ABSTRACT
Background: obesity nowadays is associated with comorbidities that double folded the mortality as cancer, cardiovascular disease, and diabetes. And weight loss by dietary changes and exercise usually does not achieve the desired weight loss goals. As such, bariatric surgery has become the treatment of choice for obesity and co-morbidities. Body contouring and specially abdominoplasty after bariatric surgery is a component in the treatment of the obese patient and is well accepted by patients, despite the extensive scarring with all of the surgical procedures. There is evidence that post-bariatric surgery patients who have subsequent body contouring surgery maintain their weight loss
Aim of the Work: to compare between formal and modern mini-abdominoplasty after laparocopic sleeve gastrectomy
Patients and Methods: this comparative study included two groups of thirty patients each, group I consisted of patients with redundancy at the ventral part of the abdomen after weight loss stabilization at BMI 30 for more than 6 months post laparoscopic sleeve gastrectomy, where formal, traditional, abdominoplasty was done to them. While group II consisted of patients with redundancy at the ventral part of the abdomen after weight loss stabilization at BMI 30 for more than 6 months post laparoscopic sleeve gastrectomy, where modern mini-abdominoplasty was done to them
Results: as regarding Flank fullness post Abdominoplasty Group I resolved the flank fullness except for 10 while Group II 20 cases still with flank fullness, therefore there was statistical significant difference between the two groups as [p value] = 0.009823. As regarding upper abdominal wall bulge condition resolved successfully in 27 cases from group I and only 10 from Group II, therefore there was statistical significant difference between the two groups as [p value] = 0.000006
Conclusion: abdominoplasty gives the patient seeking weight loss the encouragement and well to lose more weight and improve his psychological state, traditional abdominoplasty provide a comprehensive treatment of abdominal wall redundancy, even in the most severe cases, the patients get both functioning and cosmetic improvement. Mini-abdominoplasty is less effective, not appropriate method to treat patients with lipodystrophy of the trunk and fullness of the flanks post laparoscopic sleeve gastrectomy and bariatric surgeries
ABSTRACT
Background: Traditionally, open procedure through exploratory incisions remains the gold standard approach for treating colorectal [CRC]. Laparoscopic colectomy was proved to be a better alternative to the open approach. Though in some studies, it was found that the length of the operation tends to be somehow longer. However, in experienced hands it has comparable oncologic outcomes. Moreover, the laparoscopic approach is associated with less postoperative pain, faster return of bowel activity, earlier resumption of oral intake and lesser hospital stay
Aim of the Study: to study and evaluate the effectiveness of laparoscopic left hemicolectomy and sigmoidectomy compared to the open left sided colectomy and sigmoidectomy for malignancy regarding operative time, length of hospital stay, return of bowel function, resumption of oral intake, postoperative pain perception, general postoperative complications, surgical site infections and early recurrence
Patients and methods: This comparative study has been conducted in El-Demerdash hospital, Ain Shams University - Cairo, Egypt and has included 60 patients where half of the patients underwent open left hemicolectomy or sigmoidectomy and the other half underwent laparoscopic left hemicolectomy or simoidectomy. We performed both procedures during the period between 1[st] of January 2016 and 1[st] of January 2017 with 12 months of follow up post-operatively
Results: In our study, the laparoscopic operation was associated with less hospital stay, earlier return of bowel activity, earlier resumption of oral intake without the use of the regular anti-emetics with better pain control and perception postoperatively. Moreover, it was associated with less surgical site infections and general complications including the respiratory ones than the open operation. We had similar anastomotic leak rates and early recurrence rate between both operations. Finally, the laparoscopic operation was associated with more operative time compared to the open operation
Conclusion: Laparoscopic left hemicolectomy and sigmoidectomy are oncologically sound when compared to the open left hemicolectomy and sigmoidectomy for treating left sided and sigmoid cancers. Moreover the laparoscopic approach yielded better outcomes regarding the postoperative recovery compared to the open approach
Recommendation: A further high volume study is needed to assess the long term effects of both procedures in our hospital