepartmentRibeirão Preto Faculty of MedicineUniversity of São Paulo14015-010 Ribeirão PretoBrazil Endovitta Institute 04102-001 São PauloBrazil ABC Faculty of Medicine 09060-870 Santo AndreBrazil

Since its first description in 2013,robust evidence supporting the efficacy and safety of the endoscopic sleeve gastroplasty(ESG)has been on the rise.A large case series and meta-analysis report supported results up to 24 months,while some other studies already described 5-year data.If associated with pharmacotherapy,the ESG may help one to achieve weight loss similar to that of surgical sleeve gastrectomy.Though the results of the ongoing randomized trials on ESG are awaited,currently available data support the clinical use of the ESG,especially for patients who are refusing or unfit for bariatric surgery.

关键词： Endoscopy Bariatric Obesity Overweight sleeve Suturing

sleeve Design of Permanent-magnet Machine for Low Rotor Losses

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Chinese Journal of Electrical Engineering 2020年第4期6卷 86-96页

作者： Junqiang Zheng Wenxiang Zhao Jinghua Ji Jihong Zhu Christopher H.T.Lee School of Electrical and Information Engineering Jiangsu UniversityZhenjiang 212013China Department of Computer Science and Technology Tsinghua UniversityBeijing 100000China School of Electrical and Electronic Engineering Nanyang Technological University639798Singapore

In this study,a novel rotor sleeve for permanent-magnet(PM)machines equipped with fractional-slot concentrated-windings(FSCW)is proposed.With the newly designed rotor sleeve,the rotor eddy-current(EC)losses are significantly reduced,and the torque density of the machine is improved.First,the rotor EC losses of a surface-mounted PM machine with the sleeve are analyzed.Meanwhile,the sleeve EC barriers and PM segmentation technologies for the suppression of the rotor EC losses are evaluated.Subsequently,an FSCW PM machine with the newly designed sleeve is proposed and optimized for a given set of specifications.Its electromagnetic and mechanical performances are evaluated by the finite element method(FEM).Finally,three assembling methods are presented and assessed comprehensively in terms of their merits and drawbacks.

关键词： Permanent-magnet machine rotor losses sleeve eddy-current concentrated-windings

Current status of endoscopic sleeve gastroplasty: An opinion review

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World Journal of Gastroenterology 2020年第11期26卷 1107-1112页

作者： Jiunn-Wei Wang Chih-Yen Chen Division of Gastroenterology Department of Internal medicineKaohsiung Medical University HospitalKaohsiung 80756Taiwan Department of Medicine College of MedicineKaohsiung Medical UniversityKaohsiung 80756Taiwan Graduate Institute of Clinical Medicine College of MedicineKaohsiung Medical UniversityKaohsiung 80756Taiwan Division of Gastroenterology and Hepatology Department of MedicineTaipei Veterans General HospitalTaipei 11217Taiwan Endoscopy Center for Diagnosis and Treatment Taipei Veterans General HospitalTaipei 11217Taiwan Faculty of Medicine and Institute of Emergency and Critical Medicine National Yang-Ming University School of MedicineTaipei 11217Taiwan Institutional Review Board Taipei Veterans General HospitalTaipei 11217Taiwan Chinese Taipei Society for the Study of Obesity Taipei 11031Taiwan

Bariatric surgeries have been demonstrated to be safe and effective treatment options for morbid obesity patients, but operative risks and high health care costs limit their clinical application. Endoscopic bariatric therapies are emerging as valuable alternatives for patients with doubts about bariatric surgery or ineligible for it. Endoscopic sleeve gastroplasty(ESG), a relatively novel technique of endoscopic bariatric therapies, has gained standing in the past few years. The safety, feasibility, repeatability, and potential for reversibility of ESG have been proven by multicenter studies. Compared to other weight loss strategies, current evidence demonstrates that ESG offers satisfactory efficacy in weight loss. Even though it is inferior to laparoscopic sleeve gastrectomy, it has lower risks of adverse events than surgical interventions and intragastric balloon within oneyear follow-up. Furthermore, ESG may be the ideal weight control strategy for patients who have poor adherence to behavioral interventions. Even so, trends in decreased weight loss effect over time, post-procedure weight regain, postprocedure gut hormone alteration, and possible effects of race and ethnicity on ESG still remain undetermined due to very limited reports and very short followups. Further clinical trials are required to validate and answer these questions.

