Testosterone Changes in Men With Obesity and Type 2 Diabetes 6 Months After Sleeve Gastrectomy With Transit Bipartition

Background: Metabolic/bariatric surgery has been shown to increase testosterone in males with obesity. This study investigated the effect of the novel metabolic/bariatric surgery procedure, sleeve gastrectomy with transit bipartition (SG-TB), on serum total testosterone and metabolic variable changes in men with obesity and type 2 diabetes. Methods: In a prospective single-center cohort study, laboratory samples were analyzed preoperatively and at 6 months following SG-TB in patients with a body mass index (BMI) >= 30 kg/m(2). Changes in metabolic parameters and testosterone were evaluated. Results: Between July 2018 and March 2019, 166 patients with a mean baseline BMI of 34.9 +/- 3.8 kg/m(2) (mean age 51.5 +/- 9.3 y), glycosylated hemoglobin 9.5 +/- 1.3%, and testosterone 3.1 +/- 1.3 underwent SG-TB. At 6-month follow-up, mean excess BMI loss was 70.2 +/- 24.3%; glycosylated hemoglobin, 6.6 +/- 1.1% (P<0.001); and testosterone, 4.5 +/- 1.5 (P<0.001). Conclusion: In the early term following SG-TB, more than any other factor assessed, BMI loss was found to be a significant driver of improvement in testosterone levels. Regardless of preoperative obesity classification, patients with initially low testosterone attained significantly increased testosterone levels at 6-month follow-up

A New Technique of Radiofrequency-assisted Ultrasound-guided Needle-localized Laparoscopic Resection of Disappearing Colorectal Liver Metastases

The management of disappearing colorectal liver metastases in the postadjuvant chemotherapy setting is challenging. We describe a novel technique that facilitates laparoscopic resection of disappearing metastatic liver lesions with great precision. Details of this new technique are described in 2 patients with colorectal cancer synchronously metastatic to the liver. Both patients had small indistinct intraparenchymal liver lesions after adjuvant chemotherapy. A video displays the steps of the procedure. Both patients presented with colorectal cancer with synchronous liver metastasis. They received FOLFOX regimen after resection of their primary. They both responded to adjuvant chemotherapy. On repeat posttreatment imaging, the liver lesions became smaller and indistinct. With laparoscopic ultrasound, subtle parenchymal heterogeneities were identified. The lesions were initially ablated with a wide radiofrequency ablation zone. Then, without removing the needle, the prongs were deployed to the borders of the parenchymal heterogeneity. Using an ultrasonic vessel sealer, the lesions were resected. Final pathology identified 1 viable focus of cancer in each patient. Both patients were discharged home uneventfully on their second postoperative day. There were no complications. We have described a novel technique that could facilitate precise resection of intraparenchymal small indistinct or disappearing liver metastases of colorectal origin. This option should be kept within the armamentarium of the laparoscopic liver surgeon managing patients with malignant liver tumors

Natural and anthropogenic radionuclides in the granitic region of Kapidag peninsula, Western Anatolia, Turkey

Naturally occurring radionuclides of terrestrial origin (also called primordial radionuclides) are present in various degrees in all media in the environment. This study represents the reports on the natural and anthropogenic radionuclides in the Kapidag granitic region. For this purpose, activities of radionuclides in soil, beach sands and rocks of the region have been investigated to assess the radiological hazard of the natural radioactivity. The radium equivalent activities, the absorbed dose rates and the external hazard indexes have been calculated, and also in situ gamma dose rates have been measured in the region. The mean activities of U-238, Th-232 and K-40 with the ranges were determined as 31.115.7 (12.171.9), 42.515.9 (19.794.9), 590.3192.2 (184.7892.5), in the soil, as 16.59.5 (4.940.8), 67.1106.9 (18.5433.0), 569.2212.6 (162.0821.1) in the sand and as 25.412.8 (4.850.7), 37.821.5 (4.596.7), and 592.4285.5 (62.41121.6) Bq kg(1) in the rocks, respectively. It was also observed that the average activities of Cs-137 were ranged 027.8 Bq kg(1) in the soil and 0.63.8 Bq kg(1) in the beach sands. The mean Ra-eq activities of the rocks, sands and soil were found to be 125.159.5, 156.3157.2 and 137.348.8 Bq kg(1), respectively, lower than the recommended maximum value of 370 Bq kg(1) with some exceptions. The maximum contributors to the total absorbed gamma dose rates in air were determined as U-238 (45 ) for the beach sands, U-238 (40 ) for the soil and K-40 (41 ) for rocks. The average outdoor gamma dose rates for the soil due to terrestrial and cosmic radiations were found to be 64.622.7 and 47.19.6 nGy h(1), respectively, with the total of 111.729.5 nGy h(1) outdoor gamma exposure rate and the annual average effective outdoor gamma dose was calculated as 13736.2 Sv for the region. The results of the study were discussed with similar studies in close regions and the worldwide averages

A Simple Food-Diverting Operation for Type 2 Diabetes Treatment. Preliminary Results in Humans with BMI 28–32 kg/m2

The feasibility of a simple side-to-side jejunoileal anastomosis (SJA) in non-morbidly obese individuals to control type 2 diabetes mellitus (T2DM) was studied in six diabetic patients with BMI 28-32. This novel procedure was performed in two Academic Centers and preliminary data is presented

A Critical Analysis of Postoperative Morbidity and Mortality After Laparoscopic Radiofrequency Ablation of Liver Tumors

Although the laparoscopic approach provides certain advantages over the percutaneous radiofrequency thermal ablation (RFA), the morbidity needs to be defined. The aim of this study is to analyze the morbidity and underlying risk factors after laparoscopic RFA of liver tumors

Young-IFSO Bariatric/Metabolic Surgery Training and Education Survey

Background This international Young-IFSO survey aims to address variations, trends, and obstacles in bariatric/metabolic surgery (BMS) training globally, since expectations and resources differ among young surgeons.Methods The Young-IFSO scientific team designed an online confidential questionnaire with 50 questions analyzing the individual BMS training. The survey link was sent to all IFSO/ASMBS members and was shared in social media. All Young-IFSO members (age up to 45 years) were invited to participate between 16 December 2022 and 4 February 2023.Results A total of 240 respondents from 61 countries took the survey. Most respondents (70.24%) described their current position as a consultant surgeon with an average of 5.43 years' experience working in BMS, and 55% are working in a bariatric center of excellence. More than 50% of the respondents performed none or less than 10 BMS during residency. Preparation of the stomach and stapling during sleeve gastrectomy (SG) were the first steps performed, and SG was the first BMS completed as a first operating surgeon by most of the respondents (74%). In total, 201 (84.45%) surgeons reported to perform scientific work. Most respondents (90.13%) reported that surgical mentorship had improved their surgical skills.Conclusion This international experts' survey underlines the lack of a standardized global surgical curriculum of BMS during residency. It shows that SG is the single most performed procedure by young surgeons. These data might underline the importance of advancing surgical education in BMS, and accredited fellowship programs should be offered globally to maintain and raise quality of BMS