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Pyloric Sympathectomy: A Novel Way to Get Pylorus Relaxation? Report of Two Bariatric Cases

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Surgical Science 2024年第6期15卷 381-395页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Rui Ribeiro Paulo Reis Esselin de Melo Fernando Fornari Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Lusadas Amadora Hospital Lisboa Portugal Paulo Reis Institute Goinia Brazil Alfredo Nasser university Center (UNIFAN) Goinia Brazil Faculdade de Medicina Universidade de Passo Fundo Passo Fundo Brazil Faculdade de Medicina Universidade Federal da Fronteira do Sul Chapec Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of pyloric sympathectomy on the pylorus motility, leading to its permanent relaxation, observed in two bariatric surgical cases, one primary and the other, revisional. Background: Pyloric sphincter is a physiological barrier to free gastric emptying. In sleeve gastrectomy and in Roux-en-Y gastric bypass revisions, that put the remnant stomach in transit, the pylorus can contribute to generate a high intragastric pressure, which could lead to acute gastric fistulas and/or chronic gastroesophageal reflux disease. The possibility of functionally relaxing the pylorus, promoting intragastric pressure reduction, could represent a protective maneuver against these complications. Methods: We describe herein a surgical maneuver applied in two cases of bariatric surgeries, with the intention of facilitating antrum-duodenal region exposure, in a sleeve gastrectomy and in a Roux-en-Y gastric bypass conversion to SADI-S. For this, a ligation of terminal peripyloric vessels was done, allowing a passage of a tape, which surrounded the pylorus, for its traction. In both cases, 30-day and 1-year endoscopic evaluations were done, to assess esophagitis signs, anastomosis healing and anatomical pouch aspect. A clinical evaluation was also done, to assess gastroesophageal symptoms (validated questionnaire). Results: In the postoperative endoscopic evaluations, no esophagitis were observed in any case and the gastric pouches had normal aspect, with the expected anatomical findings, compatible with the surgeries performed. The anastomosis healed without problems, in the revisional case. Interestingly, in both cases, it was observed a complete pyloric sphincter relaxation, which lasted until 1-year endoscopic evaluation. There were no fistulas, nor esophagitis in any of these cases. Clinically, there were no symptoms of gastroesophageal reflux disease (validated questionnaire). Conclusion: The observation of a

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Sympathectomy Bariatric Surgery

Functional Roux-en-Y Gastric Bypass (F-RYGB), with Preservation of Duodenal Access: Report of Two Revisional Cases of Sleeve Gastrectomy

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Surgical Science 2024年第3期15卷 135-158页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Paulo Reis Esselin de Melo Rui Ribeiro Paula Volpe Carlos Eduardo Domene Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Paulo Reis Institute of Bariatric Surgery Goi&#226nia Brazil Alfredo Nasser university Center (UNIFAN) Goi&#226nia Brazil Lusíadas Amadora Hospital Lisboa Portugal Integrated Center for Advanced Medicine (CIMAMED) S&#227o Paulo Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Jejuno Gastric Bypass Vagus Nerve Vagotomy Bariatric Surgery

Sleeve Gastrectomy with Duodenal Transit Bipartition (S-DTB): Preliminary Results and Technical Aspects of Its Metabolic Structure

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Surgical Science 2024年第4期15卷 244-264页

作者： Paulo Reis Esselin de Melo Ricardo Zorron Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Rui Ribeiro Thonya Cruz Braga Paula Volpe Carlos Eduardo Domene Paulo Reis Institute Goiania GO Brazil Alfredo Nasser university Center (UNIFAN) Goiania GO Brazil Department of Bariatric and Metabolic Surgery CUF Descobertas Hospital Lisbon Portugal Victor Dib Institute Manaus AM Brazil Gastrobese Clinic Passo Fundo RS Brazil Lusiadas Amadora Hospital Lisbon Portugal Clianest Group Renaissance Hospital Goiania GO Brazil Integrated Center for Advanced Medicine (CIMAMED) Sao Paulo Brazil

