scholarly journals Risk of Dumping Syndrome after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass: Early Results of a Multicentre Prospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
M. Ramadan ◽  
M. Loureiro ◽  
K. Laughlan ◽  
R. Caiazzo ◽  
A. Iannelli ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Anastomosis Group ◽  
Dumping Syndrome ◽  
Linear Stapler ◽  
Gastrojejunal Anastomosis ◽  
Early Results ◽  
B 41 ◽  
Group A ◽  
Important Field ◽  
Group B

Background. Bariatric surgery is an important field of surgery. An important complication of bariatric surgery is dumping syndrome (DS).Aims. To evaluate the incidence of DS in patients undergoing bariatric surgery.Methods. 541 patients included from 5 nutrition and bariatric centers in France underwent either LSG or LRYGB. They were evaluated at 1 month (M1) and 6 months (M6) postoperatively by an interview and completion of a dumping syndrome questionnaire.Results. 268 patients underwent LSG (Group A) and 273 underwent LRYGB. From the LRYGB patients 229 had mechanical gastrojejunoanal anastomosis with 30 mm linear stapler (Group B) and 44 had manual (hand sewn) 15 mm gastrojejunal anastomosis (Group C). Overall incidence of DS was 8.5% at M1 and M6. In LSG group (Group A), only 4 patients (1.49%) reported episodes of DS at M1 and 3 (1.12%) at M6. In Group B, 41 patients (17.90%) reported episodes of DS at M1 and 43 (18.78%) at M6. Group C experienced one case (2.27%) of DS at M1 and none (0%) at M6.Conclusions. Patients undergoing LRYGB, especially with larger gastrojejunal anastomosis, are more prone to developing DS following surgery than patients undergoing LSG or LRYGB with calibrated manual anastomosis.

scholarly journals Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study

2021 ◽  
Vol 17 (2) ◽  
pp. 95-99
Author(s):  
Layth Saleh Owaid ◽  
Imad Wajeeh Al-Shahwani ◽  
Zuhair B. Kamal ◽  
Laith Naif Hindosh ◽  
Abbas Farman Abdulrahman ◽  
...  
Keyword(s):  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Anastomosis Group ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Cost ◽  
Mean Time

Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies. Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis.. Results:  Thirty-two patients were allocated to group A and 35 patients to group B. The mean time taken for anastomosis was significantly shorter in group A (23.25 ± 1.20 min in group A vs. 36.71 ± 1.93 min in group B; P<0.001). A significant shorter duration of hospital stay was seen in group A (7.00 ± 1.778 days in group A vs. 9.74 ± 1.990 days in group B; P<0.001). The detection of bowel sound was substantially quicker in group A as compared to group B (4.56 ± 0.50 days in group A vs. 6.46±0.50 days in group B; P<0.001). There was no significant discrepancy between the two groups regarding anastomotic leak rates (P= 0.543). The mean cost of double layer intestinal anastomosis method was significantly higher than that of single layer anastomosis (P<0.001). Conclusions: The use of single layer extra-mucosal anastomosis of the intestine has the advantage of taking less time, less morbidity and cost-effective to perform with the same rate of anastomotic leak in the closure of colostomy.

scholarly journals Assessment of Physical Fitness after Bariatric Surgery and Its Association with Protein Intake and Type of Cholecalciferol Supplementation

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 281 ◽  
Author(s):  
Smelt ◽  
Pouwels ◽  
Celik ◽  
Gupta ◽  
Smulders
Keyword(s):  
Bariatric Surgery ◽  
Muscle Strength ◽  
Physical Fitness ◽  
Protein Intake ◽  
Handgrip Strength ◽  
High Dose ◽  
Group A ◽  
Cholecalciferol Supplementation ◽  
Group B ◽  
Run Test

