Journal articles: 'Digestive system surgical procedures'

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Eisele, David W., C. Thomas Yarington, and Roger C. Lindeman. "Indications for the Tracheoesophageal Diversion Procedure and the Laryngotracheal Separation Procedure." Annals of Otology, Rhinology & Laryngology 97, no. 5 (September 1988): 471–75. http://dx.doi.org/10.1177/000348948809700507.

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Impaired protective function of the larynx can lead to intractable aspiration, a severe and potentially fatal disorder. If medical therapy fails to prevent intractable aspiration, surgical separation of the upper respiratory tract from the digestive tract is necessary to prevent recurrent contamination of the respiratory system in these patients. Two such surgical procedures are the tracheoesophageal diversion procedure and the laryngotracheal separation procedure. Our approach to patients with intractable aspiration and the indications for the use of these surgical procedures for the prevention of aspiration are discussed.

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Marochi, Bianca, Daniela Thaís Lorenzi Pereira, Luiza Manfroi Lattmann, Sthefany Mais, Arthur Nathan Luiz Ferreira Matos, Thais Mayumi Komatsu Fukuchi, Theodoro Busso Beck Neto, Maurício Chibata, and Francisco Emanuel de Almeida. "Epidemiological profile of postoperative digestive fistulas." JOURNAL OF SURGICAL AND CLINICAL RESEARCH 12, no. 2 (December 28, 2021): 77–88. http://dx.doi.org/10.20398/jscr.v12i2.25642.

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Background and objectives: Gastrointestinal fistulas are anomalous communications between the digestive system and other structures. This article presents the epidemiological profile of patients who developed postoperative abdominal fistulas and their outcomes. Methods: Cross-sectional study that evaluated surgical procedures done in a 25 week period that presented risks for fistulous formations. Were analyzed age, type of the surgery (elective or urgent), pre-existing risk factors, need for post-surgical intensive care unit, type of fistula, reoperations to the fistula treatment, and outcome (discharge or death). Results: There were 1785 abdominal surgical procedures, with a fistula incidence of 1.8%. Most of the patients who developed fistulas were over 60 years old (71.4%), and surgeries that resulted in fistulous complications were mainly urgent (75.0%), with the need for intensive care in 46.9%. The most frequent types of fistula were enteral (52.3%) and biliary (23.8%), and surgical treatment took place in 53.1% of cases. Late hospital discharge was predominant in these patients (40.6%), and the death rate was 3.1%. Discussion: These complications are common after abdominal surgery and require clinical attention. There is a correlation between the formation of the fistulas and urgent surgery procedures, directly impacting the length of hospital stay. Conclusion: The risk factors of fistula development are advanced age and the presence of malignant disease. They are more prevalent in urgent surgeries and patients were more likely to need reoperation and have a delay on discharge.

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Liu, Yan Fei, Xiao Yu Jiang, and Feng Ting Shen. "The Development of Minimally Invasive Surgery Simulation Training System Based on Virtual Reality Technology." Advanced Materials Research 403-408 (November 2011): 2300–2303. http://dx.doi.org/10.4028/www.scientific.net/amr.403-408.2300.

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Minimally Invasive Surgery Simulation Training System based on VR technology is comprised of intelligent 3-Dimensional images VR software system and simulated surgical instrument with high perceptibility and high precision force feedback characteristics. Real time VR and simulated instrument with force feedback interact with the operator in real time, achieve high immersive virtual surgery scenario, and allows trainees to perform and improve the whole surgical procedures. By applying synchronized network video server and real-time communication server based on TRP/RTCP, the instructor can view all details of an operator's surgical procedure by a network terminal, and provide real time technical guidance. The system covers minimally invasive surgeries of digestive, urinary, gynecological, thoracic, pediatric , etc.

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Antic, S., I. Dimitrijevic, V. Markovic, and J. Petrovic. "Diagnostic and therapeutic approaches to bleeding from lower parts of the digestive system." Acta chirurgica Iugoslavica 55, no. 1 (2008): 25–31. http://dx.doi.org/10.2298/aci0801025a.

