Biomedical subjects

Ming-Te Huang

Publications and source records attributed to Ming-Te Huang.

23 records · Page 2Linked to original sources

PubMed2003

Clinical significance of central obesity in laparoscopic bariatric surgery.

BACKGROUND: Laparoscopic surgery had increased the interest and growth of bariatric surgery. Whether central obesity has any adverse effect in laparoscopic bariatric surgery is not clear. METHODS: 612 morbidly obese patients received laparoscopic bariatric surgery,in a prospectively controlled clinical trial of the outcome of the bariatric surgery. For comparison, subjects were dichotomized into either a central obesity group or peripheral obesity group, based on waist/hip ratio (WHR). Various biochemistry and blood count variables, and perioperative and postoperative results were measured. RESULTS: There were more female (458) than male patients (154). Male patients had higher BMI, and female patients were younger. 56 of 154 male patients (36.4%) belonged to the central obesity (WHR >1.0), and 321 of 458 female patients (70.1%) had central obesity (WHR >0.85). Central obesity was associated with age but not with BMI in males. In females, central obesity was associated with increased BMI. Central obesity predicted increased hyperglycemia and triglyceride levels in both male and female patients. Male patients with central obesity had higher WBC counts than the other patients. Although central obesity was associated with more intra-operative blood loss and prolonged recovery in female patients, there was no increase in complication rate or difference in postoperative weight loss. CONCLUSION: Central obesity is associated with a higher degree of hyperglycemia, hyperlipidemia and leukocytosis in morbidly obese patients who undergo bariatric surgery. Although there is increased technical difficulty in patients with severe central obesity, laparoscopic bariatric surgery is safe and effective in producing weight loss.

Adipose Tissue↗

PubMed2003

Metabolic syndrome in obese patients referred for weight reduction surgery in Taiwan.

BACKGROUND AND PURPOSE: The inverse relation between life expectancy and obesity is in large part due to multiple metabolic and cardiovascular comorbidities. Metabolic syndrome (MS) is defined as a cluster of these comorbidities. The prevalence of MS in obesity is not clear. This investigation assessed the prevalence and inter-relationships of MS with various demographic and clinical characteristics in patients with severe obesity. METHODS: A total of 534 obese patients referred to a surgical center for weight reduction surgery were included in this retrospective study. Data collected included blood pressure, anthropometric measurements, and biochemical parameters associated with metabolic comorbidities and MS. The prevalence of MS in various subgroups was analyzed. RESULTS: The frequency of metabolic comorbidities included hypertension in 29.8%, hyperglycemia in 29.0%, hyperlipidemia in 61.0%, hyperuricemia in 57.9%, and abnormal liver function in 60.9%. The presence of any of these 4 metabolic comorbidities in the absence of others was uncommon. Only 28 patients (5.2%) had no metabolic comorbidities. The criteria for MS were met by 217 patients (50.7%). Patients with MS were significantly older (32.9 years vs 29.5 years), more likely to be male (31.9% vs 20.5%) and more likely to have metabolic comorbidities compared with patients without MS. In the multivariate analysis, male gender, age, and abnormal liver function remained significantly associated with the development of MS, while body mass index (BMI) was not. CONCLUSIONS: Metabolic comorbidities were common in the obese patients referred for weight reduction surgery. The cluster of metabolic comorbidities in MS was significantly associated with male gender, and increased age but not with BMI.

Adolescent↗

PubMed2002

Laparoscopic Heller myotomy with fundoplication for achalasia.