: Background: Several studies showed that there is a relationship between vitamin and mineral status and muscle strength. In particular this is the case for handgrip strength (HS) and vitamin D deficiency. In bariatric surgery there is a risk of decrease in muscle strength after surgery and also vitamin and mineral deficiencies are not uncommon. The aim of this study is to assess the effect of low vitamin 25 (OH) cholecalciferol levels, high dose cholecalciferol supplementation regime and protein intake on physical fitness, measured using handgrip strength (HS) and the shuttle walk run test (SWRT). Methods: For this retrospective study, 100 patients who have had bariatric surgery were included. Group A (n = 50) used 800 IU oral cholecalciferol per day. Group B (n = 50) used 800 IU oral cholecalciferol daily and 50,000 IU liquid cholecalciferol monthly lifelong. Both groups were matched on common variables. To measure physical fitness, we used the HS manometer of Jamar and the Shuttle Walk Run Test (SWRT) to assess physical capacity. Results: No significant differences in HS and SWRT outcomes were found between patients with serum 25 (OH) cholecalciferol < 75 nmol/L or >75 nmol/L. The postoperative HS is significantly influenced by protein intake (p = 0.017) and no significant influence was seen in outcomes of the SWRT (p = 0.447). Conclusion: We have found that serum 25 (OH) cholecalciferol and different cholecalciferol supplementation regimes do not have a significant effect on HS and SWRT before, three and 6 months after surgery. It seems that protein intake plays a more important role in maintaining adequate muscle strength.

scholarly journals Standard versus eversion-modified double-staple technique for low colorectal anastomoses after resection of rectal cancer

Surgery Today ◽  
2020 ◽  
Author(s):  
Giulio Illuminati ◽  
Rocco Pasqua ◽  
Bruno Perotti ◽  
Paolo Urciuoli ◽  
Priscilla Nardi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Rectal Stump ◽  
Postoperative Mortality ◽  
Linear Stapler ◽  
Colorectal Anastomoses ◽  
Staple Technique ◽  
Group A ◽  
Group B ◽  
Related Survival

Abstract Purpose The double-staple technique, performed as either the standard procedure or after eversion of the rectal stump, is a well-established method of performing low colorectal anastomoses following the resection of rectal cancer. Eversion of the tumor-bearing ano-rectal stump was proposed to allow the linear stapler to be fired at a safe distance of clearance from the tumor. We conducted this study to compare the results of the standard versus the eversion-modified double-staple technique. Methods The subjects of this retrospective study were 753 consecutive patients who underwent low stapled colorectal anastomosis after resection of rectal cancer. The patients were divided into two groups according to the method of anastomosis used: Group A comprised 165 patients (22%) treated with the modified eversion technique and group B comprised 588 patients (78%) treated with the standard technique. The primary endpoints of the study were postoperative mortality, surgery-related morbidity, the number of sampled lymph nodes in the mesorectum, and late disease-related survival. Results Postoperative mortality was 1.2% in group A and 1.7% in group B (p = 0.66). Postoperative morbidity was 12% in group A and 11% in group B (p = 0.75). The mean number of sampled lymph nodes in the mesorectum was 23 (range 17–27) in group A and 24 (range 19–29) in group B (p = 0.06). The 5-year disease-related survival was 73% in group A and 74% in group B (p = 0.75). Conclusion The standard and eversion-modified double-staple techniques yield comparable results.

scholarly journals The Dominance Pattern of Coronary Artery of Adult Bangladeshi People- A Postmortem Morphological Study

1970 ◽  
Vol 1 (1) ◽  
pp. 21-25
Author(s):  
MA Hussain ◽  
A Nahar ◽  
S Ara
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Heart Diseases ◽  
Age Groups ◽  
B 41 ◽  
Group A ◽  
Proper Diagnosis ◽  
Group B ◽  
Dominance Pattern

Background: Incidence of the heart disease increases day by day in Bangladesh. Recent advances in cardiac surgery and the search for new techniques toward investigation of the heart are demanding a review of the anatomy of the coronary arteries. Method: The present study was performed on sixty (60) adult postmortem human hearts of Bangladeshi people. The samples were divided into 3 age groups: Group A (20 to 40 years) consists of 35 male & 7 female samples, Group B (41 to 60 years) consists of 3 female samples and Group C (61 to 75 years) consists of 7 male samples. Results: In the present study, dominance pattern of the coronary artery was right for male in-group A, B, C were 32 (91.4%), 7(87.5%), 6(85.7%), respectively and for female were 6 (85.7%). 3 (100%) respectively. It was left for male in-group A, B, C were 3 (8.6%), 1 (12.5%), 1(14.3%), respectively and for female was 1 (14.3%). Conclusion: The results of the present study can be helpful to the cardiologists and cardiovascular surgeons in the proper diagnosis and management of the heart diseases. Key words : Postmortem heart, Coronary arteries, Ischaemic heart disease.   DOI: http://dx.doi.org/10.3329/cardio.v1i1.8200 Cardiovasc. j. 2008; 1(1) : 21-25  

scholarly journals Yang-Monti ileal ureter-bladder anastomosis or Yang-Monti ileal ureter-ureteral anastomosis for the treatment of ureteral stenosis: What is better?

