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Early benefits of stomach reconstruction from small intestine after surgical removal of stomach in those who have stomach cancer.

ABSTRACT: Intervention1: Hunt Lawrence Jejunal pouch after total gastrectomy, esophagojejunostomy and Roux en Y: To analyze benefits of Jejunal pouch after total gastrectomy Control Intervention1: Total gastrectomy, esophagojejunostomy and Roux en Y without jejunal pouch: To compare outcomes in both groups Primary outcome(s): Safety Morbidity associated with surgery Efficacy To incidence of dumping Timepoint: Safety Morbidity associated with surgery prolonged intensive care, complications associated with surgery i.e. respiratory infections, anastomotic leak, bleed etc Efficacy To incidence of dumping i.Early dumping: Patients who complain of crampy abdominal pain, bloating, diarrhea, giddiness within 30-60min post prandialy. ii.Late dumping: Patients who complain of giddiness, sweating within 1-3 hours post prandialy.

DISEASE(S): Gastric Adenocarcinoma

PROVIDER: 2574343 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Obesity is associated with multiple diseases. Bariatric surgery is the most effective therapy for severe obesity that can reduce body weight and obesity-associated morbidity. The metabolic alterations associated with obesity and respective changes after bariatric surgery are incompletely understood.We comprehensively assessed metabolic alterations associated with severe obesity and distinct bariatric procedures. In our longitudinal observational study, we applied a (1)H-nuclear magnetic resonance-based global, untargeted metabolomics strategy on human serum samples that were collected before and repeatedly <=1 y after distinct bariatric procedures [i.e., a sleeve gastrectomy, proximal Roux-en Y gastric bypass (RYGB), and distal RYGB]. For comparison, we also analyzed serum samples from normal-weight and less-obese subjects who were matched for 1-y postoperative body mass index (BMI) values of the surgical groups. We identified a metabolomic fingerprint in obese subjects that was clearly discriminated from that of normal-weight subjects. Furthermore, we showed that bariatric surgery (sleeve gastrectomy and proximal and distal RYGB) dynamically affected this fingerprint in a procedure-dependent manner, thereby establishing new fingerprints that could be discriminated from those of BMI-matched and normal-weight control subjects. Metabolites that largely contributed to the metabolomic fingerprints of severe obesity were aromatic and branched-chain amino acids (elevated), metabolites related to energy metabolism (pyruvate and citrate; elevated), and metabolites suggested to be derived from gut microbiota (formate, methanol, and isopropanol; all elevated). Our data indicate that bariatric surgery, irrespective of the specific kind of procedure used, reverses most of the metabolic alterations associated with obesity and suggest profound changes in gut microbiome-host interactions after the surgery. This trial was registered at clinicaltrials.gov as NCT02480322.

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Early benefits of stomach reconstruction from small intestine after surgical removal of stomach in those who have stomach cancer.

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