One-third of advanced-melanoma patients given nivolumab in study are alive five years after starting treatment

“You have got to read this. Using a stomach feeding tube to treat obesity? How about that.The treatments for medical conditions in severe obesity are not ideal. The surgery is complicated. This website explains the details of the types of gastrointestinal operations developed to try to reverse obesity safely. https://asmbs.org/resources/story-of-obesity-surgery This simple idea of inserting a tube to drain the stomach appears to produce excellent results with minimal complications. The report of a new procedure was  April 11, 2016 at a conference of Interventional Radiologists. It is not FDA approved yet. Expect it will be approved and cost effective. This is great news for obese patients with severe degeneration in their backs, hips, knees and feet.” Bill Chesnut, MD

To go back to New Health News: http://billchesnutmd.com/new-health-news

Reversible Gastrostomy Tube May Be an Alternative to Bariatric Surgery: Presented at SIR

Created 04/11/2016 – 16:21

By Lorraine L. Janeczko

VANCOUVER — April 11, 2016 — A tube running from the stomach directly out the body through the abdomen may be an alternative to bariatric surgery for obese patients, according to research presented here at the 41st Annual Scientific Meeting of the Society of Interventional Radiology (SIR).

“This is a safe, easy, relatively low-risk procedure that can be removed when desired and can result in high weight loss,” said Shelby Sullivan, MD, Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri. “Right now, very few patients are optimally treated for obesity, and we need to be able to treat more patients with additional tools like this device that have lower risk than bariatric surgery but that achieves higher weight loss than lifestyle therapy alone.”

The AspireAssist Aspiration Therapy System consists of a percutaneous gastrostomy tube with one end placed inside the stomach and the other end connected to a port outside the abdomen, as well as a removable siphon that facilitates aspiration. The device allowed each patient to expel roughly 30% of their most recent meal before it was digested. Although the study was planned to run for 1 year, 12 patients chose to remain implanted for 3 years.

To evaluate the weight-loss efficacy and safety of the endoscopically placed device, lead author Stephen Solomon, MD, Department of Radiology, Cornell University, New York, New York, and colleagues enrolled 25 obese patients with a mean body mass index (BMI) of 39.8 kg/m2 in a pilot study at Blekinge County Hospital, Karlskrona, Sweden, between July and September 2012.

Of these, 22 patients completed 1 year, 15 completed 2 years, and 12 completed 3 years. For the 12 who completed 3 years, the mean weight loss was 26 kg with a mean excess weight loss of 58%. The mean weight loss at the end of years 1, 2, and 3 was 48% (19 kg), 46% (18 kg), and 45% excess weight loss (19 kg), respectively, on an intent-to-treat basis using the last observation carried forward method.

“The misconception is that you can eat anything and then aspirate it,” explained Dr. Sullivan. “In reality, patients must eat less than before. The food particles have to be smaller than 5 mm in size to fit through the tube. To get good aspiration, patients have to chew their food until it disintegrates in their mouth.”

“People not only get tired of chewing and stop eating earlier in the meal than before, they eat more slowly, can sense feeling full and push away from the meal,” he said. “The patients also need to drink a lot of water with their meal to create a slurry that can be aspirated. This reduces the amount of food they can fit into their stomach.”

The device is available on a limited basis in Europe and select additional regions. It is not approved by the US Food and Drug Administration (FDA) yet.