Biography:

Olha V Storchylo graduated Odessa State University (Ukraine) in Biochemistry in 1983. She completed her Postgraduation in Human and Animal Physiology and Biochemistry at the Pavlov Institute of Physiology Russian Academy of Sciences, USSR in 1988 and joined the Human and Animal Physiology Department of Odessa State University as an Assistant Professor. From 2008 until now, she is an Associate Professor of Medical Chemistry Department of Odessa National Medical University. Her fields of interests are nutrition, digestion and absorption in the small intestine and effects of milk thistle fruits on it, total body irradiation, radio pharmacology, nutrigenomics, pharmacogenomics.

Abstract:

Revision of the own data of experimental studies of membrane hydrolysis and absorption of mono- and dimeric nutrients in the small intestine of rats for the last 30 years are presented. The results of investigations of digestion and absorption of carbohydrates (glucose and maltose) in vitro by the preparations of accumulating mucous and in vivo in the chronic experiments on isolated and
functioning portions of the small intestine of the rats are analyzed. In vitro test determined a concentration-dependent relationship between the protein and carbohydrate origin substrates with varying degrees of polymerization. The peculiarities of absorption of different concentrations of glucose and maltose in the presence of equimolar solutions of glycine and glycyl-glycine respectively were discussed. Analysis of the data of hydrolysis of different concentrations of maltose in vitro and in vivo was made, and the coefficients of conjugation of digestion of maltose and absorption of produced M-glucose were compared. The high stability of the free glucose transport system both in vitro and in vivo was found.

Biography:

Erika La Vella completed her Doctorate of Osteopathic Medicine at Pacific Northwest University and her residency training at Good Samaritan Regional Medical Center in Corvallis, Oregon. She earned her Bachelor degree of Science in Nutrition from the University of Idaho. She has two publications and serves as an Editorial Board Member of the Journal of Surgery and Research. She now practices as a Robotic General and Bariatric Surgeon at a community hospital in Corvallis, Oregon. She has always appreciated the direct relationship that food quality, digestion and lifestyle have on human health. She believes that when individuals are healthy, their families and communities around them begin to thrive.

Abstract:

Background: Bile reflux gastritis of the remnant stomach following Roux-en-Y gastric bypass (RYGB) causing chronic abdominal pain has not been reported. We report a series of symptomatic patients with remnant gastritis treated effectively with remnant gastrectomy.

Objective: To report our experience with bile reflux remnant gastritis after RYGB and our outcomes following remnant gastrectomy.

Setting: Community teaching hospital.

Methods: All patients undergoing remnant gastrectomy were retrospectively reviewed for presenting symptoms, diagnostic workup, pathology, complications, and symptom resolution.

Results: Nineteen patients underwent remnant gastrectomy for bile reflux gastritis at a mean of 4.4 years (52.3 months, range 8.5- 124 months) after RYGB. All patients were female and presented with pain, primarily epigastric 18/19 (95%), and described as burning 11/19 (58%), with 10/19 (53%) reporting nausea. Endoscopy was performed preoperatively on all patients with successful remnant inspection in 13 (68%), using push endoscopy (n=10) or operative assist (n=3) with 12/13 (92%) biopsy-positive for reactive gastropathy. Seventeen (90%) completed a HIDA scan with 100% positivity demonstrating bile reflux across the pylorus. Surgical approach was laparoscopic or robotic in 18 (95%) with hospital LOS of 2.7 days (range 0 to 12 d) with no major complications or readmissions. Pathology of the remnant confirmed reactive gastropathy in 90% (n=17). 90% (N=17) of patients reported sustained symptom resolution and 11% (n=2) of patients remained symptomatic at last follow up. We followed all patients for a mean of 6.6 years (1-194 months).

Conclusion: Bile reflux gastritis of the remnant stomach is a new consideration for chronic abdominal pain months to years following RYGB. HIDA imaging and endoscopic biopsy are highly suggestive. Remnant gastrectomy is safe and effective treatment.

Biography:

Alexander Surya Agung is the Head of Surgery Department at Bhayangkara Police Hospital in Surabaya Indonesia. He completed his Medical Doctor and General Surgeon at Airlangga University, Surabaya Indonesia. He is interested in minimally invasive surgery and has attended courses in Singapore, India, Taiwan and Philippines. He is a Member of ISES, Indonesian Society of Endolaparoscopic Surgery, Indonesian Hernia Society, Endoscopic and Laparoscopic Surgeon of Asia, Asia Pacific Hernia Society and European Association for Endoscopic Surgery.