2019 ◽  
Author(s):  
zhenxing wang ◽  
zhaolin sun ◽  
xiushu yang ◽  
guangheng luo ◽  
ye tian ◽  
...  
Keyword(s):  
Histological Examination ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Anastomosis Group ◽  
Transitional Epithelium ◽  
Advantages And Disadvantages ◽  
Before And After ◽  
Group A ◽  
Ileal Ureter ◽  
Group B

Abstract Background: To establish an animal model of the minipigs of ileal ureter-bladder anastomosis and ureteral-ureteral anastomosis using the Yang-Monti technique, and compare the advantages and disadvantages. Methods: 14 minipigs were randomly divided into two groups. Group A received the left Yang-Monti ileal ureter-ureteral anastomosis ; group B received the left Yang-Monti ileal ureter-bladder anastomosis. The length of the incision and the operation time of the two groups were compared. Changes in serum creatinine and urea nitrogen were observed. IVU,cystography,Urinary culture examination and histological examination were performed. Results: the remaining 11 miniature pigs had no urinary fistula or intestinal fistula.The operation time and incision length of group A were longer than group B. All minipigs had normal renal function before and after surgery. There was no stenosis obstruction in the venous pyelography. The narrowest diameter of group A was larger than that of group B; no contrast agent was returned to the upper urinary tract in the two groups. Postoperative urine culture examinations were colonized with Escherichia coli. the obstruction and stenosis were found in group A; the ileal ureteral diameter of group A was larger than that of group B. Histological examination showed that the transitional epithelium and columnar epithelial mucosa in group A were not close together; the intestinal villi are slightly atrophied and shortened. Conclusions: Compared with the Yang-Monti ileal ureteral anastomosis, the Yang-Monti ileal ureter-bladder anastomosis is simpler, more reliable, and less complication.

scholarly journals Yang-Monti ileal ureter-bladder anastomosis or Yang-Monti ileal ureter-ureteral anastomosis for the treatment of ureteral stenosis: What is better?

2019 ◽  
Author(s):  
zhenxing wang ◽  
zhaolin sun ◽  
xiushu yang ◽  
guangheng luo ◽  
ye tian ◽  
...  
Keyword(s):  
Histological Examination ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Anastomosis Group ◽  
Transitional Epithelium ◽  
Advantages And Disadvantages ◽  
Before And After ◽  
Group A ◽  
Ileal Ureter ◽  
Group B

Abstract Background: To establish an animal model of the minipigs of ileal ureter-bladder anastomosis and ureteral-ureteral anastomosis using the Yang-Monti technique, and compare the advantages and disadvantages. Methods: 14 minipigs were randomly divided into two groups. Group A received the left Yang-Monti ileal ureter-ureteral anastomosis ; group B received the left Yang-Monti ileal ureter-bladder anastomosis. The length of the incision and the operation time of the two groups were compared. Changes in serum creatinine and urea nitrogen were observed. IVU,cystography,Urinary culture examination and histological examination were performed. Results: the remaining 11 miniature pigs had no urinary fistula or intestinal fistula.The operation time and incision length of group A were longer than group B. All minipigs had normal renal function before and after surgery. There was no stenosis obstruction in the venous pyelography. The narrowest diameter of group A was larger than that of group B; no contrast agent was returned to the upper urinary tract in the two groups. Postoperative urine culture examinations were colonized with Escherichia coli. the obstruction and stenosis were found in group A; the ileal ureteral diameter of group A was larger than that of group B. Histological examination showed that the transitional epithelium and columnar epithelial mucosa in group A were not close together; the intestinal villi are slightly atrophied and shortened. Conclusions: Compared with the Yang-Monti ileal ureteral anastomosis, the Yang-Monti ileal ureter-bladder anastomosis is simpler, more reliable, and less complication.

scholarly journals Compare outcome in patients of ileostomy and colostomy closure with surgical stapler versus ileostomy and colostomy closure with hand sewn anastomosis: a prospective study