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Bleeding from the gastrointestinal tract represents a relatively common diagnostic and therapeutic challenge in clinical work of gastroenterologists and surgeons. Bleeding from the lower GI (LGIB) is mostly caused by pathologic conditions of the colon, although the source of bleeding cannot always be exactly localized, thus rendering optimal and prompt therapy difficult. During two year period, at III department of the First Surgical Clinic in Belgrade, we performed 424 colonoscopies for LGIB. According to our results the exact diagnosis was established in about 76% (324 patients) showing a great similarity with the results of other published studies (varying between 74% and 89%). The most common causes of bleeding were diverticulosis (37.11%), polyposis (10.3%) and colorectal cancer (46.14%). Besides that we have mentioned some specific facts involving the diagnosis and treatment of LGIB with an accent on some rare conditions, like angiodysplasia. Review of the diagnostic procedures and treatment modalities of the LGIB is useful for everyone who meets with this type of pathology in clinical practice. The diagnostic approach and the surgical treatment of these patients may represent a great problem, since the planning of the operative procedure can be very difficult and with uncertain result. Based on the literary data and our experience we have tried to set the algorithm of the diagnostics and treatment of the LGIB.

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Castillo, Cristina, and Joaquin Hernández. "Ruminal Fistulation and Cannulation: A Necessary Procedure for the Advancement of Biotechnological Research in Ruminants." Animals 11, no. 7 (June 23, 2021): 1870. http://dx.doi.org/10.3390/ani11071870.

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Rumen content is a complex mixture of feed, water, fermentation products, and living organisms such as bacteria, fungi, and protozoa, which vary over time and with different feeds. As it is impossible to reproduce this complex system in the laboratory, surgical fistulation and cannulation of the rumen is a powerful tool for the study (in vivo and in situ) of the physiology and biochemistry of the ruminant digestive system. Rumen fistulation in cattle, sheep, and goats has been performed extensively to advance our understanding of digestive physiology and development, nutrient degradability, and rumen microbial populations. The literature reports several fistulation and cannulation procedures in ruminants, which is not the focus of this paper. However, this method questions the ethical principles that alter the opinions of certain animal groups or those opposed to animal experimentation. In this article, we analyze the objectives of fistulation and cannulation of ruminants and the care needed to ensure that the welfare of the animal is maintained at all times. Due to the ethical issues raised by this technique, several in vitro digestion methods for simulating ruminal fermentation have been developed. The most relevant ones are described in this article. Independently of the procedure, we want to point out that research carried out with animals is obliged by legislation to follow strict ethical protocols, following the well-being and health status of the animal at all times.

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Chu, Daniel, Po-Hung Chen, Steven Brant, Steven Miller, Natasha Turner, and Susan Hutfless. "P125 COMPLICATIONS FOLLOWING OUTPATIENT COLONOSCOPY IN INFLAMMATORY BOWEL DISEASE (IBD) PATIENTS." Inflammatory Bowel Diseases 26, Supplement_1 (January 2020): S24. http://dx.doi.org/10.1093/ibd/zaa010.055.