关键词： Obesity Endoscopic bariatric therapy Endoscopic sleeve gastroplasty Laparoscopic sleeve gastrectomy Intragastric balloon Behavioral weight loss intervention

Repair of peripheral nerve defects by nerve transposition using small gap bio-sleeve suture with different inner diameters at both ends

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Neural Regeneration Research 2019年第4期14卷 706-712页

作者： Yu-Hui Kou You-Lai Yu Ya-Jun Zhang Na Han Xiao-Feng Yin Yu-Song Yuan Fei Yu Dian-Ying Zhang Pei-Xun Zhang Bao-Guo Jiang Peking University People's Hospital The Affiliated Hospital of Xuzhou Medical University

During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the problem of high tension at the suture site, which may even lead to the failure of nerve suture. We investigated whether a small gap bio-sleeve suture with different inner diameters at both ends can be used to repair a 2-mm tibial nerve defect by proximal transposition of the common peroneal nerve in rats and compared the results with the repair seen after epineurial neurorrhaphy. Three months after surgery, neurological function, nerve regeneration, and recovery of nerve innervation muscle were assessed using the tibial nerve function index, neuroelectrophysiological testing, muscle biomechanics and wet weight measurement, osmic acid staining, and hematoxylin-eosin staining. There was no obvious inflammatory reaction and neuroma formation in the tibial nerve after repair by the small gap bio-sleeve suture with different inner diameters at both ends. The conduction velocity, muscle strength, wet muscle weight, cross-sectional area of muscle fibers, and the number of new myelinated nerve fibers in the biosleeve suture group were similar to those in the epineurial neurorrhaphy group. Our findings indicate that small gap bio-sleeve suture with different inner diameters at both ends can achieve surgical suture between nerves of different diameters and promote regeneration and functional recovery of injured peripheral nerves.

关键词： nerve regeneration bio-sleeve small gap sleeve suture nerve transposition nerve defect nerve conduit nerve reinnervation peripheral nerve neural regeneration

New results on the safety of laparoscopic sleeve gastrectomy bariatric procedure for type 2 diabetes patients

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World Journal of Diabetes 2019年第2期10卷 78-86页

作者： Ohad Guetta Alex Vakhrushev Oleg Dukhno Amnon Ovnat Gilbert Sebbag Department General Surgery B Soroka University Medical Center

BACKGROUND It has been established that bariatric surgery,including laparoscopic sleeve gastrectomy(LSG),has a positive impact on type 2 diabetes mellitus(T2DM).However,less frequently T2DM is reported as a risk factor for complications with this type of surgery.AIM To evaluate the safety of LSG in T2DM.METHODS A retrospective cohort study was conducted over patients admitted for LSG from January 2008 to May 2015.Data was collected through digitized records.Any deviation from normal postoperative care within the first 60 d was defined as an early complication,and further categorized into mild or severe.RESULTS Nine hundred eighty-four patients underwent LSG,among these 143(14.5%)were diagnosed with T2DM.There were 19 complications in the T2DM group(13.3%)compared to 59 cases in the non-T2DM(7.0%).Out of 19 complications in the T2DM group,12 were mild(8.4%)and 7 were severe(4.9%).Compared to the non-T2DM group,patients had a higher risk for mild complications(Odds-ratio 2.316,CI:1.163-4.611,P=0.017),but not for severe ones(P=0.615).An increase of 1% in hemoglobin A1c levels was associated with a 40.7% increased risk for severe complications(P=0.013,CI:1.074-1.843)but not for mild ones.CONCLUSION Our data suggest that LSG is relatively safe for patients with T2DM.Whether preoperative control of hemoglobin A1c level will lower the complications rate has to be prospectively studied.

