The widespread epidemic of obesity and type 2 diabetes (T2D), suggests that both disorders are closely linked. Several pre-clinical and clinical studies have showed that adipose-derived mesenchymal stem cells (ASC) transplantation is efficient and safe. Moreover, scientists have already highlighted the therapeutic capacity of their secretomes. In this study, we used quantitative PCR, a flow cytometry-based system, the ELISA method, spectrophotometry, and confocal and scanning electron microscopy, to compare the differences in proliferation activity, viability, morphology, mitochondrial dynamics, mRNA and miRNA expression, as well as the secretory activity of ASCs derived from two donor groups—non-diabetic and T2D patients. We demonstrated that ASCs from T2D patients showed a reduced viability and a proliferative potential. Moreover, they exhibited mitochondrial dysfunction and senescence phenotype, due to excessive oxidative stress. Significant differences were observed in the expressions of miRNA involved in cell proliferations (miR-16-5p, miR-146a-5p, and miR-145-5p), as well as miRNA and genes responsible for glucose homeostasis and insulin sensitivity (miR-24-3p, 140-3p, miR-17-5p, SIRT1, HIF-1α, LIN28, FOXO1, and TGFβ). We have observed a similar correlation of miR-16-5p, miR-146a-5p, miR-24-3p, 140-3p, miR-17-5p, and miR-145-5p expression in extracellular vesicles fraction. Furthermore, we have shown that ASC_T2D exhibited a lower VEGF, adiponectin, and CXCL-12 secretion, but showed an overproduction of leptin. We have shown that type 2 diabetes attenuated crucial functions of ASC, like proliferation, viability, and secretory activity, which highly reduced their therapeutic efficiency.

Laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions.

Purpose: Improvement of the quality of life after bariatric surgery is an important outcome of the treatment. Assessing the long-term QoL results provides better insights into the effectiveness of bariatric surgery.Materials and Methods: This is a cohort study including patients who underwent bariatric surgery between June 2009 and May 2010 in one academic center. Patients underwent either laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB). Overall, 34 patients underwent LSG (52.3%) and 31 patients underwent LRYGB (47.7%). Preoperatively, and after 1 and 10 years, QoL was assessed using two standardized questionnaires: SF-36 and MA-QoLII. After 10 years, 72% of patients filled out these questionnaires.Results: The global QoL score before surgery was 48.3 ± 20.6. At the 1-year follow-up, the global total QoL score was 79.7 ± 9.8. At the 10-year follow-up, the global total QoL score was 65.1 ± 21.4. There was a significant increase in total QoL between measurements before the operation and 10 years after surgery in the whole study group (p = 0.001) and for patients who underwent LSG (p = 0.001). There was no significant difference between total QoL prior to surgery and 10 years after for patients who underwent LRYGB (p = 0.450).Conclusion: LSG led to significant improvement in QoL.

Background: The aim of this study was to assess the usefulness of protective negative-pressure wound therapy (NPWT) in the reduction of wound healing complications (WHC) and surgical site infections (SSI) after diverting ileostomy closure in patients who underwent surgery for colorectal cancer. Methods: In this prospective randomized clinical trial in a tertiary academic surgical center, patients who had colorectal cancer surgery with protective loop ileostomy and were scheduled to undergo ileostomy closure with primary wound closure from January 2016 to December 2018 were randomized to be treated with or without NPWT. The primary endpoint was the incidence of WHC. Secondary endpoints were incidence of SSI, length of postoperative hospital stay (LOS), and length of complete wound healing (CWH) time. Results: We enrolled 35 patients NPWT (24 males [68.6%]; mean age 61.6 ± 11.3 years), with NPWT and 36 patients (20 males [55.6%]; mean age 62.4 ± 11.3 years) with only primary wound closure (control group). WHC was observed in 11 patients (30.6%) in the control group and 3 (8.57%) in the NPWT group (p = 0.020). Patients in the NPWT group had a significantly lower incidence of SSI (2 [5.71%] vs. 8 [22.2%] in the control group; p = 0.046) as well as significantly shorter median CWH (7 [7–7] days vs. 7 [7–15.5] days, p = 0.030). There was no difference in median LOS between groups (3 [2.5–5] days in the control group vs. 4 [2–4] days in the NPWT group; p = 0.072). Conclusions: Prophylactic postoperative NPWT after diverting ileostomy closure in colorectal cancer patients reduces the incidence of WRC and SSI. Clinical trial registration: clinicaltrials.gov (NCT04088162).

The enhanced recovery after surgery (ERAS) protocol, which emphasizes preoperative interventions, is safely implemented in patients undergoing bariatric surgery. Patients are additionally encouraged to achieve weight loss preoperatively. We aimed to identify factors contributing to preoperative weight loss and assess their influence on outcomes of bariatric surgery among patients under the ERAS protocol.

Background: The laparoscopic right hemicolectomy is the standard surgical treatment for right-sided colon cancer. The continuity of the digestive tract is restored through ileocolic anastomosis which can be performed extracorporeally or intracorporeally. The study aimed to compare both anastomotic techniques in laparoscopic right hemicolectomy. Materials and methods: A single-blinded two-armed randomized control trial with 1:1 parallel allocation carried out from 2016 to 2020 in a single center. The follow-up period was 30 days. Compared interventions involved extracorporeal and intracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy. The main outcome of the study was bowel recovery measured as the time to the first stool. Other outcomes involved the time to the first flatus, morbidity, and duration of surgery. Results: One hundred and seventeen patients undergoing a laparoscopic right hemicolectomy with curative intent were eligible for the trial. Eight patients refused to participate. One hundred and two patients were analyzed, 52 in the intracorporeal group and 50 in the extracorporeal group. The groups did not differ in terms of cancer stage or body mass index, but did differ in age and sex. Intracorporeal anastomosis was associated with a shorter time to the first stool than extracorporeal, 32.8 h (26.0–43.7) vs. 41.7 (35.9–50.0), p = 0.017. There was no significant difference in the time to the first flatus, 30 h (23.2–42.3) vs. 26.6 h (21.8–37.3), p = 0.165. Similarly, overall complications did not differ (EC 12/50 vs. IC 10/52, p = 0.56). There were no differences in length of surgery, 190 min (150–230) and 190 min (180–220), p = 0.55. Conclusion: Intracorporeal ileocolic anastomosis following laparoscopic right hemicolectomy results in slightly faster bowel recovery, with no differences in morbidity and duration of surgery.