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Abstract Inflammatory Bowel Disease (IBD) patients have frequent complications after surgical procedures. Inflammation, immunosuppression and other factors that are more common in Crohn’s disease (CD) and ulcerative colitis (UC) may play a role in increasing their complication risk profile. IBD patients also undergo colonoscopy procedures more frequently than the general population. We aimed to identify risks of complications during or within 7 days of colonoscopy in IBD patients. Methods: Colonoscopy procedures performed between January 2016 through March 2019 in an outpatient setting (hospital or ambulatory surgical center) were identified from the United States Medicare fee-for-service claims. All Medicare beneficiaries were eligible. Colonoscopy was identified using the Healthcare Common Procedure Coding System (HCPCS) codes (‘45378’ through ‘45393’ and ‘45398’). A patient was considered to have Crohn’s disease (CD) if ICD-10-CM code K50.x was recorded; Ulcerative Colitis (UC) if ICD-10-CM code K51.x was recorded; and IBD if either was recorded on the date of the procedure. Complications recorded during the procedure included intestinal perforation (K63.1), gastrointestinal hemorrhage (K92.2), and “other post-procedural complications of the digestive system” (K91), including, but not limited to, post-gastrectomy syndrome, malabsorption, and intestinal obstruction. We examined these complications in procedures performed on IBD patients compared to the general population using logistic regression. We accounted for age, sex, race, year of colonoscopy, comorbidity score, and procedure discontinuation (identified by HCPCS modifier) in the analysis. A random effect for patient was included in the model to account for multiple procedures performed in the same patient during the study period, restricting patients from contributing multiple procedures. Results: There were 3,181,759 eligible procedures. There were 26,583 (0.84%) colonoscopy procedures in CD patients and 50,708 (1.59%) in UC patients. After accounting for other risk factors, CD and UC were more likely to have intestinal perforation than the non-IBD population (CD OR=2.7, 95% CI: 1.1–6.5; UC=OR 1.9, 95% CI 0.9–4.1), with CD having a statistically significant increase. Women were at greater risk for perforations (OR=1.3; 95% CI: 1.0–1.7). Conversely, IBD patients were less likely than non-IBD patients to have a complication recorded as “other” (CD OR=0.5; 95% CI: 0.2–0.9; UC OR=0.5; 95% CI:0.3–0.8). Older age at colonoscopy (OR=1.02, 95% CI 1.01–1.03), six or more comorbidities (OR=1.9, 95% CI: 1.5–2.3) and procedure discontinuation (OR=2.0, 95% CI 1.2–3.4) were associated with complications regardless of IBD status. Conclusion: IBD was associated with higher risk of perforation, and lower risk of other postprocedural complications in outpatient colonoscopy procedures.

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Ahmed, Shakera, Anwarul Karim, Tanvir Kabir Chowdhury, Orindom Shing Pulock, Nowrin Tamanna, Mastura Akter, Puja Biswas, et al. "Patients’ characteristics and 30-day mortality for those undergoing elective surgeries during the COVID-19 pandemic in Bangladesh." PLOS ONE 18, no. 8 (August 14, 2023): e0289878. http://dx.doi.org/10.1371/journal.pone.0289878.

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Background The COVID-19 pandemic has significantly impacted the surgical practice throughout the world, including elective surgical care. This study investigated the characteristics of patients undergoing elective surgery, the prevalence of COVID-19 infection, the surgical procedures performed, and 30-day mortality in general and pediatric surgical settings in selected tertiary-level hospitals in Bangladesh from November 2020 to August 2021. Methods This serial cross-sectional study included 264 patients scheduled for elective surgeries during the study period. All patients underwent COVID-19 real-time polymerase chain reaction (RT-PCR) testing within 24 hours before surgery. Data on age, sex, common comorbidities, surgical procedures, and 30-day mortality were collected and analyzed. Furthermore, comparisons were made between COVID-19 positive and negative patients. Results The prevalence of COVID-19 infection among patients was 10.6%. Older age, a history of major surgery within the last three months, hypertension, and diabetes mellitus were significantly associated with COVID-19 infection. All COVID-19-negative patients underwent surgery, while only 46.4% of COVID-19-positive patients underwent surgery. The most common surgical procedures were related to the digestive system, breast, and urinary system. Only one patient (0.4%) died within 30 days after surgery among the COVID-19-negative patients, whereas two patients (7.1%) died among the COVID-19-positive patients: one before surgery and one after surgery. Conclusions This study provides valuable insights into the characteristics, burden of COVID-19 infection, and 30-day mortality of patients undergoing elective surgery in tertiary care centers in Bangladesh during the pandemic.

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Antioch, Kathryn M., and Xichuan Zhang. "Using endoscopic procedures forAN-DRG assignment:Australia leads the way." Australian Health Review 21, no. 4 (1998): 80. http://dx.doi.org/10.1071/ah980080.