关键词： Bariatric surgery Laparoscopic sleeve gastrectomy Type 2 diabetes Complications Morbidity Hemoglobin A1c Fasting plasma glucose Clavien-Dindo classification

Laparoscopic sleeve gastrectomy:More than a restrictive bariatric surgery procedure?

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World Journal of Gastroenterology 2015年第41期21卷 11804-11814页

作者： David Benaiges Antonio Más-Lorenzo Albert Goday José M Ramon Juan J Chillarón Juan Pedro-Botet Juana A Flores-Le Roux Department of Endocrinology and Nutrition Hospital del Mar Department of Medicine Universitat Autònoma de Barcelona Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) CiberOBN Instituto de Salud Carlos III Department of Gastrointestinal Surgery Hospital del Mar

sleeve gastrectomy(SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a single technique have led to a rise in its use, and it is currently the second most performed technique worldwide. SG achieves clearly better results than other restrictive techniques and is comparable in some aspects to the Roux-en-Y gastric bypass, the current gold standard in bariatric surgery. These benefits have been associated with different pathophysiologic mechanisms unrelated to weight loss such as increased gastric emptying and intestinal transit, and activation of hormonal mechanisms such as increased GLP-1 hormone and decreased ghrelin. The aim of this review was to highlight the salient aspects of SG regarding its historical evolution, pathophysiologic mechanisms, main results, clinical applications and perioperative complications.

关键词： Bariatric surgery sleeve gastrectomy Severe obesit

Bariatric surgery and diabetes remission: sleeve gastrectomy or mini-gastric bypass?

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World Journal of Gastroenterology 2013年第39期19卷 6590-6597页

作者： Marco Milone Matteo Nicola Dario Di Minno Maddalena Leongito Paola Maietta Paolo Bianco Caterina Taffuri Dario Gaudioso Roberta Lupoli Silvia Savastano Francesco Milone Mario Musella Department of Advanced Biomedical Science University of Naples "Federico Ⅱ"80131 NaplesItaly

AIM:To investigate the weight loss and glycemic control status[blood glucose,hemoglobin A1c(HbA1c)and hypoglycaemic treatment].METHODS:The primary risk factor for type 2 diabetes is obesity,and 90%of all patients with type 2 diabetes are overweight or obese.Although a remarkable effect of bariatric surgery is the profound and durable resolution of type 2 diabetes clinical manifestations,little is known about the difference among various weight loss surgical procedures on diabetes remission.Data from patients referred during a 3-year period(from January2009 to December 2011)to the University of Naples"FedericoⅡ"diagnosed with obesity and diabetes were retrieved from a prospective database.The patients were split into two groups according to the surgical intervention performed[sleeve gastrectomy(SG)and mini-gastric bypass(MGB)].Weight loss and glycemic control status(blood glucose,HbA1c and hypoglycaemic treatment)were evaluated.RESULTS:A total of 53 subjects who underwent sleeve gastrectomy or mini-gastric bypass for obesity and diabetes were screened for the inclusion in this study.Of these,4 subjects were excluded because of surgical complications,7 subjects were omitted because young surgeons conducted the operations and 11 subjects were removed because of the lack of follow-up.Thirtyone obese patients were recruited for this study.A total of 15 subjects underwent SG(48.4%),and 16underwent MGB(51.6%).After adjusting for various clinical and demographic characteristics in a multivariate logistic regression analysis,high hemoglobin A1c was determined to be a negative predictor of diabetes remission at 12 mo(OR=0.366,95%CI:0.152-0.884).Using the same regression model,MGB showed a clear trend toward higher diabetes remission rates relative to SG(OR=3.780,95%CI:0.961-14.872).CONCLUSION:Although our results are encouraging regarding the effectiveness of mini-gastric bypass on diabetes remission,further studies are needed to provide definitive conclusions in selecting the ideal procedure for diabetes remission.

