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Medicina
Special Issues
Combining Gastroenterology and Surgery: New Treatment Insights
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Combining Gastroenterology and Surgery: New Treatment Insights

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 6110

Special Issue Editor

Dr. Sjaak Pouwels

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Guest Editor
1. Department of General, Abdominal Surgery and Coloproctology, Helios St. Elisabeth Klinik, Oberhausen, Germany
2. Helios Obesity Center West, Helios St. Elisabeth Hospital Oberhausen, Oberhausen, Germany
3. Faculty of Health, University of Witten/Herdecke, Witten, Germany
Interests: intensive care medicine; bariatric surgery; oncological surgery; logistics; perioperative optimalisation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the last few years, we have seen tremendous improvements in treatment methods for chronic diseases like cancer, obesity and many more. Within these developments, it is increasingly important to work side-by-side with fellow medical specialists. In particular, gastroenterologists and surgeons have been working together in both the surgical and endoscopic fields. Good examples include endoscopic treatments for obesity performed by gastroenterologists, as well as the early endoscopic resection of cancers. For these developments, both specialties need to get out of their comfort zones.

Therefore, this Special Issue is focused on the new treatment insights in which knowledge of both gastroenterologists and surgeons are combined. This Special Issue is therefore titled ‘Combining Gastroenterology and Surgery: New Treatment Insights’.

We welcome all manuscripts that cover new treatment insights in which surgical and gastroenterological knowledge is combined. We invite you to submit research about the challenges, trends and perspectives in new treatments in gastroenterology and surgery.

Dr. Sjaak Pouwels
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastroenterology
  • surgery
  • chronic diseases
  • laparoscopy
  • endoscopy
  • minimally invasive
  • obesity
  • cancer
  • multidisciplinary treatment
  • new insights

Published Papers (3 papers)

