Andrea Lazzati

• MD, PhD
• Surgeon at Hôpital Avicenne – Hôpitaux Universitaires Paris-Seine-Saint-Denis

Background Although complications primarily affect patients, they also seem to cause repetitive trauma for surgeons. The concept of the "second victim" was introduced by Dr. A. Wu in 2000. This study aims to analyze the psychological impact of serious complications on metabolic and bariatric surgeons. Methods The target population included all met...

Background This study is part of an initiative to improve the FAIRness (Findability, Accessibility, Interoperability, Reusability) of metabolic bariatric surgery (MBS) registries globally. It explores the extent to which European registry data can be manually integrated without first making them FAIR and assesses these registries’ current level of...

Introduction The quality of hospital care, especially surgery, is traditionally assessed using indicators derived from healthcare databases or safety indicators. Given the growing importance of placing the patient at the heart of care evaluation, the use of questionnaires such as the Patient-Reported Experience Measures and Patient-Reported Outcome...

Aim Some patients with inflammatory bowel disease (IBD) require subtotal colectomy (STC) with ileostomy. The recent literature reports a significant number of patients who do not undergo subsequent surgery and are resigned to living with a definitive stoma. The aim of this work was to analyse the rate of definitive stoma and the cumulative incidenc...

Introduction The International Federation for Surgery for Obesity and Metabolic Disorders (IFSO) Global Registry aims to provide descriptive data about the caseload and penetrance of surgery for metabolic disease and obesity in member countries. The data presented in this report represent the key findings of the eighth report of the IFSO Global Reg...

(Presque) une avant-première des nouvelles recommandations de chirurgie bariatrique

Introduction Contradictions remain on the impact of interhospital competition on the quality of care, mainly the mortality. The aim of the study is to evaluate the impact of interhospital competition on postoperative mortality after surgery for colorectal cancer in France. Methods We conducted a retrospective cross-sectional study from 2015 to 201...

1.1. Objective: This study aimed to determine the presence of SARS-CoV-2 virus in the pneumoperitoneum and/or peritoneal fluid during emergency laparoscopy performed in patients infected by SARS-CoV-2 virus during the first waves of COVID-19 pandemic. 1.2. Summary background data: All recommendations edited by the French and foreign Surgical Societ...

Backgroud The risk of esophageal cancer after bariatric surgery is a matter of debate. Several studies have reported that bariatric surgery patients have a lower risk of cancer. However, esophageal cancer is associated with gastroesophageal reflux disease, which may increase after bariatric surgery and in particular after sleeve gastrectomy. Objec...

Background: Acute chest syndrome (ACS) is a life-threatening complication of sickle-cell disease (SCD). Although respiratory pathogens are frequently detected in children with ACS, their respective role in triggering the disease is still unclear. We hypothesized that ACS incidence followed the unprecedented population-level changes in respiratory...

Background Preoperative attrition is highly prevalent in patients referred for bariatric surgery. Little information is available neither on reasons reported by patients for attrition in knowledge nor costs of attrition in a publicly funded health system. Objectives To assess the reasons for the attrition of bariatric candidates and calculate its...

Introduction: The French Society of Digestive Surgery (Société Française de Chirurgie Digestive [SFCD]) has elaborated clinical practice guidelines for the management of the obese patient undergoing gastro-intestinal surgery. Methods: The literature was analyzed according to the GRADE® (Grading of Recommendations Assessment, Development and Eval...

Surgical interventions for obesity have quintupled in the world in 15 years (140,000 in 2003 vs. 720,000 in 2018), however growth has slowed since 2011. This progressive increase varies by country and from 2008 through 2018, 6.5 million people have undergone bariatric surgery. Growth was strongest in the Asia/Pacific region. Belgium is the country...

Importance: Bariatric surgery has been associated with a reduced risk of cancer in individuals with obesity. The association of bariatric surgery with esophageal and gastric cancer is still controversial, however. Objective: To compare the incidence of esophageal and gastric cancer between patients with obesity who underwent bariatric surgery an...