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The study reported in this article sought to develop Australian National Diagnosis Related Groups (AN-DRGs) using endoscopic procedures in Major Diagnostic Category (MDC) 6 (Digestive System) and MDC 7 (Hepatobiliary System and Pancreas) through statistical analysis of the Australian Casemix Clinical Committee's recommendations. Five ANOVA were undertaken on final recommendations for gastroscopy and colonoscopy in MDC 6. The Reduction in Variance (RIV) for the AN-DRGs in version 3 relative to version 2 increased by up to 14.6%, representing RIV of between 25.28% to 32.30%. For all ANOVAs, F>100, alpha < .0001, Coefficient of Variation (CV) was generally lower in version 3 by between 0.4% to 22.9%, except for AN-DRGs for other gastroscopy for major gastro-intestinal disease, which increased by 8.7%. Two ANOVA for Endoscopic Retrograde Cholangio-pancreatography Procedures (ERCP) recommendations resulted in RIV of up to 18.67%, F>100, alpha <- .0001 and CV up to 0.8091. MDC 6, in AN-DRG versions 3 and 3.1, has 11 AN-DRGs following the surgical hierarchy involving gastroscopy and colonoscopy. Patients assigned will not have an operating room procedure; they will have anon-operating room procedure that is either a complex therapeutic or other(diagnostic or therapeutic) procedure. Similar AN-DRGs are in MDC 7 for ERCP. Version 3.1 has expanded the definition of Common Bile Duct Exploration (CDE) to include ERCP. There is no separate AN-DRG for laparoscopy cholecystectomy.

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Hasdemir, Oğuz, Cavit Çöl, Oktay Büyükaşık, and Nihat Akçayöz. "Results after radical surgical treatment for advanced carcinoma of hypopharynx." Open Medicine 4, no. 4 (December 1, 2009): 512–18. http://dx.doi.org/10.2478/s11536-009-0017-6.

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AbstractThe aim of the study was to investigate patients with hypopharyngeal cancer. And this study focuses on a case series with hypopharynx cancer and cervical oesophageal cancer invading the hypopharynx. There were 13 cases over a period of 8 years, treated with pharyngo-laryngo-esophagectomy (PLE) and cervical lymph node dissection. In 10 of the patients, reconstruction was done with gastric pull-up (GP). In 3 of the 10 patients gastric reconstruction was added to aid in pyloric drainage (2 pyloromyotomy and 1 pyloroplasty) but the remaining 7 patients did not receive such procedures. The reconstruction of the digestive system after PLE is still a matter of debate. GP method is the most frequently preferred method for reconstruction. We believe that a more important problem than gastric drainage is the reflux of the gastric content and pyloric drainage which will not have a positive effect for solving this clinical situation. But we need bigger series for analyze of this specific condition.

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Sánchez-Margallo, Francisco Miguel, and Juan A. Sánchez-Margallo. "Assessment of Postural Ergonomics and Surgical Performance in Laparoendoscopic Single-Site Surgery Using a Handheld Robotic Device." Surgical Innovation 25, no. 3 (February 26, 2018): 208–17. http://dx.doi.org/10.1177/1553350618759768.

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Purpose. New laparoscopic devices are being continuously developed to overcome some of the technical and ergonomic limitations of laparoendoscopic single-site (LESS) surgery. This study aims to assess the surgeon’s surgical performance and ergonomics during the use of a handheld, robotic-driven, articulating laparoscopic instrument during LESS surgery. Methods. Seven right-handed experienced surgeons took part in this study. A set of basic suturing tasks and digestive and urological procedures in a porcine model were performed. Surgeons used both a conventional laparoscopic needle holder and a robotic device. The learning curve, execution time, and precision using the surgical needle were assessed. The surgeon’s posture was analyzed using a motion tracking system and a data glove. Results. After the training period, execution time on the intracorporeal suturing was significantly shorter using the conventional needle holder. The precision was higher using the conventional instrument in the horizontal plane, but the number of attempts to position the needle was lower using the robotic device (1.625 ± 0.250 vs 1.188 ± 0.375 attempts). The extension of the elbow (134.681 ± 14.35° vs 120.631 ± 13.134°) and the flexion of the shoulder (26.122 ± 7.411° vs 18.475 ± 14.166°) were significantly lower using the robotic instrument. The wrist posture using the robotic device was ergonomically acceptable during both surgical procedures. Conclusions. Results show a positive learning curve in ergonomics and surgical performance using the robotic instrument during LESS surgery. This instrument improves the surgeon’s body posture and the needle positioning errors. The use of the robotic instrument is feasible and safe during LESS partial nephrectomy and sigmoidectomy procedures.