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10 pages, 305 KiB  
Article
Surgery for Inflammatory Bowel Disease in the Era of Biologic Therapy: A Multicenter Experience from Romania
by Christopher Pavel, Mircea Diculescu, Gabriel Constantinescu, Oana-Mihaela Plotogea, Vasile Sandru, Corina Meianu, Ion Dina, Ioana Pop, Andreea Butuc, Mariana Mihaila and Madalina Stan-Ilie
Medicina 2023, 59(2), 337; https://doi.org/10.3390/medicina59020337 - 10 Feb 2023
Cited by 2 | Viewed by 1495
Abstract
Background and Objectives: Biologic therapy has fundamentally changed the opportunity of medical treatment to induce and maintain remission in inflammatory bowel disease (IBD). Nevertheless, the rate of surgery is still at a very high rate, profoundly affecting the quality of life. We aimed [...] Read more.
Background and Objectives: Biologic therapy has fundamentally changed the opportunity of medical treatment to induce and maintain remission in inflammatory bowel disease (IBD). Nevertheless, the rate of surgery is still at a very high rate, profoundly affecting the quality of life. We aimed to analyze surgical cases at three major IBD units in order to identify the main risk factors and the impact of biologic therapy on pre- and postsurgical outcomes. Material and Methods: This was a multicenter retrospective cohort study that included 56 patients with IBD-related surgical interventions from 3 tertiary care hospitals in Bucharest, Romania. The study was conducted between January 2017 and June 2021. All data were retrospectively collected from the medical records of the patients and included the age at diagnosis, age at the time of surgery, IBD type and phenotype, biologic therapy before or/and after surgery, timing of biologic therapy initiation, extraintestinal manifestations, type of surgery (elective/emergency), early and long-term postoperative complications and a history of smoking. Results: A low rate of surgical interventions was noted in our cohort (10.3%), but half of these occurred in the first year after the IBD diagnosis. A total of 48% of the surgical interventions had been performed in an emergency setting, which seemed to be associated with a high rate of long-term postoperative complications. We found no statistically significant differences between IBD patients undergoing treatments with biologics before surgery and patients who did not receive biologics before the surgical intervention in terms of the IBD phenotype, type of surgery and postoperative complications. Conclusion: Our study showed that biologics initiated before the surgical intervention did not influence the postoperative complications. Moreover, we demonstrated that patients with Crohn’s disease and no biologics were the most susceptible to having to undergo surgery. Conclusion: In conclusion, the management of patients with IBD requires a multidisciplinary approach that considers an unpredictable evolution. Full article
(This article belongs to the Special Issue Combining Gastroenterology and Surgery: New Treatment Insights)
11 pages, 536 KiB  
Article
Risk Factors for Severe Postoperative Complications after Oncologic Right Colectomy: Unicenter Analysis
by Eugenia Claudia Zarnescu, Narcis Octavian Zarnescu, Nicoleta Sanda and Radu Costea
Medicina 2022, 58(11), 1598; https://doi.org/10.3390/medicina58111598 - 04 Nov 2022
Cited by 1 | Viewed by 2121
Abstract
Background and Objectives: This study aimed to investigate the potential risk factors for severe postoperative complications after oncologic right colectomy. Materials and Methods: All consecutive patients with right colon cancer who underwent right colectomy in our department between 2016 and 2021 were [...] Read more.
Background and Objectives: This study aimed to investigate the potential risk factors for severe postoperative complications after oncologic right colectomy. Materials and Methods: All consecutive patients with right colon cancer who underwent right colectomy in our department between 2016 and 2021 were retrospectively included in this study. The Clavien–Dindo grading system was used to evaluate postoperative complications. Univariate and multivariate logistic regression analyses were used to investigate risk factors for postoperative severe complications. Results: Of the 144 patients, there were 69 males and 75 females, with a median age of 69 (IQR 60–78). Postoperative morbidity and mortality rates were 41.7% (60 patients) and 11.1% (16 patients), respectively. The anastomotic leak rate was 5.3% (7 patients). Severe postoperative complications (Clavien–Dindo grades III–V) were present in 20 patients (13.9%). Univariate analysis showed the following as risk factors for postoperative severe complications: Charlson score, lack of mechanical bowel preparation, level of preoperative proteins, blood transfusions, and degree of urgency (elective/emergency right colectomy). In the logistic binary regression, the Charlson score (OR = 1.931, 95% CI = 1.077–3.463, p = 0.025) and preoperative protein level (OR = 0.049, 95% CI = 0.006–0.433, p = 0.007) were found to be independent risk factors for postoperative severe complications. Conclusions: Severe complications after oncologic right colectomy are associated with a low preoperative protein level and a higher Charlson comorbidity index. Full article
(This article belongs to the Special Issue Combining Gastroenterology and Surgery: New Treatment Insights)
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12 pages, 623 KiB  
Systematic Review
Remission of Type 2 Diabetes Mellitus (T2DM) after Sleeve Gastrectomy (SG), One-Anastomosis Gastric Bypass (OAGB), and Roux-en-Y Gastric Bypass (RYGB): A Systematic Review
by Vignesh Balasubaramaniam and Sjaak Pouwels
Medicina 2023, 59(5), 985; https://doi.org/10.3390/medicina59050985 - 19 May 2023
Cited by 5 | Viewed by 2056
Abstract
Background and Objectives: The three most widely performed bariatric surgeries are Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one-anastomosis gastric bypass (OAGB). Aside from the benefits of weight loss, current findings suggest that these procedures can also induce remission of T2DM [...] Read more.
Background and Objectives: The three most widely performed bariatric surgeries are Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one-anastomosis gastric bypass (OAGB). Aside from the benefits of weight loss, current findings suggest that these procedures can also induce remission of T2DM (type 2 diabetes mellitus). There are limited data that directly compare these three procedures. This study aims to compare the short-term and long-term remission of T2DM after RYGB, SG, and OAGB. Materials and Methods: Three databases (Embase, PubMed, and Cochrane) were searched for randomised controlled trials, prospective studies, and retrospective studies that compared the effects of RYGB, SG, and OAGB on T2DM remission. Studies published between 2001 and 2022 were analysed. Only patients with T2DM and who had primary bariatric surgery were included. Results: After applying the inclusion and exclusion criteria, seven articles were included in the review. It was found that all three procedures had comparable T2DM remission. RYGB was noted to have the highest complication rate when compared to SG and OAGB. Importantly, it was noted that other predictive factors such as age, duration of diabetes, baseline HbA1c, BMI, and use of antidiabetic medication play a crucial role in T2DM remission. Conclusions: This systematic literature review confirms the existing data that all three bariatric surgeries induce remission of T2DM. Increasing in popularity, OAGB had comparable outcomes to RYGB and SG in inducing T2DM remission. In addition to the choice of bariatric surgery, there are other independent predictive factors that have an impact on T2DM remission. Further studies with larger sample sizes, longer follow-up periods, and studies that control confounding factors are required in this field. Full article
(This article belongs to the Special Issue Combining Gastroenterology and Surgery: New Treatment Insights)
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