Laparoscopic adjustable gastric banding for morbid obesity: radiographic management and imaging of postoperative complications

We present the results of our experience in 150 individuals underwent laparoscopic adjustable gastric banding [LAGB] to assess its efficacy in terms of weight loss and safety as well as to validate the role of radiographic assessment in determining the range of early and late possible postoperative complications. 150 consecutive [105 women, 45 men] morbidly obese patients with BMI of >40 kg/m[2] or BMI of >35 kg/m[2] with one obesity related disease who underwent LAGB were included in this study. Water soluble upper gastrointestinal study was done on the second postoperative day to ensure adequate position of the band, check the device components, and exclude perforation. 4 weeks after surgery stoma size adjustment was performed. Additional sessions were scheduled depending on the patient's ability to eat, weight loss curve, or manifestation of complications. Patients were followed up to 36 months. The% mean excess weight loss [EWL] at 1 year, 2 years, and 3 years was 44.4% [ +/- 17.8], 51.8% [ +/- 20.9], and 52.0% [ +/- 19.6], respectively. Complications relating to the gastric band occurred in 10 patients [6.5%]. Acute Gastric Perforation occurred in 2 patients [1.3%], band erosion in 4 patients [2.6%], slippage of the gastric band with gastric strangulation in 4 patients [2.6%]. Tube-related complications were detected in 15 patients [10%] and included port site discomfort in 3 patients [2%], port infections in 5 patients [3.3%], tube disconnection in 3 patients [2%] and tube leak in 4 patients [2.7%]. The LAGB procedure is a minimally invasive, totally reversible laparoscopic alternative in the treatment of morbid obesity. Various complications may be detected on follow-up imaging studies. The radiologist should be aware of these possible complications and their radiologic appearances

Rectal cancer: local staging using combined pelvic phased-array and endorectal coil MRI

We aim to assess the role of magnetic resonance imaging [MRI] in staging rectal cancer using pelvic phased array coil alone and both pelvic phased array and endorectal coils with comparison of the two techniques. 50 consecutive patients [30 men and 20 women] with primary rectal cancer were examined with either pelvic alone or pelvic and endorectal MRI for preoperative evaluation of tumor extent. The results of the examinations were compared with the histopathology of resected specimens. The sensitivity, specificity and accuracy of combined endorectal and pelvic MRI and pelvic MRI alone in identifying the depth of tumor penetration and the number of regional lymph nodes were calculated. Considering T3 staging, our study showed that MRI is 92% accurate while, it was 94% accurate in the assessment of pelvic organ infiltration [T4]. The overall accuracy for T staging was 90%. Also in the assessment of perirectal lymph node involvement MRI proved to have high accuracy [86%], as compared to the post operative pathological results. On comparing the results of the two different techniques used in this work, we found no significant difference in relation to the post operative pathological data. We can conclude that MRI is of high diagnostic value in establishing the best treatment strategy for cancer rectum patients