BACKGROUND AND PURPOSE: Laparoscopic Heller cardiomyotomy for the treatment of achalasia can be performed safely. The application of this minimally invasive approach has not been reported in Taiwan. This study assessed the results obtained using this new method in Taiwanese patients. METHODS: From January 1998 to December 2000, we recruited 10 patients (3 men, 7 women; average age 37.3 yr) with achalasia who underwent laparoscopic cardiomyotomy and fundoplication. Before and after surgery, the severity of three symptoms (dysphagia, regurgitation, chest pain) was evaluated by symptom scores (0 = symptom absent; 1 = occasional; 2 = every day; 3 = every meal). Barium swallow study and panendoscopy were performed in all patients. Esophageal manometry was performed before surgery in seven patients. Laparoscopic Heller myotomy and anterior (Dor) fundoplication was performed through five abdominal trocar sites. The myotomy extended 7 cm, 6 cm above and 1 cm below the gastroesophageal junction. RESULTS: Barium swallow study showed that one patient had a normal or mildly dilated esophagus (< 3 cm) and nine patients had moderate esophageal dilatation (3-7 cm). Mean operative time was 162.5 +/- 29.7 minutes. Mean hospital stay was 5.1 +/- 1.6 days (range, 3-9 d). The mean follow-up time was 21.3 +/- 9.4 months, longer than 19 months in eight patients. Dysphagia was alleviated in all but one patient (90%). Regurgitation and chest pain also improved in all patients. No intraoperative complication occurred. Postoperative weight gain (> 4 kg) was noted in all patients. CONCLUSIONS: Laparoscopic Heller myotomy and anterior fundoplication result in significant symptomatic relief for patients with achalasia.

Adolescent↗

PubMedDate not supplied

Laparoscopic mini-gastric bypass for failed vertical banded gastroplasty.

BACKGROUND: Bariatric surgery is the only method for sustained weight loss in morbid obesity. However, 10-25% of patients will require re-operation for unsatisfactory weight loss or weight regain after restrictive surgery. Re-operation is associated with higher morbidity and mortality. This study is to evaluate the s a fety and efficacy of laparoscopic mini-gastric bypass (LMGB) for failed vertical banded gastroplasty (VBG). METHODS: From May 2001 to March 2003, 29 consecutive patients underwent LMGB for failed VBG. Average age was 39.7 years (range 22 to 56), and average BMI before re-operation was 41.7 kg/m(2) (range 35.0-70.8). 8 patients had previous open VBG, and 21 had laparoscopic VBG. The re-operation was for regain of weight in 16 patients, inadequate weight loss in 10 patients, and severe reflux esophagitis in 3 patients. Re-operation was performed after an average of 58.5 months (range 14 to 180). RESULTS: All the re-operations were completed laparoscopically. Average operative time was 171.4 minutes (range 130 to 290). There was 1 mortality, due to leakage (3.4%). 1 re-operation was necessary, for incarceration of small bowel in a trocar wound 10 days after the LMGB (3.4%). 1 anastomotic site bleeding and 1 wound infection occurred. Average BMI 12 months after the LMGB was 32.1 kg/m(2) (range 26.4 to 42.7). The quality of life study was significantly improved. The revision operation had much more technical difficulty for those with previous open VBG than laparoscopic VBG. CONCLUSION: LMGB is an effective and safe revision operation for patients with failed VBG. A large series and long-term follow up is needed for confirmation.

Adult↗

PubMedDate not supplied

Comparison of serum CA72-4, CEA, TPA, CA19-9 and CA125 levels in gastric cancer patients and correlation with recurrence.

BACKGROUND/AIMS: Serum tumor markers were investigated as prognostic factors for recurrence in patients with gastric cancers. METHODOLOGY: Preoperative serum levels of CEA, CA72-4, CA19-9, TPA and CA125 were sampled in 196 patients with gastric cancers undergoing curative surgery. The results were compared with the clinical recurrence and various clinicopathological factors. RESULTS: CA72-4, CEA, CA19-9, TPA and CA125 had sensitivities of 16.4%, 31.4%, 16.1%, 31.6%, and 6%, respectively. Sensitivity of two combinations was as high as 56.5%. Seventy-seven patients (39.9%) had clinical recurrence in the follow-up periods. For those with preoperatively elevated serum tumor markers, 38% (12/32) had CA72-4, 42% (13/31) had CA19-9, 48% (29/60) and had CEA, 54% (6/11) had CA125, and 62% (37/61) had TPA, and remained disease-free. Univariate analysis showed that TNM staging, Tumor size, Borrmann classification of tumor growth, and preoperative serum CA72-4 level were correlated with recurrence of disease. Multivariate analysis showed that independent prognostic factor of recurrence was TNM staging (P = 0.0007). CONCLUSIONS: Preoperative serum CA72-4 level is correlated with staging of disease, but is not an independent predictor for clinical recurrence of disease in patients with gastric cancers that undergo surgery.

Adult↗