Obesity is a significant and escalating health issue both in Brazil and globally, with over 650 million overweight adults worldwide. The treatment of obesity can be performed clinically, endoscopically or surgically;surgical treatment proves to be safe and more effective in terms of weight loss and long-term maintenance. Objective: This study aimed to monitor the progress of weight loss and comorbidity control in patients undergoing sleeve gastrectomy with duodenal bipartition. Methods: This pilot project involved 8 patients divided into 2 arms. In the first arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenoileal transit bipartition (S-RYDITB), while in the second arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenojejunal transit bipartition (S-RYDJTB). Both procedures involved Roux-en-Y reconstruction without duodenal exclusion. In S-RYDITB, the duodenal-ileal anastomosis was performed 300 cm from the ileocecal valve (ICV), creating a 250 cm common channel and a 50 cm alimentary channel. In S-RYDJTB, a biliopancreatic loop was created 200 cm from the angle of Treitz, with a 1 m alimentary channel. Results: Five patients underwent the procedures, with one undergoing S-RYDITB and four undergoing S-RYDJTB. No adverse events such as hospitalizations, readmissions, reoperations, fistulas, bleeding, pulmonary embolism, diarrhea, dumping syndrome, or hypoglycemia occurred during the study period. The mean length of hospital stay was 2 days. The average BMI decreased from 37.27 kg/m2 preoperatively to 29.48 kg/m2 after 6 months. The significant percentage of weight loss was 21.22%, with excess weight loss of 63.6%. Ninety-five percent remission of comorbidities, including hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, steatosis, and pre-diabetes. Two patients underwent sleeve gastrectomy with duodenal bipartition using a single anastomosis. Conclusion: Duodenal switch surgery has gained worldwide recog

关键词： Obesity Bariatric Surgery Metabolic Surgery Duodenal Switch

Alternative uses for tannery wastes:a review of environmental,sustainability,and science

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Journal of Leather Science and Engineering 2020年第1期2卷 249-268页

作者： Cesar Vinicius Toniciolli Rigueto Marieli Rosseto Daniela Dal Castel Krein Bruna Elisangela Pessini Ostwald Lillian Avila Massuda Barbara Belem Zanella Aline Dettmer Postgraduate Program in Food Science and Technology(PPGCTA) University of Passo Fundo(UPF)Faculty of Agronomy and Veterinary Medicine(FAMV)Passo FundoRSBrazil Chemical Engineering Course University of Passo Fundo(UPF)Faculty of Engineering and Architecture(FEAR)Passo FundoRSBrazil

The manufacture of leather covers a wide productive chain and beyond contributes to the economic *** various stages of leather processing result in high volumes of solid *** Brazil,a daily generation of 375 tons of solid waste is estimated,and landfills are still the most used route to its *** this review,emphasis will be given to researches that have sought alternatives for the use of solid waste from the tannery *** the main applications of solid tannery wastes,the following stand out production of adsorbent materials,biodiesel,biogas,biopolymers,applications in agriculture and other applications involving extraction/recovery of compounds of industrial/commercial interest,isolation of microorganisms and production of enzymes and applications in the animal *** each alternative of waste application,the technologies used,the opportunities,and the challenges faced are *** hope that this review can provide valuable information to promote the broad understanding of the possibilities that tannery solid wastes has for the development of biodegradable and agricultural products,wastewater treatment,extraction of compounds of industrial and commercial interest,among others.