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EVERLING, Eduardo Morais, Daniela Santos BANDEIRA, Felipe Melloto GALLOTTI, Priscila BOSSARDI, Antoninho José TONATTO-FILHO, and Tomaz de Jesus Maria GREZZANA-FILHO. "OPEN VS LAPAROSCOPIC HERNIA REPAIR IN THE BRAZILIAN PUBLIC HEALTH SYSTEM. AN 11-YEAR NATIONWIDE POPULATION-BASED STUDY." Arquivos de Gastroenterologia 57, no. 4 (December 2020): 484–90. http://dx.doi.org/10.1590/s0004-2803.202000000-85.

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ABSTRACT BACKGROUND: Abdominal wall hernia is one of the most common surgical pathologies. The advent of minimally invasive surgery raised questions about the best technique to be applied, considering the possibility of reducing postoperative pain, a lower rate of complications, and early return to usual activities. OBJECTIVE: To evaluate the frequency of open and laparoscopic hernioplasties in Brazil from 2008 to 2018, analyzing the rates of urgent and elective surgeries, mortality, costs, and the impact of laparoscopic surgical training on the public health system. METHODS: Nationwide data from 2008 to 2018 were obtained from the public health registry database (DATASUS) for a descriptive analysis of the selected data and parameters. RESULTS: 2,671,347 hernioplasties were performed in the period, an average of 242,850 surgeries per year (99.4% open, 0.6% laparoscopic). The economically active population (aged 20-59) constituted the dominant group (54.5%). There was a significant reduction (P<0.01) in open surgeries, without a compensatory increase in laparoscopic procedures. 22.3% of surgeries were urgent, with a significant increase in mortality when compared to elective surgeries (P<0.01). The distribution of laparoscopic surgery varied widely, directly associated with the number of digestive surgeons. CONCLUSION: This study presents nationwide data on hernia repair surgeries in Brazil for the first time. Minimally invasive techniques represent a minor portion of hernioplasties. Urgent surgeries represent a high percentage when compared to other countries, with increased mortality. The data reinforce the need for improvement in the offer of services, specialized training, and equalization in the distribution of procedures in all regions.

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Muñoz, Laura, Elisa Puigdomènech, Xavier Garcia Cuscó, César Velasco, and Mireia Espallargues. "PP284 Volume-Result Relationship Analysis In Digestive Oncological Surgery In Spain By Using Health Data Records." International Journal of Technology Assessment in Health Care 36, S1 (December 2020): 24–25. http://dx.doi.org/10.1017/s026646232000149x.

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IntroductionIn order to improve patients’ health outcomes, it is important to know the available evidence regarding centralization of surgical interventions for digestive cancer in hospitals with the highest volume of cases. We aim to describe and identify the number of annual interventions recommended by hospitals in order to maximize the health outcomes and efficiency for patients undergoing digestive cancer surgery during 2013–2016 in centers belonging to the Spanish National Health System (SNS).MethodsThe study design was a retrospective cohort study (patients aged ≥18 years). Data from Spanish public hospitals’ basic minimum set of data at hospital discharge for esophagus, stomach, liver, pancreas and rectum cancers was used. Age, sex primary/secondary diagnosis and procedures (Charlson index) were included. Reinterventions, hospital stay and in-hospital mortality were considered as the outcomes and measures of efficiency. Hospitals were grouped as low-/medium-/high-volume according to the number of annual procedures. Descriptive analysis and logistic and Poisson regression models with Stata16 were undertaken.ResultsHigh-volume hospitals performed between 67.4 (rectum) and 88.6 (liver) percent of interventions. The percentage of in-hospital mortality for all cancers was lower in high-volume centers (9.6% esophagus, 6.6% stomach, 7.1% pancreas, 4.2% liver and 2.2% rectum), showing a negative association between center volume and in-hospital mortality, which was statistically significant for esophagus (odds ratio [OR] = 0.48; 95% confidence interval [CI]: 0.28–0.81), stomach (OR = 0.51; 95% CI: 0.39–0.68) and rectum (OR = 0.63; 95% CI: 0.48–0.83) cancers. A non-statistically significant lower in hospital stay was observed in high-volume hospitals.ConclusionsThese results indicate that in Spain there is a negative association between the number of digestive oncological interventions per hospital and in-hospital mortality. This could help to define a threshold or cut-off point for the concentration of digestive cancer surgery in the SNS that might result in an improvement of lower in-hospital mortality and/or hospital stay.