Analysis of the impact of different bariatric surgery procedures of the risk of esophageal cancer

Lecture on the association of obesity, bariatric surgery and cancer

Importance: Acute chest syndrome (ACS) is one of the leading acute severe complications of sickle-cell disease (SCD). Although Streptococcus pneumoniae (S pneumoniae) is highly prevalent in children with SCD, its precise role in ACS is unclear. The efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) implementation on ACS is still unknown....

Importance: An association between pneumococcal nasopharyngeal carriage and invasive pneumococcal disease (IPD) has been previously established. However, it is unclear whether the decrease in IPD incidence observed after implementation of nonpharmaceutical interventions (NPIs) during the COVID-19 pandemic was associated with concomitant changes in...

Background Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group dur...

Introduction Le risque de cancer de l'œsophage et de l'estomac après une chirurgie bariatrique est débattu. Plusieurs études ont rapporté que les patients opérés d'une chirurgie bariatrique ont un risque plus faible de cancer. Cependant, les cancers de l'œsophage et de l'estomac sont associés à des facteurs de risque spécifiques, qui pourraient aug...

Introduction Des contradictions subsistent quant à l'impact de la concurrence interhospitalière sur la qualité des soins, principalement la mortalité, et très peu d'études existent sur ce sujet. L'objectif de cette étude était d’évaluer l'impact de la concurrence interhospitalière sur la mortalité postopératoire après chirurgie du cancer colorectal...

Introduction Un confinement national a été déclaré par les autorités gouvernementales le 12 mars 2020 pour limiter les risques de propagation du virus Sars-Cov2. L'activité au bloc opératoire a été annulée pour libérer des équipes paramédicales et médicales pour les réorienter vers les soins liés à la pandémie COVID19. Le but de cette étude était d...

Background The impact of weight loss induced by bariatric surgery on cancer occurrence is controversial. To study the causal effect of bariatric surgery on cancer risk from an observational database, a target-trial emulation technique was used to mimic an RCT. Methods Data on patients admitted between 2010 and 2019 with a diagnosis of obesity were...

Purpose The present study aims to determine the impact of previous bariatric surgery (BS) on the length of hospital stay; the incidence of mortality, re-transplantation, and re-hospitalization after LT; and the related economic costs, through the analysis of the French National Health Insurance Information System. Materials and Methods All patient...

Analyse de données massives issues de la base de PMSI sur les complications de la chirurgie bariatrique en France.

Suivi endoscopique après chirurgie bariatrique

Importance Caustic ingestion in adults may result in death or severe digestive sequelae. The scarcity of nationwide epidemiological data leads to difficulties regarding the applicability of their analysis to less specialized centers, which are nevertheless largely involved in the emergency management of adverse outcomes following caustic ingestion....

Purpose Several strategies are suggested for ventral hernia repair (VHR) in bariatric candidates, in terms of timing and technique. The aim was to describe practices in VHR in bariatric patients on a nationwide scale in France. Materials and Methods We used the prospective national hospital discharge summaries database system to conduct a retrospe...

Background and AimsEndoscopy is effective in management of bariatric surgery (BS) adverse events (AEs) but a comprehensive evaluation of long-term results is lacking. Our aim is to assess the effectiveness of a standardized algorithm for the treatment of BS-AE.Patients and Methods We retrospectively analyzed 1020 consecutive patients treated in our...

A Correction to this paper has been published: https://doi.org/10.1007/s11695-021-05407-9

Background: The COVID-19 pandemic has had a major impact on healthcare in many countries. This study assessed the effect of a nationwide lockdown in France on admissions for acute surgical conditions and the subsequent impact on postoperative mortality. Methods: This was an observational analytical study, evaluating data from a national discharg...

PurposeFollow-up is a cornerstone of the success of bariatric surgery. However, adherence to monitoring decreases over time. The reasons for non-compliance with follow-up still remain unclear.Materials and Methods This is a retrospective, single-center, cohort study, including all patients undergoing bariatric surgery between 2014 and 2017. Patient...

Background As the prevalence of obesity in adolescents has reached an alarming level of 16%, the rate of metabolic bariatric surgery (MBS) in this population is also rising in several countries. Objective: This study aimed to compare the trends in types of MBS, short-term safety, and revisional rates, in younger adolescents under 18 years of age, c...