2020 ◽  
Vol 7 (10) ◽  
pp. 3256
Author(s):  
Vikram B. Gohil ◽  
Jenil Y. Bhatt ◽  
Samir M. Shah ◽  
Rijuta Aphale
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Anastomotic Leak ◽  
Oral Intake ◽  
Anastomosis Group ◽  
Distal Anastomosis ◽  
Colostomy Closure ◽  
Stoma Closure ◽  
Group A ◽  
Group B

Background: Diverting temporary stoma is created to protect the primary bowel pathology and distal anastomosis. Once that primary pathology has been overcome or distal anastomosis gets healed, closure of temporary stomas can be carried out. Invention of stapling devices for intestinal anastomosis provided another dimension than hand sewn method to the stoma closure techniques. In this study, we have compared two methods of loop stoma closure-hand sewn method versus stapler method.Methods: This is prospective comparative study in which 50 cases of loop ileostomy/colostomy were taken. 25 patients underwent ileostomy/colostomy closure by hand sewn anastomosis (group A). Another 25 patients underwent ileostomy/colostomy closure by stapler anastomosis (group B). Time taken for operation, initiation of oral intake, anastomotic leak, post-operative wound infection and total hospital stay duration were compared between these two groups to conclude about which method is superior and in the best interest of patient and surgeon.Results: Mean operation time 105.96 minutes (group A) and 72.84 minutes (group B). Mean time to start oral intake 5.36 days (group A), 3.6 days (group B). 16% patients (4/25) group A and 4% patients (1/25) group B developed anastomotic leak. 28% patients (7/25) group A and 8% patients (2/25) group B had post-operative wound infection. Mean hospital stay 10.4 days in group A and 7.84 days in group B.Conclusions: Stapler method provides significant benefits in terms of less operative time, early oral intake and less hospital stay. Overall stapler method for stoma closure is more efficient and cost effective.

scholarly journals Experience of using ursodeoxycholic acid to dissolve gallstones

2020 ◽  
pp. 160-165
Author(s):  
V. V. Tsukanov ◽  
E. V. Onuchina ◽  
A. V. Vasyutin ◽  
Yu. L. Tonkikh
Keyword(s):  
Prospective Study ◽  
Ursodeoxycholic Acid ◽  
Contractile Function ◽  
Pain Syndrome ◽  
Continuous Treatment ◽  
Continuous Administration ◽  
B 41 ◽  
Group A ◽  
Group B ◽  
Observation Period

Objective of the study. A 5-year prospective study was aimed to evaluate the efficacy of Ursosan treatment for dissolving gallstones.Material and methods. Patients who had single gallbladder stones were randomized to group A, in which 47 people completed the study (16 men and 31 women, median age is 67.6 years), and group B – 41 people 14 men and 27 women, median age is 68, 1 years). All patients of group A continuously received continuous treatment with ursodeoxycholic acid drug Ursosan at a dose of 10 mg /kg per day for 5 years. The patients of group D did not receive Ursosan; these individuals received periodic courses of spasmodic drugs. The patients passed clinical examination, laboratory tests, transabdominal ultrasound of the liver and biliary tract before the study, 2 times a year for 5 years and after the study.Results. After 5 years of treatment, stones were detected in 10.6% of patients in group A. In group B, the incidence of gallstones did not change after 5 years of treatment, that is, calculi were detected in all patients (p <0.001). At the end of the study, no muldoi tiple stones were observed in any of the patients of group A, while multiple stones were detected in 2/3 of group B patients after 5 years of treatment. A distinct decrease in pain syndrome frequency and improvement in contractile function of the gallbladder were recorded in patients of group A as compared to the patients of group B by the end of the observation period. The side effect profile did not differ in groups A and B. The study showed good tolerance of Ursosan for 5 years of continuous administration of the drug.Findings. The 5-year prospective study showed that Ursosan’s efficacy in dissolving gallstones accounted for 90%. Ursosan also prevented the formation of new calculi and reduced the frequency of pain, improved the gall-bladder contractile function and reduced the need for cholecystectomy by the end of the observation period.

scholarly journals Comparison of Yang-Monti ileal ureter-bladder anastomosis versus Yang-Monti ileal ureter-ureteral anastomosis for the treatment of ureteral stenosis: a randomized controlled trial in a miniature pig model

