Similar length of colon is removed regardless of localization in right-sided colonic cancer surgery.

BACKGROUND: Colorectal cancers represent a heterogenous group of tumours. While left segmental colectomy is an accepted and oncologically safe practice for left-sided colonic cancer (CC), some authors suggest that limited segmental resection of right-sided cancer should be debated in order to preserve length of the resected colon. To our knowledge, caecum and ascending CC have not been analysed as different groups of tumours. The objective of this study was to assess if, retrospectively, surgical treatment of caecal cancer differed from ascending CC. METHODS: A review of all consecutive patients with right colonic resection for cancer admitted to the University hospital of Grenoble from January 2005 to August 2016 was performed. Length of resected colon was compared between caecal primary and ascending CC. Other technical and pathological aspects were analysed such as minimal invasive surgery and number of harvested lymph nodes from anatomic specimens. RESULTS: Among operated patients, tumour was localized pre-operatively on caecum in 110 cases and on the right ascending colon in 119 cases. Pre-operative localization had no effect on resected colon length (mean 24.5 cm, 24 ± 10.34 versus 25 cm ± 7.28, P = 0.95), on the number of harvested lymph nodes with a mean of 15 (±7.6) nodes in the caecal group versus 15.2 (±7.3) (P = 0.72). We noticed 15 cases of discordance between pre- and post-operative localization (4 versus 11, P = 0.08). CONCLUSION: Length of resected colon does not differ depending on localization of tumour in our center.

Malnutrition after bariatric surgery.

BACKGROUND: Malnutrition is a rare but severe complication following obesity surgery. Our objective was to analyze these cases of malnutrition and their management at the Grenoble University Hospital. METHODS: Retrospective data between 2006 to 2016 was analyzed from Department of Medical Information, Severe Obesity Outcome Network, and register of the Department of Artificial Nutrition. Data collected concerned age, sex, anthropometric data, surgical procedures and history of obesity surgery, initial surgical follow-up, delay from surgery, nutritional characteristics, nutritional and surgical management, follow-up and outcomes. RESULTS: Six patients had protein malnutrition after obesity surgery. Five patients (N.=5/6 83%) were initially operated on in other establishments. Only 1 patient in the cohort of 484 patients operated at on our institution was suffering from malnutrition (N.=1/484, 0.2%). All patients showed an excess weight loss of over 100%. Albumin level averaged 24.8 g/L at time of diagnosis. Patients were mainly operated on for an omega bypass (N.=4/6, 66%). Delay of malnutrition was 17.25 months in this category of patients whereas it was 84 months in patients having been operated on by another intervention. 3 patients (i.e. 50%) had chronic kidney disease when their initial surgery was performed. Two patients presented acute idiopathic pancreatitis following obesity surgery. CONCLUSIONS: Patients are at risk of malnutrition, especially after omega bypass and in patients with chronic kidney disease. Occurrence of acute pancreatitis is an alert to the risk of malnutrition.