Background Laparoscopy for gastric cancer has not been as popular compared with other digestive surgeries, with conflicting reports on outcomes. The aim of this study focuses on the surgical technics comparing open and laparoscopy by assessing the morbi-mortality and long-term complications after gastrectomy. Methods A retrospective study (2013–20...

Background Diverticular disease is a common disorder. Several guidelines report on its optimal management. The aim of this study was to describe the evolution of the prevalence of this disease, the treatment strategies, and the mortality rate on a national level.Methods We conducted a retrospective study on prospective data using a nationwide datab...

Background Readmission after bariatric surgery may to lead to fragmentation of care if readmission occurs at a facility other than the index hospital. The effect of readmission to a non-index hospital on postoperative mortality remains unclear for bariatric surgery. Objectives Postoperative mortality rate according to readmission destination. Set...

Background Endoscopy plays a pivotal role in the management of adverse events (AE) following bariatric surgery. Leaks, fistulae and post-operative collection after sleeve gastrectomy (SG) may occur in up to 10% of cases. Objective to evaluate the efficacy and safety of Endoscopic Internal Drainage (EID) for the management of leak, fistula and coll...

LUS patterns of COVID-19 pneumonia have been described and shown to be characteristic. The aim of the study was to predict the prognosis of patients with COVID-19 pneumonia, using a score based on LUS findings. Materials and Methods An observational, retrospective study was conducted on patients admitted to Niguarda hospital with a diagnosis of COV...

Introduction Le cancer pulmonaire est la première cause de décès par cancer dans le monde. Malgré les avancées thérapeutiques, le pronostic reste sombre. L’objectif principal est d’identifier des facteurs de risque de mortalité à 90 jours de la première hospitalisation pour cancer pulmonaire (mortalité précoce). Méthodes Il s’agit d’une analyse de...

Background The outbreak of COVID-19 infection has led to the reorganization of hospital care in several countries. The objective was to report the postoperative mortality after elective digestive resections in a nationwide cohort during the lockdown period. Method This is analytic study was performed using a national billing database (PMSI). Patie...

Obesity is a chronic disease that presents a significant prevalence among women within childbearing age. Laparoscopic sleeve gastrectomy (LSG) is a widely used method for the treatment of obesity. Several studies have examined this operation’s impact on pregnancy outcomes with contradictory results. The aim of this systematic review was to examine...

Purpose: One anastomosis gastric bypass (OAGB) is now recognized as a mainstream bariatric procedure, nonetheless concerns about the risk of nutritional deficiencies and biliary reflux persist, and the ideal length of the biliopancreatic limb (BPL) is debated. Materials and methods: Data of patients who underwent OAGB between May 2010 and Decemb...

IntroductionIn the last two decades, an impressive increase in the number of surgical interventions was recorded in bariatric surgery. Similarly, several bibliometric studies reported an increasing trend for scientific production. This study aims to compare these two trends.Methods This study focused on the period 2003–2016 and included the followi...

Introduction La prise en charge en France des patients ayant ingéré un produit caustique est mal connue. Une étude de cohorte nationale a été réalisée. Méthodes Les données du PMSI combinant les codes (CIM-10) d’une ingestion de substance corrosive à ceux d’une atteinte œsophagienne ont été analysées. Résultats Un total de 4228 patients (H : 52 %...

ContextThe 30-day readmission rate after bariatric surgery is considered an important metric of the quality of hospital care. However, readmission rate beyond 30 days is rarely reported and does not provide any information about trajectories of care which would be of great interest for healthcare planning. The aim of this study was to analyze traje...

Background: Sleeve gastrectomy is the most common bariatric procedure worldwide. Several studies report good short- and midterm results. However, recent studies report alarming long-term outcomes, in particular about the revision rate. Objectives: The aim of this study is the assessment of the revisional rate after sleeve gastrectomy and the ana...

Introduction Le taux de réadmission à 30 jours après une chirurgie bariatrique est considéré comme un indicateur important de la qualité des soins hospitaliers. Cependant, le taux de réadmission au-delà de 30 jours est rarement rapporté et ne fournit aucune information sur les trajectoires de soins. Le but de cette étude était d’analyser les trajec...