2019 ◽  
Author(s):  
zhenxing wang ◽  
zhaolin sun ◽  
xiushu yang ◽  
guangheng luo ◽  
ye tian ◽  
...  
Keyword(s):  
Histological Examination ◽  
Controlled Trial ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Anastomosis Group ◽  
Transitional Epithelium ◽  
Advantages And Disadvantages ◽  
Group A ◽  
Ileal Ureter ◽  
Group B

Abstract Background: To establish an animal model of the minipigs of ileal ureter-bladder anastomosis and ureteral-ureteral anastomosis using the Yang-Monti technique, and compare the advantages and disadvantages. Methods: 14 minipigs were randomly divided into two groups. Group A received the left Yang-Monti ileal ureter-ureteral anastomosis ; group B received the left Yang-Monti ileal ureter-bladder anastomosis. The length of the incision and the operation time of the two groups were compared. Changes in serum creatinine and urea nitrogen were observed. IVU,cystography,Urinary culture examination and histological examination were performed. Results: the remaining 11 miniature pigs had no urinary fistula or intestinal fistula.The operation time and incision length of group A were longer than group B. All minipigs had normal renal function before and after surgery. There was no stenosis obstruction in the venous pyelography. The narrowest diameter of group A was larger than that of group B; no contrast agent was returned to the upper urinary tract in the two groups. Postoperative urine culture examinations were colonized with Escherichia coli. the obstruction and stenosis were found in group A; the ileal ureteral diameter of group A was larger than that of group B. Histological examination showed that the transitional epithelium and columnar epithelial mucosa in group A were not close together; the intestinal villi are slightly atrophied and shortened. Conclusions: Compared with the Yang-Monti ileal ureteral anastomosis, the Yang-Monti ileal ureter-bladder anastomosis is simpler, more reliable, and less complication.

scholarly journals 40 Weeks of Gestation is as High-Risk Gestation as 41 Weeks in Low-Risk Pregnancies

2020 ◽  
Vol 24 (4) ◽  
pp. 358-362
Author(s):  
Aqsa Ikram Ul Haq ◽  
Shama Bashir ◽  
Nargis Shabana ◽  
Nadia Sadiq ◽  
Fatima Chaudhry Inayat ◽  
...  
Keyword(s):  
High Risk ◽  
Vaginal Delivery ◽  
Low Risk ◽  
P Value ◽  
Gestation Age ◽  
B 41 ◽  
Group A ◽  
Study Population ◽  
Group B ◽  
Meconium Stained Amniotic Fluid

Introduction: Postdate pregnancy is associated with a higher frequency of obstetrical complications and perinatal morbidity. The incidence of meconium-stained amniotic fluid is 30% at 40 weeks which is very high. This study aimed to find out the need for fetal surveillance and delivery in our population, keeping in view that 40 weeks of gestation is as high risk as 41 weeks gestation in low-risk pregnancies.Material and Methods: The study was conducted at Obstetrics & Gynecology Department, Unit-II, Holy Family Hospital, and Rawalpindi from 16 February to 15 August 2019 after ethical clearance. Postdate pregnant women from 40 to 41 weeks who meet study criteria were enrolled in the study. We divided participants into two groups. Group A (40 to 40+6 weeks of gestation) while group B had Group B (41 to 41+6 weeks of gestation). Results: A total of 236 postdate mothers presented of which 148(62%) were in group A while 88 (38%) were in group B. Mean gestational age in our study was 40.88 ± 0.71 weeks. overall vaginal delivery, cesarean delivery, and meconium stained liquor were found in 75.84%, 24.16%, and 35.17% patients respectively. 82 (34.7%) participants presented with meconium-stained liquor meconium-stained liquor with women in group B has a higher frequency of meconium-stained liquor, 45 (30.41%) in group A and 37 (42.04%) in group B, P-value 0.069. rate of vaginal delivery was 71.62% in group A and 82.95% in group B which was statistically significant. P-value 0.049Conclusion: High percentage of meconium-stained liquor was observed in the study population. Frequency of vaginal delivery increases if postdate women waited till 41 weeks. 30% of women at gestation age 40 to 40+6 have meconium-stained liquor which shows almost 1/3 of pregnant ladies are exposed to the compromised fetal status which is a considerable risk. This increases further as the gestation age advances. Appropriate interventions should be taken at 40 weeks in low-risk pregnancies to avoid perinatal risk.

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