Abstract:

Objectives: Laparoscopic procedures are becoming routine and common. Patients who need simple and short time procedures enjoy shorter hospital stays and quicker recovery times. These procedures have progressed to an ambulatory procedure. We present 7 years’ experience (Jan 2010-Dec 2016) ambulatory laparoscopic surgery, several cases lower abdominal laparoscopic surgery (high vasoligation varicocelectomy), inguinal hernia repair TAPP, cystectomy, ovarectomy and adhesion release), and underwent by loco regional anesthesia.

Methods: Between Jan 2010 to Dec 2016, 498 patients underwent ambulatory laparoscopic surgery (high ligation varicocelectomy: 412 patients, inguinal hernia repair TAPP: 53 patients, abdominal pain due to adhesion to abdominal wall:17 patients, cystectomy: 14 patients, bilateral ovarectomy: 2 patients), ASA I –II, underwent by loco regional anesthesia (Spinal block, sedation (midazolam) and analgesia (morphin/fentanyl)), spinal anesthesia level VL (video laparoscopy) III-IV, spinocan 29G with blocked target VTh IV-V, using low pressure CO2 (10-12 mmHg) pneumoperitoneum.

Results: There were 3 patients admitted for observation, due to bradycardia, hypotension and PONV (Postoperative nausea and vomiting). There was neither conversion from spinal to general anesthesia nor to opened surgery. Age: 17-48 years (average 21 years), sex: male 463, female 35, defects; varicocele: unilateral 345, bilateral 67, Inguinal hernia: unilateral 51, bilatreral 2, operating time: 15-60 minutes (average 30 minutes), no postural headache and urine retention was found, cost effective: 40-50% lower.

Conclusions: Ambulatory laparoscopic surgery is feasible and safe under regional anesthesia and more cost effective. Further studies are required to validate this technique.

Biography:

Antonino Crino has completed his Postgraduate in Endocrinology, Diabetology and Metabolic Diseases and Pediatrics. He is now responsible for Autoimmune
Endocrine Diseases Unit at Bambino Gesù Hospital, Research Institute, Palidoro (Rome). He is Coordinator of the Genetic Obesity Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (SIEDP). He is a referent for central Italy of patients with Prader-Willi syndrome (he follows more than 250 PWS patients). The focus of his research and clinical work is in many fields of pediatric endocrinology. In the last 10 years, he has had a particular interest in genetic obesity, especially in Prader-Willi syndrome. As for the Prader-Willi syndrome, the research programme actually focuses on endocrine problems and on the use and effectiveness of bariatric surgery for treatment of severe obesity in these patients. He has published more than 100 papers in reputed journals and has produced and provided many abstracts both in Italy and at international congresses. He has organized medical congresses and scientific meetings and he collaborates with many scientific institutions either national or international.

Abstract:

Background: Improvement in weight control remains the most important goal of any treatment program in Prader-Willi syndrome (PWS). To date, bariatric surgery experience in Prader-Willi syndrome (PWS) is limited, and different procedures have been used with varying success. Malabsorptive procedures, such as biliopancreatic diversion (BPD), are not always recommended for PWS due to lack of safety data and can involve long-term complications.

Patients & Methods: We report 10 severely obese patients (6 males) with genetically confirmed PWS (7 del15, 3 UPD15) who underwent Scopinaro’s BPD after inability to control food intake with the classical approaches. Surgery was performed on patients aged 18.8±3 yrs. (mean±SD) (range: 15.4-24.4) and the BMI (kg/m2) was ≥40 in all cases (49.9±6.7). At baseline, severe co-morbidities were present, such as obstructive sleep apnea (OSAS), type 2 diabetes mellitus (T2DM), hypertension, metabolic syndrome and/or steatohepatitis.

Results: No perioperative complications were observed. After a follow-up period of 13.9±7.3 yrs. (range 4.8-27; mean age at follow-up: 32.5±6.8 yrs) the maximum weight loss % (MWL%) was 30.7±10 (10.1-52.6). Following BPD, BMI decreased in six patients, stable in three subjects and increased in one individual. The mean BMI at the last visit was 40.5±8.8 (28.9-51.6). After BPD, appetite was reduced in seven cases; eight subjects had hypochromic anemia and seven had diarrhea; OSAS were present in 5 patients and osteoporosis/osteopenia in all individuals. T2DM disappeared and behavioral problems improved in some cases. One patient suddenly died at the age of 37.3 yrs. After surgery all patients received medical therapy to prevent nutritional deficiency.

Conclusion: The long-term outcome of BPD in our PWS seems to be favorable, with a significant reduction of weight excess in the majority of subjects. Thus, BPD seems to be a good option in the presence of severe comorbility and in selected PWS patients, with co-operating families, when other classical approaches have failed. Due to the presence of specific side effects of the procedure, however, a careful long-term multidisciplinary follow-up is always necessary.

