The impact of selected factors on parameters of weight loss after sleeve gastrectomy.

INTRODUCTION: The effectiveness of sleeve gastrectomy has been confirmed in many studies. The impact of individual factors on the parameters of weight loss is still not clear. AIM: To identify important factors affecting the parameters of weight loss after sleeve gastrectomy. MATERIAL AND METHODS: The impact of prognostic factors and postoperative care components on body mass index (BMI) and percentage excess weight loss (%EWL) was assessed in a group of 100 consecutive patients who underwent laparoscopic sleeve gastrectomy. RESULTS: The baseline BMI and body mass in patients with BMI < 30 kg/m2 and BMI ≥ 30 kg/m2 12 months after surgery were, respectively, 39.7 ±3.2 vs. 45.9 ±4.6 kg/m2, p < 0.0001, and 114.4 ±16.8 vs. 130.3 ±18.5 kg, p < 0.0001. In the group with EWL < 50%, the average age was 47.1 ±7.7 vs. 40.6 ±10.8 in the group with EWL ≥ 50%, p = 0.0025. In the group of patients with preoperative weight loss, %EWL was 61.4 ±17.2 vs. 53.3 ±19.3% in the group with no weight loss, p = 0.0496. Body mass index of the patients who started physical activities was 30.6 ±4.2 kg/m2 vs. 34.0 ±5.6 kg/m2 in the patients with no physical activity, p = 0.0013, and %EWL was 63.4 ±14.6 vs. 47.0 ±19.9%, p < 0.0001, respectively. In the case of patients regularly consulted by a dietician BMI was 30.6 ±4.2 kg/m2 vs. 35.1 ±5.5 kg/m2 in the group without systematic consultations, p < 0.0001, and %EWL was 63.1 ±15.1% vs. 42.3 ±18.2%, p < 0.0001. CONCLUSIONS: Lower baseline body weight parameters, younger age, preoperative weight loss, starting systematic physical activities and constant care of a dietician were conducive to achieving better results of surgery, as assessed on the basis of changes in BMI and %EWL.

Gastroesophageal reflux in alcohol-abusing patients.

INTRODUCTION: Consumption of large amounts of alcohol can promote regurgitation of hydrochloric acid into the esophagus and therefore cause symptoms of gastroesophageal reflux disease. Most individuals who experience alcohol-related health problems are not addicted to alcohol, but they usually show a hazardous pattern of alcohol consumption. OBJECTIVES: Objectives The aim of the study was to examine the gastrointestinal tract in hazardous drinkers and to establish whether such alcohol consumption pattern may be an important risk factor for developing gastroesophageal reflux. PATIENTS AND METHODS: Primary care patients (n = 2000; mean age 41.1 years) from Warsaw, Poland, responded to 2 surveys: AUDIT (Alcohol Use Disorders Identification Test) and Carlsson's questionnaire. Patients characterized as hazardous drinkers and having symptoms of reflux disease entered the second phase of the study: gastroscopy and pH-metry. The results were compared with those obtained in the control group (n = 60), which included patients with reflux symptoms but who abstained from alcohol or were moderate drinkers. RESULTS: According to the survey results, 18.75% of the study group showed a hazardous pattern of alcohol consumption, while 33% had symptoms of gastrointestinal reflux disease. A positive pH-metry result was observed in 87.5% of the hazardous drinkers. Endoscopic features of esophagitis were observed in 64% of the patient group and 28% of the control group. Hazardous alcohol consumption and male sex may be the risk factors for developing reflux-related esophagitis. CONCLUSIONS: Primary care physicians should routinely ask their patients about alcohol consumption. Hazardous alcohol drinking may be a risk factor for developing reflux disease.

[Evaluation of the efficacy of surgical treatment of gastroesophageal reflux disease]. / Ocena skutecznosci chirurgicznego leczenia zarzucania zoladkowo-przelykowego.

THE AIM OF THE STUDY: In a group of 100 patients efficacy of surgical treatment of GERD was prospectively assessed. MATERIALS AND METHODS: 37 women and 63 men were qualified into the study. During preoperative period the following symptoms were assessed: heartburn, belching, chest pain, epigastric pain, regurgitations, dysphagia and the following examinations were performed: esophagogastroscopy, esophageal barium meal X-ray examination, esophageal manometry an 24-hours pH-metry. All patients were operated laparoscopically. RESULTS: Based on preoperative esophageal manometry 67 Nissen and 33 Toupet fundoplications were done. Mean patients' age was 51,54 years. Postoperative mortality was 0%. While assessing clinical symptomps one found statistically significant reduction of preoperative complaints, improvement of motility of esophageal body and parameters of lower esophageal sphincter, and normalization of 24-hours pH-metry record. CONCLUSIONS: Antireflux operations effectively reduce pathological GERD and improve esophageal motility.