Gastric bypass - 10 years' results.

INTRODUCTION: Gastric bypass has not gained as much popularity in the Czech Republic as technically simpler restrictive bariatric procedures, frequently with a fading long-term effect. The aim of the presentation is to point out the long-term results after two types of gastric bypasses. METHOD: Retrospective analysis of prospectively collected data in an initial set of patients after laparoscopic RYGB (Roux Y gastric bypass) and OAGB/MGB (one anastomosis/mini gastric bypass) performed at Breclav Hospital in 2010-2013. Evaluation based on the BAROS system, according to weight development, comorbidities, psychological aspects, complications and reoperations. RESULTS: Data available for evaluation are from 32 patients out of a total of 60; the follow-up rate is 53%. The patients are lighter by 34 kg on average (0-64 kg); TBWL (total basic weight loss): 25.7%. The majority of operated diabetics are free of signs of diabetes, and all others have a reduced need for antidiabetic medication. Hypertension, sleep apnea and psychological assessment of life in 6 domains improved. Eight of the 32 followed patients underwent reoperation during 10 years; only 2 of these procedures were acute for complications (anastomotic ulceration), both in smokers; further elective reoperations included 2 conversions of OAGB/MGB to RYGB due to reflux, 2 corrective surgeries, and 2 procedures for a suspected internal hernia. There was no conversion from laparoscopic to open surgery, no peritonitis associated with a leak, and no mortality within 30 days. The BAROS score (5.56) indicates a "very good result" of the gastric bypasses after 10 years. CONCLUSION: Gastric bypasses are safe and provide a high and lasting metabolic effect that meets the general expectations of an invasive intervention that can fundamentally improve the quality of treatment for otherwise incurable chronic diseases related to adiposity (so-called ABCD), especially type 2 diabetes.

Gastric bypass and its role in metabolic and bariatric surgery.

INTRODUCTION: Historically, gastric bypass (GB) has been the oldest procedure used in bariatric surgery. Even though technically demanding, it had been the most widely used method for decades worldwide and still holds an irreplaceable position for its pronounced and long-term metabolic effect as well as for the therapeutic effect in gastroesophageal reflux (GERD). METHOD: The authors retrospectively analyse a series of 268 cases of GB, focusing on short-term weight loss, the metabolic effect on type two diabetes (T2DM), complication and reoperation rates and the BAROS scoring system in Roux-en-Y bypass (RYGB) and in minigastric bypass with one anastomosis (MGB/OAGB), comparing both of them to more frequently used gastric plication and sleeve gastrectomy. RESULTS: Both GB, without any increase in complication and reoperation rates, lead to a higher weight loss and the best BAROS scoring in comparison to other, simpler restrictive procedures. One year after GB, resolution of T2DM is seen in most diabetes patients operated on, the number needed to treat being.

Studies on the immobilization of glucuronidase (Part 1). Covalent immobilization on various carriers (a comparison).

beta-Glucuronidase (EC 3.2.1.31) was immobilized on various organic and inorganic carriers by different methods. Optimum coupling conditions have been worked out. The immobilization were characterized and compared to each other. Parameters resulting in most stable preparations with high activities are discussed.