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Bezrodnyi, B. G., I. V. Kolosovich, V. P. Slobodjanyk, O. M. Petrenko, and M. S. Filatov. "TECHNOLOGY OF PALLIATIVE SURGICAL TREATMENT OF PATIENTS WITH UNRESECTABLE CANCER OF THE HEAD OF THE PANCREAS, COMPLICATED BY MECHANICAL JAUNDICE." Medical Science of Ukraine (MSU) 15, no. 1-2 (December 6, 2019): 40–50. http://dx.doi.org/10.32345/2664-4738.1-2.2019.06.

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Relevance. It is relevant to develop new technological solutions for palliative surgical treatment of patients with unresectable pancreatic head cancer (UPHC), since the incidence of postoperative complications in such patients reaches 25 %, and mortality – 20 %. Objective. To improve the diagnosis and immediate results of palliative surgical treatment of patients with UPHC complicated by obstructive jaundice, duodenal obstruction, and carcinomatous pancreatitis. Materials and methods. At the first stage of the study, criteria for the diagnosis of PHC complications, tactics and methods for their surgical correction were evaluated (group I, 159 patients). After analyzing the results, a new technology for the surgical treatment of patients is formulated, the clinical testing of which was carried out in the second stage. An open, prospective, randomized study included 112 patients with UPHC complicated by obstructive jaundice (group II), who underwent palliative surgical treatment using patented surgical procedures. A comparative analysis of the results of surgical treatment of patients of both groups was carried out. Results. The safety and effectiveness of the simultaneous implementation with biliodigestive gastrodigestive shunting has been proven. The advantages of the tactics of two-stage surgical treatment of patients with signs of liver failure are shown. In patients with high anesthetic and surgical risk, the replacement of open surgery with endoscopic prosthetics of the biliary system and duodenal obstruction is justified. In severe forms of carcinomatous pancreatitis with expansion of the main pancreatic duct, a technique for combined bilio- and pancreatodigestive shunting is proposed. When multiple organ dysfunctions with hepatic-renal, hemorrhagic syndromes are formed in patients with obstructive jaundice, decompression of the biliary system by minimally invasive techniques is shown in the first stage, and the main stage of surgical intervention in the second. As a result, the incidence of postoperative complications was 9,8 %, mortality – 3,7 %. Conclusions. In patients with UPHC cancer complicated by obstructive jaundice, performing instead of traditional biliodigestive bypass surgery combined bilioastrodigestive bypass surgery is a safe procedure that does not increase the frequency of postoperative complications, prevents the need for repeated gastro-digestive interventions, improves the quality of life of patients in the long-term postoperative period. The operation of choice in the surgical treatment of patients with UPHC complicated by obstruction of the biliary system and duodenum with high surgical and anesthetic risk is endoscopic interventions with endoscopic prosthetics of the bile ducts and duodenum.

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Plotnikova, Ekaterina Yu, Gleb I. Kolpinsky, Irina N. Semenchuk, and Konstantin A. Krasnov. "Gastroenterological problems of bariatric surgery." Clinical review for general practice 4, no. 8 (August 28, 2023): 83–92. http://dx.doi.org/10.47407/kr2023.4.8.00335.

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Dietary imbalances and overeating can lead to a common disease today - obesity. Apart from aesthetic considerations, obesity is defined as an excess of adipose tissue, which can lead to serious health problems and predispose to a number of pathological changes and clinical diseases such as diabetes, hypertension, atherosclerosis, coronary heart disease, obstructive sleep apnea, depression, arthropathy weight-related diseases, as well as endometrial and breast cancer. Body weight exceeding the ideal weight for age, sex and height by 20% poses a serious health risk. Bariatric surgery is a comprehensive surgical treatment for morbid obesity when other treatments such as diet, increased physical activity, behavior modification and medications have failed. The two most common procedures used today are sleeve gastrectomy and Roux-en-Y gastric bypass. These procedures have gained popularity recently and are generally considered safe and effective. The article describes common and standard disorders in the digestive system that occur after bariatric surgery. A clinical example of a patient’s history after sleeve gastrectomy is also given, who was not observed and did not carry out the standard necessary postoperative measures.