关键词： Leather Adsorption Biodiesel Biogas Biopolymers Agriculture

Influence of Vernalization and Photoperiod on the Duration of Stem Elongation and Spikelet Fertility in Wheat

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Agricultural Sciences 2014年第14期5卷 1547-1557页

作者： Osmar Rodrigues Mauro César Celaro Teixeira Edson Roberto Costenaro Leandro Vargas Rafael Damo Embrapa Wheat Passo Fundo Brazil university of passo fundo Passo Fundo Brazil

A longer stem elongation phase (from the terminal spikelet-TS to the anthesis-ANT phases) increases grain production due to an increase in spikelet fertility. However, the mechanism behind the greater number of fertile flowers that occur when the duration of stem elongation is modified by photoperiod and vernalization is not fully understood. The goal of this study was to investigate the effect of combinations of photoperiod and vernalization on the duration of stem elongation and spikelet fertility in wheat. Thus, a greenhouse experiment was performed by subjecting 13 wheat genotypes to two vernalization regimes (V0—non-vernalized plants and V40—plants with 40 vernalization days) and to two photoperiod regimes (NP—natural and NP + 6—photoperiod extended by six hours), during the stem elongation phase. The natural photoperiod increased the spikelet fertility of eight cultivars without a corresponding increased duration of the TS-ANT phase, suggesting the existence of a direct effect of photoperiod on increased spikelet fertility. Vernalization increased the duration of the TS-ANT phase, without influencing spikelet fertility. There was genetic variability in the responses to photoperiod and vernalization.

关键词： Double Ridge Terminal Spikelet Elongation

Different Forms of Rationalities in Aristotle： From Being to Acting

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Journal of Philosophy Study 2017年第1期7卷 27-32页

作者： Nadir Antonio Pichler university of passo fundo

Pampa Biome Native Plant Appreciation by the Analysis of <i>Glandularia peruviana</i>(L.) Cuttings Growth

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American Journal of Plant Sciences 2015年第3期6卷 427-432页

作者： Luciana Dall’Agnese Cláudia Petry Paloma Alves da Silva Sexto Graduate Program in Agronomy School of Agronomy and Veterinary Medicine University of Passo Fundo Passo Fundo Brazil

A native plant of Biome Pampa (Southern Brazil), the Glandularia peruviana (L.) Small species has been, until now, little studied as ornamental plant for use as mulch and formation of massifs. Whilst this species didn’t suffer any genetic improvement process, it is extremely ornamental by its color and size. In order to promote its comercial propagation and its use to improve the Pampa biodiversity, this study was conducted to know, as a ruderal plant native from South America, how the behavior of the plants was when employed plant propagation and use of artificial auxin on the cuttings. The test consisted of assessing the growth of cuttings treated or not with indol-butyric acid, analyzed at diferent ages, at 21, 24, 27 and 31 days in the university of passo fundo, passo fundo, Brazil. It was observed that the plant total dry mass values showed no standard of behavior, values for dry matter, whether of leaves, stem, root, shoot and total not responded to treatments and analyzed ages. The same occurred for specific leaf weight, plant height, number of green leaves, number of dead leaves, average leaf length and average number of stems. The lack of significant treatment and age effects may be explained by the plant primitiveness, which is ruderal, so its development has little influenced by the propagation practices.

关键词： Glandularia peruviana Indol-Butyric Acid Native Plant Age Propagation Ruderal

Sensory Evaluation of Winter Cereal Silage

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Journal of Chemistry and Chemical Engineering 2017年第3期11卷 102-106页

作者： Carlos Eugenio Fortes Teixeira Renato Serena Fontaneli Tecnico em mecdnica Engenharia Mecdnica--IFSul--Campus Passo Fundo Passo Fundo Brazil Agronomia/ppgAgro UPF Universidade de Passo Fundo Passo Fundo Brazil

Chemical Bromatological Evaluation of Biomass for Silage of the Winter Cereals

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Journal of Chemistry and Chemical Engineering 2017年第4期11卷 152-156页

作者： Carlos Eugenio Fortes Teixeira Renato Serena Fontaneli Tecnico em Mecdnica Engenharia Mecanica IFSul Campus Passo Fundo Passo Fundo RS Brazil Agronomia ppgAgro UPF Universidade de Passo Fundo Pesquisador EMBRAPA TRIGO Passo Fundo RS Brazil