关键词： Bariatric surgery sleeve Bypass Obesity and diabetes

Endoscopic sleeve gastroplasty: From whence we came and where we are going

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World Journal of Gastrointestinal Endoscopy 2019年第5期11卷 322-328页

作者： Diogo Turiani Hourneaux de Moura Eduardo Guimar?es Hourneaux de Moura Christopher C Thompson Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical School Department of Endoscopy of Clinics Hospital of S?o Paulo University

The most effective and durable treatment for obesity is bariatric surgery.However,less than 2% of eligible patients who fulfill the criteria for bariatric surgery undergo the procedure. As a result,there is a drive to develop less invasive therapies to combat obesity. Endoscopic bariatric therapies(EBT) for weight loss are important since they are more effective than pharmacological treatments and lifestyle changes and present lower adverse event rates compared to bariatric surgery. Endoscopic sleeve gastroplasty(ESG) is a minimally invasive EBT that involves remodeling of the greater curvature. ESG demonstrated favorable outcomes in several centers,with up to 20.9% total body weight loss and 60.4% excess weight loss(EWL) on 2-year follow-up,with a low rate of severe adverse events(SAE). As such,it could be considered safe and effective in light of ASGE/ASMBS thresholds of > 25% EWL and ≤ 5% SAE,although there are no comparative trials to support this. Additionally,ESG showed improvement in diabetes mellitus type 2,hypertension,and other obesity-related comorbidities. As this procedure continues to develop there are several areas that can be addressed to improve outcomes,including device improvements,technique standardization,patient selection,personalized medicine,combination therapies,and training standardization. In this editorial we discuss the origins of the ESG,current data,and future developments.

关键词： Endoscopy Surgery Bariatric Obesity Overweight Comorbidities Gastroplasty sleeve Endoscopic sleeve gastroplasty Editorial

Routine surveillance endoscopy before and after sleeve gastrectomy?

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World Journal of Gastrointestinal Endoscopy 2019年第1期11卷 1-4页

作者： Radwan Kassir Rani Kassir Bénédicte Deparseval Sarah Bekkar Chloé Serayssol Olivier Favre Pierre-Philippe Garnier Department of Bariatric Surgery CHU Félix Guyon Department of Gastroenterology CHU Félix Guyon

There is no consensus when it comes to the necessity of an oeso-gastroduodenal fibroscopy(OGDF) before and after bariatric surgery. Many reports expressed the preoccupations about a gastroesophagal reflux disease(an acute risk of Barrett's esophagus) and its consequences after a sleeve gastrectomy(SG) and the risk of leaving a premalignant lesion in an excluded stomach after a Roux-en-Y gastric bypass. The International Federation for the Surgery of Obesity and Metabolic Disorders recommends a surveillance endoscopy, routinely after a SG. After review of the literature, we set out the arguments in favor of performing a systematic preoperative and post-operative OGDF.

关键词： Bariatric Surgery Endoscopy sleeve gastrectomy Surveillance Oesogastroduodenal fibroscopy Novo Barrett's esophagus Gastroesophagal reflux

Laparoscopic sleeve gastrectomy and gastroesophageal reflux

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World Journal of Gastroenterology 2015年第36期21卷 10348-10357页

作者： Fabien Stenard Antonio Iannelli Digestive and Oncology Unit Mutualiste Hospital Digestive Unit Archet 2 HospitalUniversity Hospital of Nice Inserm U1065Team 8 "Hepatic complications of obesity" University of Nice Sophia-Antipolis

Bariatric surgery is the only effective procedure that provides long-term sustained weight loss. sleeve gastrectomy(SG) has emerged over the last few years to be an ideal bariatric procedure because it has several advantages compared to more complex bariatric procedures,including avoiding an intestinal bypass. However,several published follow-up studies report an increased rate of gastroesophageal reflux(GERD) after a SG. GERD is described as either de novo or as being caused by aggravation of preexisting symptoms. However,the literature on this topic is ambivalent despite the potentially increased rate of GERDs that may occur after this common bariatric procedure. This article reviews the mechanisms responsible for GERD in obese subjects as well as the results after a SG with respect to GERD. Future directions for clinical research are discussed along with the current surgical options for morbidly obese patients with GERD and undergoing bariatric surgery.

关键词： Gastroesophageal reflux sleeve gastrectomy Morbid