Introduction La chirurgie bariatrique est considérée comme le traitement le plus efficace contre l’obésité. Néanmoins, cette chirurgie nécessite un suivi préopératoire conséquent au cours duquel les abandons de parcours sont fréquents. Cette étude a pour objectif d’analyser le taux d’abandon lors de la phase préopératoire de la chirurgie bariatriqu...

Introduction Le taux de réhospitalisations après chirurgie est considéré comme un indicateur de qualité de la prise en charge intra-hospitalière et de la coordination des soins entre la ville et l’hôpital. Cependant il n’est pas encore clair si les patients obtiennent les mêmes résultats lorsqu’ils sont réadmis dans l’hôpital où la chirurgie a eu l...

Background Readmission rate is considered an indicator of quality of care, which is already used in some countries to impose financial penalties on hospital with readmissions in excess of the national average. Nevertheless, this indicator presents some controversial drawbacks. The objective of this study was the assessment of readmission rate after...

Depuis un quart de siècle, l’obésité a doublé sa prévalence dans les pays occidentaux. Elle est devenue la deuxième cause de mort évitable après le tabac et a été reconnue comme une maladie à part entière. Au stade actuel de nos connaissances, la chirurgie est le traitement le plus efficace pour cette pathologie. La chirurgie de l’obésité, appelée...

Introduction The immunosuppressive therapy for life after liver transplantation (LT) is considered as a risk factor for obesity. Seven percent of the transplanted patients develop severe or morbid obesity. The obesity induces non-alcoholic steatohepatitis (NASH), which is a major risk factor for liver cirrhosis and hepatocellular carcinoma, without...

Introduction Le taux de ré-hospitalisations est considéré comme un indicateur de qualité déjà utilisé aux États-Unis pour valoriser ou pénaliser le remboursement des hôpitaux. Des expériences pilotes sont mise en place en France. Cette étude évalue pour la première fois le taux de ré-hospitalisations non programmées après chirurgie bariatrique. Mé...

Introduction L’utilisation de l’immunonutrition, recommandée en France pendant sept jours avec chaque chirurgie digestive carcinologique majeure, est basée sur une diminution des complications post-opératoires. Son effet est actuellement controversé. L’objectif de cette étude était d’évaluer à l’échelle nationale l’effet de l’immunonutrition préopé...

Discipline Épidémiologie. Introduction et but de l’étude L’immunonutrition se définit par l’ajout de nutriments spécifiques en quantité supérieure à la normale pour moduler l’immunité, dans le cadre d’une assistance nutritionnelle. Les recommandations nationales indiquent qu’elle devrait être prescrite avant toute chirurgie digestive oncologique m...

Objective: The objective of the present study was to assess the effect of preoperative immunonutrition on a nationwide scale. Background: According to international guidelines, immunonutrition should be prescribed before major oncologic digestive surgery to decrease postoperative morbidity. Nevertheless, this practice remains controversial. Met...

Introduction Laparoscopic sleeve gastrectomy (LSG) has become one of the most popular bariatric surgeries worldwide. However, complications related to the stapler line can be very serious. Among several challenging post-LSG complications, fistula is the most feared. Its management can be very challenging and chronic. In case of chronic fistula and...

This study is a review on the management of ventral hernia during bariatric surgery. The main outcomes are the recurrence rate after ventral hernia repair and the incidence of prosthetic infection. Eleven studies were included. Ventral hernias were treated by simple suture (n = 191), synthetic mesh (n = 186), and biological mesh (n = 72). Mean defe...

Purpose: The epidemic of obesity has determined an important rise in popularity for bariatric surgery (BS) in France. The role of general practitioners (GPs) in the decision-making process of candidates to BS as well as in their life-long follow-up after surgery is therefore destined to grow up. The aim of this survey was to provide a picture of t...

Background Bariatric patients are often candidates for plastic surgery. However, the rate of post-bariatric procedures is not known. Objectives The aim of this study was to analyze the rate of plastic surgery, and factors related to surgery, in bariatric patients. Setting University Hospital, France Methods This was a cohort study based on admin...

Background: Knowledge regarding the feasibility and safety of sleeve gastrectomy (SG) in obese liver transplant recipients is scarce. We report our experience of sleeve gastrectomy following liver transplantation (LT). Methods: All patients who had undergone LT and subsequently underwent SG at our institution were retrospectively reviewed. Surgical...