Biography:

I Herrero Fresneda is a PhD in Biological Sciences and has wide experience in biomedical research and university teaching. She has published more than 50 original articles in specialized peer-reviewed journals. She was the Principal Investigator in experimental renal transplantation at Bellvitge Hospital and Associate Professor of Cell Biology at the University of Barcelona. While looking for a professional change she began to assess the viability of a lot of business ideas she had always had. In the 1st edition of the d-HEALTH program of MOEBIO she met the team with whom she cofounded usMIMA and created MOWOOT. Working in MOWOOT as Chief Scientific Officer she has discovered that she can leave a better world by helping people.

Abstract:

Statement of the Problem: It has been demonstrated that colon-specific massage is effective against constipation (ref). This study aimed to assess the effectiveness of MOWOOT, a medical device that automatically reproduces the abdominal massage of health professionals.

Sample: 15 people (45-86yo) suffering from chronic constipation for more than 5years who didn’t use manual abdominal massage as treatment.

Treatment: 15 minutes of massage with MOWOOT daily at the same time for 15 days. Patients should not discontinue their usual pharmacological treatments.

Methods: Before (PRE) and after (POST) treatment patients answered validated questionnaires to quantify fecal consistency (Bristol scale) and constipation index (CCCS). During treatment, they filled out a bowel diary. Patients with anal sphincter dyssynergia and those with <50% adherence to treatment were excluded from the analysis. Each patient served as his own control Student’s T Test (paired values) or Mann-Whitney U tests were used for quantitative or non-parametric variables. P<0.05 was considered statistically significant.

Results: No adverse effects were reported. All the people described a pleasant relaxing sensation during the massage. Two people left the study. Three were excluded due to lack of adherence. Out of 10 people who completed the treatment, two were excluded due to anal dyssynergia. The final sample analyzed was n=8 (70.70±3.94yo). The results showed a clear increase in the average number of bowel movements per week (4.75±0.86 pre vs 6.5±1.09 post, P=0.0062); significant improvement in fecal consistency (Bristol 3.09±0.66 pre vs 5.02±0.41 post, P= 0.0335) and halving the defecation time (8.55±1.48 pre vs 4.59±0.74 min post, P=0.0036), resulting in a clear reduction in the constipation index (11.50±1.25 pre vs 8.25±.08 post, P=0.0001).

Conclusions: The specific massage of colon administered automatically with MOWOOT reduces the fecal consistency, increases the frequency of evacuations, and decreases the time of deposition, improving chronic constipation in adults.

Biography:

Jehad Alshawi is Laparoscopic & General surgeons. Alshawi Graduated from Australia while Alshurafa from Germany ,both working in advance laparoscopy with experience in Bariatric surgery as Morbid obesity is a major disease in Saudi Arabia. In addition, ,alshawi has a master degree in Heath Administration..both have long experience with morbid obesity surgery.MPrince Sultan and national guard hospital are major tertiary hospital.

Abstract:

Aims and Objectives: Present our recent experience in the commonest anti-obesity two procedures. Comparing the early results of laparoscopic gastric bypass and sleeve gastrectomy. Showing the current trends in the anti-obesity surgeries

Results: The study is retrospective. Include all the patients have underwent bariatric surgeries from first October 2011 to 30 September 2012. These operations all were performed by the same surgeon Total number of bariatric surgeries was 405 operations, 160 laparoscopic gastric bypass and 219 laparoscopic sleeve gastrectomy

Conclusions: Both procedures (LSG & GB) are common, feasible, and safe bariatric procedures. Both groups of patients are comparable in demographic data. Both procedures have comparable results in term of hospital stay. OR time, 3 months and FU compliance, but LSG has more weight loss in first 3 months. Patients preference and acceptance is more in favor of LSG. LSG carries slightly higher risk in term of short term complications specially leak Larger size samples and more studies are required to compare between the two groups of operations

Biography:

Chen Min has completed her PhD from Wuhan University, School of Medicine. She is an associated Physician working in the affiliated Drum Tower Hospital of Nanjing University, Medical School, P R China for almost seven years. She is In Charge of teaching work in the Department as Teaching Secretary. She has published more than 10 papers in reputed journals. Her research field is about basic and clinical research in gastric cancer.

