ABSTRACT
INTRODUCTION: The most popular scale to stratify the postoperative risk is the Obesity Surgery Mortality Risk Score (OS-MRS). The design and ease of interpretation make the scale a potential tool for clinical use. AIM: To evaluate the usefulness of the OS-MRS scale in the enrollment of patients for laparoscopic bariatric procedures, including laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). MATERIAL AND METHODS: The medical records of patients who underwent LSG or LRYGB due to obesity between January 2010 and December 2010 were reviewed retrospectively. The decision of choosing the surgical procedure was made on the basis of OS-MRS risk category. The primary endpoint of this study was the 90-day mortality, and the secondary endpoint was the presence of major complications. RESULTS: There were 107 patients including 66 women and 41 men. The OS-MRS classes were A (48%), B (47%) and C (5%). The LSG was applied to patients with higher body mass index and to patients of class C. The secondary endpoints occurred in 6 patients, distributed in 10% of class A, 2% of class B and 0% of class C patients (p < 0.05). In 5 of 6 cases the endpoint was observed after LRYGB. Fatal cases were not observed. CONCLUSIONS: The OS-MRS can be a useful clinical tool for choosing the appropriate laparoscopic bariatric procedure, depending on the risk of postoperative complications. Low risk of postoperative complications should not lower the watchfulness of the surgeon.
ABSTRACT
UNLABELLED: Gastroesophageal reflux disease (GERD) has been a serious health and social problem. Population based survey revealed that around 40 per cent of the whole population reported monthly GERD related symptoms. When not treated properly GERD can lead to severe complications such as Barrett's oesophagus (BE) and adenocarcinoma as a consequence. Various methods can be useful in diagnosis of GERD but only gastroscopy is a widespread investigation that enables to establish the diagnosis of reflux disease. The symptoms of reflux disease can be effectively treated by drugs, surgical procedures remain the way of curing the cause of gastroesophageal reflux. Nowadays the laparoscopic fundoplication is a standard in operative treatment of the ailment. AIM OF STUDY: was to evaluate of GERD treatment with laparoscopic "floppy" Nissen fundoplication (LFN). MATERIAL AND METHODS: A group of 41 patients who underwent LNF were recruited for the study. All qualified patients underwent pre and post-surgical upper GI endoscopy and were requested to answer the questions in a GERD-related quality of life questionnaire. The main group of patients was divided into two subgroups--those with concomitant hiatal hernia and those without hernia. The outcomes of treatment were then compared between the subgroups. RESULTS: After the procedure the endoscopic improvement of reflux oesophagitis and better symptoms self-assessment were found. CONCLUSIONS: Laparoscopic "floppy" Nissen fundoplication is an effective method of treatment of erosive oesophagitis and its symptoms.
Subject(s)
Esophagitis, Peptic/therapy , Fundoplication/methods , Gastroesophageal Reflux/surgery , Laparoscopy/methods , Adult , Aged , Esophagitis, Peptic/complications , Female , Gastroesophageal Reflux/complications , Gastroesophageal Reflux/diagnosis , Gastroscopy , Hernia, Hiatal/complications , Humans , Male , Middle Aged , Treatment Outcome , Young AdultABSTRACT
Colorectal cancer has become the commonest form of cancer in gastrointestinal (GI) tract and nowadays it is the second cause of death among all malignant tumours. Bladder cancer is the fourth commonest tumour in males and eighth in females. In the article we present the case of 72-year-old patient with pelvic tumour and accompanied diagnostic and therapeutic problems. Despite repeated colon and bladder biopsies no malignancy was found. The results of imaging investigations suggested a bladder-derived tumour (from a bladder diverticulum or persisting urachus). An inflammatory tumour was also taken into consideration. The diagnosis confirmed in histological examination was adenocarcinoma of the colon. The article presents successive stages of diagnosis and therapy.
Subject(s)
Adenocarcinoma/diagnosis , Adenocarcinoma/pathology , Colonic Neoplasms/diagnosis , Colonic Neoplasms/pathology , Adenocarcinoma/surgery , Aged , Biopsy , Colonic Neoplasms/surgery , Diagnosis, Differential , Humans , Male , Urinary Bladder Neoplasms/diagnosisABSTRACT
Hernioplasty is the most common procedure performed on surgical wards. The golden standard among the different techniques of hernia repair is the usage of mesh. It resulted in the reduction of recurrences below 1% of primary repairs. Usage of the artificial material results in less numbers of recurrences which is 1% less than primary repairs. The aim of this article was to review contemporary opinions on repair operations of an abdominal hernia. Appropriate documentation and publications were reviewed in this area. We presented the usage of new techniques in ventral hernioplasty including laparoscopic approach and the intraperitoneal usage of mesh. The presentation was based on references and our experience. Conclusions regarding the lack of treatment standards and superiority of usage of the artificial materials method were formulated accordingly.