Introduction L’obésité et le syndrome métabolique sont des facteurs de risque de survie du greffon et du malade après transplantation hépatique (TH). Les données sur le rôle de la chirurgie bariatrique dans cette population sont rares. Nous présentons une série de sleeve gastrectomy (SG) après TH. Méthodes Tous les patients adultes opérés d’une SG...

Background Laparoscopic sleeve gastrectomy (LSG) has become one of the most popular bariatric surgeries worldwide, given good result concerning weight loss and long-term morbidity.While surgical technique is well standardized, specimen extraction is still a matter of controversy between surgeons.In this video, we present a simple, fast, safe, and r...

Background Obesity is a chronic disease that requires procedures to enable to maintain good long-term results. Laparoscopic adjustable gastric banding (LAGB) studies with a long-term follow-up are limited and have often given conflicting results. We report our results in terms of banding life span and weight loss in a cohort of 301 patients operate...

Background: The interest in bariatric surgery has considerably increased in the scientific community in the last two decades. We present a bibliometric analysis of scientific publications in bariatric surgery focusing on the period 2010-2014. Methods: We used the Web of Science database as source of data. The main bibliometric indicators were ap...

Single-anastomosis pylorus-preserving procedures (SAPPP) were recently introduced into bariatric surgery in order to combine the physiologic advantages of a post-pyloric reconstruction with the technical advantages of an omega loop. Surgery consists of a sleeve gastrectomy that is performed first, followed by a duodeno-enterostomy. Two main variant...

Objective: The aim of this study was to analyze the adjustable gastric banding (AGB) natural history on a national basis. Background: Adjustable gastric banding represented the most common bariatric procedure in France until 2010. Since then, the number of AGBs has decreased and the rate of band removal and revisional surgeries has progressively...

Background: Weight loss failure and proton pomp inhibitor (PPI)-resistant gastroesophageal reflux diseases (GERD) after sleeve gastrectomy (SG) are frequently encountered. Objectives: The aim of this study was to evaluate the efficacy and risks of SG conversion to Roux-en-Y gastric bypass (RYGB) in the case of weight loss failure or severe GERD....

Current knowledge indicates that malnutrition increases the rate of post-operative complications, particularly respiratory and infectious, after major surgery. Almost all liver surgery is performed in patients with cancer, a factor that increases the risk of malnutrition. The primary risk factors for post-operative complications are pre-operative h...

Background: Adjustable gastric banding (AGB) has been a very common bariatric procedure, but long-term AGB related complications have led to an increased number of second procedures. Sleeve gastrectomy (SG) is one option and can be done as a 1- or 2-step procedure. Objective: To compare the 1-step and 2-step approachs of conversion of AGB to SG...

Résumé Il est désormais admis que la dénutrition augmente les complications postopératoires, en particulier respiratoires et infectieuses après chirurgie majeure. La chirurgie hépatique est principalement réalisée chez des malades porteurs de cancers, ce qui augmente le risque de dénutrition. Les principaux facteurs de risque de complications posto...

Background: Early postoperative mortality after bariatric surgery has been reported in large national studies before sleeve gastrectomy (SG) was introduced as a stand-alone procedure. The aim of this study was to investigate the 90-day postoperative mortality rates after bariatric surgery in France on a nationwide basis. Methods: All morbidly ob...

Health-related information on the Internet is constantly increasing, but its quality and accountability are difficult to assess. Patients browse the Net to get more information, but the impact of the Internet on their decisions about surgical techniques, referral centers, or surgeon choice are still not clear. This study aimed to describe the role...

This study aims to conduct a systematic review on bariatric surgery (BS) for patients in the setting of liver transplantation (LT). A literature review was conducted on the PubMed, Embase, and Cochrane Library databases. Studies in the English language on adults reporting on BS prior to, during, or after LT were included. Eleven studies with 56 pat...

Contexte Le taux de mortalité de la chirurgie bariatrique en France n’est connu que par des études monocentriques. Méthodes Les données ont été extraites de la base de données nationale du Programme de médicalisation des systèmes d’information (PMSI). Tous les séjours des patients ayant eu un acte de chirurgie bariatrique entre 2007–2012 ont été r...