Abstract:

Cancer cells consume large amounts of glucose to produce lactate, even in the presence of ample oxygen. This phenomenon is called the Warburg effect. C-Myc is an important member of the Myc gene family and is involved in the development of various tumors. It plays an important role in the regulation of tumor energy metabolism which can regulate glycolysis to promote tumor Warburg effect. Our study aims to improve the malignant biological behavior by controlling the energy metabolism of gastric cancer through the mTOR/HIF-1α/PKM2 and STAT3/c-Myc signaling pathway through a series experiments in vitro tests. Human gastric cancer AGS and HGC-27 cells were treated with PKM2 and C-Myc lentivirus, the effects of knockdown PKM2 or C-MYC were analyzed on cell proliferation, cell apoptosis, the ability of cell migration and growth signaling pathway in vitro. The expression of PKM2, C-MYC, LDHA, STAT3, P-STAT3, GLUT-1 gene was identified by quantitative real-time polymerase chain reaction and western blotting, Lactate and glucose levels were tested by the corresponding kit. Our findings showed that PKM2 and C-MYC were up-regulated in human gastric cancer. Knockdown C-MYC in gastric cancer cells suppressed cell proliferation capacity and glycolysis level, co-knockdown of PKM2 and C-MYC, the inhibitory effect on gastric cancer cells was more obvious compared to knockout PKM2 or C-MYC alone. And there was a correlation between mTOR/PKM2 and STAT3/C-myc signaling pathways. Our results suggest that C-MYC may be considered a potential therapeutic target for gastric cancer, and PKM2 combined with C-MYC can better inhibit the malignant biological behavior of gastric cancer.

Biography:

Mogens Fenger MD is an expert in in population and medical genetics. Focus of his research is implementation of information theoretical aspects and network structures in his research of genetics of obesity and diabetes mellitus type 2. Dr. Fenger had established a biobank harboring more 1.000 RYGB patients. He collaborates with major institutions in Denmark and abroad.

Abstract:

Roux-en-Y gastric bypass surgery (RYGB) is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter often vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but the observation may suggest that the fates of obesity and diabetes are only partly linked metabolic conditions. The trajectories of weight reduction differ significantly between groups and any sub-populations of groups, the latter identified by the distance between individual trajectories using a k-means procedure. This suggests that different domains in the enormous genetic network governing basic metabolism are perturbed in obesity and diabetes, and in fact some of the patients are affected by two distinct diseases: obesity and diabetes mellitus type 2. Thus, the obesity part of the glycaemic derangement may have been ameliorated by RYGB (at least to some extent), but some defects of the diabetic state had not. It could actually be argued that the diabetics are not transformed into a non-diabetic state, as the true reference is the non-diabetics RYGB patients. Compared to this reference population, pivotal variables related to metabolism and diabetes remains significantly different.

Biography:

Silvestrov Maksym has completed National Medical University in Kyiv in 2004. He has completed specialization in General Surgery in 2006; specialization in Surgical Oncology. 2009. He was a Surgeon at Zina Memorial Lissod Cancer Hospital from the period 2009-2014. He is the Head of Surgical Department, Innovacia Cancer Centre and Spizhenko Cancer Center, Kyiv, Ukraine. He has published documents in laparoscopic treatments for general surgery and oncological surgery procedures. He has participated in many national and international congresses.

Abstract:

Natural orifice transluminal endoscopic surgery (NOTES) is surgical technique whereby "scarless" abdominal operations can be performed with an endoscope passed through a natural orifice (mouth, urethra, anus etc.). Laparoscopy can minimize external incision and scars but can’t avoid damage of abdominal wall for specimen extraction. Since 2015 we perform hybrid technique for women, when after laparoscopical colon or upper rectal cancer resection specimen had extracted through vaginal fornix.

Methodology: From October 2015 to October 2017 we performed 10 laparoscopic resections with transvaginal specimen extraction for women with colorectal cancer: 7 - for sigmoid cancer and 3 - for rectal cancer (all rectal with standard TME (Total mesorectal excision)). All patients were cured with standard cancer treatments protocols.

Results: The average hospital stay was 4.2 days (range 3 to 5). We had no any wound complication or local recurrence in vaginal fornix. We don’t use opioid analgesics in postoperative period. All resection was R0.

Conclusions: Use of hybrid technique can avoid abdominal wall damage and result fast recovery with good cosmetics. It seems safe but late oncological outcomes needs to be investigated.

Biography:

Triki Ismail is a Gastroenterologist and Specialist in the management of IBD. He has hospital and liberal experience to treat Inflammatory bowel disease since he has done research work in this direction. He is also a Member of several associations for patients.

Abstract:

Therapeutic issues have evolved in management of inflammatory bowel disease(IBD) and a new therapeutic target is the achievement of mucosal healing (MH). Indeed, this concept is associated with better long-term outcome in term of sustained clinical remission, a decrease in the need for hospitalizations and surgery and improvement quality of life. Several methods have been used to define and evaluate MH. Among them, histology and endoscopy are the main methods that are competed by imaging or biological methods which are subject of validation studies. We draft on the advantages and disadvantages of each technic to better define what MH is.