0000000000253392
AUTHOR
Carlos Sala
Vertical Banded Gastroplasty Converted to Roux-en-Y Gastric Bypass: Little Impact on Nutritional Status after 5-Year Follow-up
Background: Conversion to a Roux-en-Y gastric bypass (RYGBP) has been advocated after the failure of vertical banded gastroplasty (VBG). The aim of this study was to analyze the differences in anthropometric and nutritional parameters between patients with VBG and those converted to RYGBP. Methods: 45 patients initially underwent VBG. 22 of these patients have maintained this operation for more than 5 years (Group A) and 23 have been converted to RYGBP (Group B), after 2 years of follow-up. We analyzed anthropometric and nutritional parameters (macronutrients,micronutrients and lipid profile), and postoperative morbidity after both procedures. Data were recorded before the first operation a…
Neoplasias de páncreas y periampulares: morbimortalidad, resultados funcionales y supervivencia a largo plazo
Resumen Objetivos Evaluar la morbimortalidad postoperatoria, el estado funcional y la supervivencia a largo plazo de pacientes con tumores de pancreas o periampulares a los que se intervino quirurgicamente. Pacientes y metodos Cohorte de 160 pacientes a los que se intervino consecutivamente: 80 duodenopancreatectomias cefalicas (DPC), 30 resecciones corporocaudales (RCC), 7 duodenopancreatectomias totales, 4 resecciones centrales y 3 ampulectomias; en 36 pacientes no se realizo reseccion. La funcion pancreatica se evaluo mediante test de sobrecarga oral a la glucosa, grasas en heces y elastasa fecal. Resultados La tasa de resecabilidad fue del 77,5%. En los pacientes resecados (n = 124) la …
Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass.
Background: One of the co-morbidities frequently associated with morbid obesity is gastro-esophageal reflux disease (GERD), present in >50 % of morbidly obese individuals. We compared the anti-reflux effect of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP), and their effect on esophageal function. Methods: 10 patients underwent VBG and 40 patients underwent RYGBP. Anthropometric parameters, symptomatology of GERD, esophageal manometry (EM), isotopic esophageal emptying (IEE) and 24hr esophageal pH monitoring were recorded in all patients preoperatively, and at 3 months and 1 year postoperatively. Results: Preoperatively, there was a high prevalence of GERD, symptoma…
Efficacy and cost-effectiveness of the UltraCision harmonic scalpel in thyroid surgery: an analysis of 200 cases in a randomized trial.
Thyroid surgery technique has undergone very few changes in the last century. The UltraCision harmonic scalpel (UHS) (Smithfield, RI) has been widely used in laparoscopic surgery and is documented to be safe and fast for cutting and coagulating tissue. We studied whether the use of the UHS could have advantages in thyroid surgery in terms of operative time, length of hospitalization, morbidity, and general costs.Our study was a prospective randomized trial of thyroidectomies and lobectomies performed for benign thyroid diseases in an endocrine surgery unit between February 2001 and July 2002. Patients were randomized in two groups: group A (n=100) underwent thyroidectomy using UHS and group…
Effect of epidural anesthesia on colorectal anastomosis: a tonometric assessment.
PURPOSE: Epidural anesthesia is believed to benefit colorectal anastomotic blood flow because of the sympathetic blockade it produces. Our purpose is to measure with tonometry the effect of epidural anesthesia on colorectal anastomotic oxygenation. PATIENTS AND METHODS: Fifteen patients operated on for rectal cancer (radical anterior resection) were monitored postoperatively using tonometers placed in the stomach (celiac trunk), transverse colon (superior mesenteric artery), and the anastomotic area during the operation. An epidural catheter was placed at L1-2, and on the first postoperative day, 8 ml of bupivacaine (0.25 percent) was administered. The anesthetic effect extended up to T-4. …
Pancreatic and periampullary tumours: morbidity, mortality, functional results, and long-term survival
Abstract Aims To evaluate postoperative morbidity and mortality, pancreatic function and long-term survival in patients with surgically treated pancreatic or periampullar tumours. Patients and methods Cohort study including 160 patients consecutively operated on: 80 pancreaticoduodenectomies (PD), 30 distal pancreatectomies (DP), 7 total pancreatectomies, 4 central pancreatic resections, and 3 ampullectomies. The tumour was not resected in 36 patients. Pancreatic function was evaluated by oral glucose tolerance test, faecal fat excretion, and elastase. Results Resectability rate was 77.5%. In resected patients (n = 124), 38.7% had complications with a pancreatic fistula rate of 6.4% and a m…