Revisional bariatric surgery due to failure of the initial technique: 25 years of experience in a specialized Unit of Obesity Surgery in Spain.

Abstract Objectives To evaluate the effectiveness of conversion surgery in a bariatric surgery unit with 25 years of experience. Method Retrospective observational study of patients with type II obesity or higher who were reoperated by means of conversion surgery due to weight regain, residual body mass index (BMI) >35 kg/m2 or Results A total of 112 patients were included, with a mean age of 40.2 years, who initially underwent vertical banded gastroplasty (VBG) (32.1%), gastric banding (GB) (23.2%), Roux-en-Y gastric bypass (RYGB) (21.4%) and sleeve gastrectomy (SG) (23.2%). The conversion techniques, with a median time between the two surgeries of 70 months, included: RYGB, SG, one-anasto…

Effect Of Preoperative Respiratory Physiotherapy Program On The Oxygenation In Obese Morbid Patients Undergoing Laparoscopic Bariatric Surgery

Sphincter damage during fistulotomy for perianal fistulae and its relationship with faecal incontinence.

Abstract Background The length of sphincter which can be divided during fistulotomy for perianal fistula is unclear. The aim was to quantify sphincter damage during fistulotomy and determine the relationship between such damage with symptoms and severity of faecal incontinence and long-term quality of life (QOL). Methods A prospective cohort study was performed over a 2-year period. Patients with intersphincteric and mid to low transsphincteric perianal fistulas without risk factors for faecal incontinence were scheduled for fistulotomy. All patients underwent 3D endoanal ultrasound (3D-EAUS) pre-operatively and 8 weeks postoperatively. Measurements were taken of pre- and postoperative anal…

Cirugía bariátrica de conversión por fallo de la técnica inicial: 25 años de experiencia en una Unidad especializada de Cirugía de la Obesidad en España

Resumen Objetivos Valorar la eficacia de la cirugia de conversion en una unidad de cirugia bariatrica con 25 anos de experiencia. Metodo Estudio observacional retrospectivo de pacientes con obesidad tipo II o superior reintervenidos mediante cirugia de conversion por reganancia de peso, indice de masa corporal (IMC) residual > 35 kg/m2 o perdida Resultados Se incluyeron un total de 112 pacientes con una media de edad de 40,2 anos intervenidos inicialmente mediante gastroplastia vertical anillada (GVA) (32,1%), banda gastrica ajustable (BGA) (23,2%), bypass gastrico en Y de Roux (BGYR) (21,4%) y gastrectomia vertical (GV) (23,2%). Las tecnicas de conversion, realizadas tras una mediana de 70…

Nitric oxide mediates abnormal responsiveness of thyroid arteries in methimazole-treated patients

Objective: We studied the intervention of nitric oxide (NO), prostacyclin (PGI2) and endothelium-derived hyperpolarizing factor (EDHF) in mediating responses to acetylcholine in thyroid arteries from euthyroid (E) and methimazole-treated (MT) patients. Design and methods: Branches of the superior thyroid artery were obtained from 19 E patients and 17 MT patients (euthyroid at the time of surgery) undergoing total thyroidectomy or hemithyroidectomy. Artery rings were suspended in organ baths for isometric recording of tension. Results and conclusions: Acetylcholine caused endothelium-dependent relaxation of greater magnitude in arteries from MT patients (pD2 7.68±0.19 in E and 8.17±0.26 in M…

Influencia de la presencia de anomalía anatómica carotídea en la cirugía de rescate por recidiva de carcinoma papilar de tiroides

Is laparoscopic approach still a risk factor for postappendectomy intra-abdominal abscess?

Background The impact of laparoscopic appendectomy (LA) on the incidence of intra-abdominal abscess (IAA) remains controversial. We aimed to identify risk factors for postappendectomy IAA and assess the impact of appendectomy approach in postoperative morbidity. Methods A retrospective single-center study including consecutive patients who underwent appendectomy for acute appendicitis between 2015 and 2018 was performed. Demographic, clinical, intraoperative, and perioperative variables were collected. Univariate and multivariate analyses was performed to detect independent risk factors for IAA. Comparison of LA and open appendectomy was conducted, and propensity score model (PSM) was used …

Smoking in hospitalized patients. A great opportunity

The objective of this study is to describe the characteristics of smokers admitted to different medical and surgical services in a university hospital and the perception of patients regarding the need for a specialized intervention. The sample comprises a total of 307 patients (mean age of 59.4 years), being 40% (n = 123) non-smokers, 42.7% (n = 131) ex-smokers, and 17.3% (n = 53) smokers. The average consumption of smokers was 22.2 cigarettes / day and the severity of nicotine dependence evaluated with the Fagerstrom test exceeded 5 points in more than half of the sample. On the other hand, 77.7% had made at least one previous attempt to quit tobacco use. Almost the entire sample (89.9 %) …