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Whitney, Robin L., Janice Bell, Daniel J. Tancredi, Patrick S. Romano, Richard J. Bold, and Jill Joseph. "Inpatient care use among Californian patients with cancer in the year after diagnosis." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 235. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.235.

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235 Background: Inpatient care use is the chief driver of regional spending variation among some cancer patients and contributes more to cancer-related healthcare spending than does any other service category– including costly chemotherapy drugs. However, few studies are available to describe population rates of and reasons for hospitalization. Methods: California Cancer Registry (CCR) data linked with administrative claims data were used to quantify and describe inpatient care use among individuals diagnosed with cancer in California between 2009-2012 (n = 412, 850). Multistate models were used to estimate age-adjusted hospitalization rates, accounting for survival. Characteristics of hospitalizations were described and tabulated, including reasons for admission, procedures, and emergency department (ED) origin. Results: Among individuals with cancer, 62% had at least one hospitalization in the year after diagnosis, nearly half of which originated in the ED (45%). Among individuals with late stage cancers, 73-77% had an admission, 42-66% of which originated in the ED. Many hospitalizations included at least one surgical procedure (54%), diagnostic procedure (24%), or chemotherapy (11%). The most frequent principal diagnoses (other than malignancy) were infection-related (11%), cardiovascular (4%) and complications of a medical device or care (4%). Estimated hospitalization rates were highest for individuals with hepatobiliary/pancreatic cancers (2.5 hospitalizations), bone/soft tissue cancers (2.1 hospitalizations), and digestive system cancers (2.0 hospitalizations), and lowest for individuals with melanoma (0.3 hospitalizations), and breast or prostate cancer (0.6 hospitalizations). Conclusions: The population burden of inpatient care use among individuals with newly diagnosed cancer is substantial. Many hospitalizations originate in the emergency room, suggesting that they are unplanned. Oncology care providers’ efforts to reduce acute care use might target subgroups with higher rates, including hepatobiliary/pancreatic, bone/soft tissue, digestive, and late-stage cancers. Further research is warranted that examines the extent to which such visits are avoidable.

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Noor Ul Sabah Butt, Mudassar Fiaz Gondal, Jawad Abbasi, Sajeel Saeed, Omer Fraz, and Faizan Fazal. "Temporal Trends and Spectrum of Pediatric Surgical Conditions Operated In A Tertiary Care Teaching Hospital In Pakistan." Proceedings 37, no. 4 (November 13, 2023): 10–14. http://dx.doi.org/10.47489/szmc.v37i4.407.

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Introduction: Knowing the temporal trends as to when and how many pediatric surgery patients present and are operated on in a newly developed unit is crucial in the allocation of resources and policy making in health care center. Aims & Objectives: The aim of this study is to describe the spectrum and pattern of operated pediatric surgery patients in a newly developed pediatric surgical unit of Pakistan. Place and Duration of Study: This study was conducted at Pardiatric Surgery Unit of Holy Family hospital, Rawalpindi between January 2020 and September 2021. Material & Methods: This was a retrospective descriptive study conducted on all patients that were operated under Pediatric surgery unit over a period of 20-months. Data regarding age, sex, diagnosis, and procedure performed were obtained. Diagnoses were categorized based on organ system. SPSS version 22 was used to perform the data analysis., a p-value of ?0.05 was considered significant. Results:898 procedures were performed in total with a male to female ratio of 2.03:1. Most of the patients fell under 2-8 years of age. Digestive system disorders (164, 18.3%) and genitourinary (377, 42%) made most of the cases observed, with inguinal hernias making up to 15.0% of all cases. Oddsratio was calculated for different variables which showed that male patients , patients with gastrointestinal problems had greater odds of being operated. Conclusion: The expected number of operated cases in a newly developed unit is comparable to other units that have been established for a long time.More focus research needs to be done on different aspects of pediatric surgery in our region and to try for integration of pediatric surgery into public health programs including primary and secondary health centers to meet the increasing demand of pediatric surgical patients presented to tertiary care.

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Proniagin, S. V., K. V. Stegniy, E. R. Dvoinikova, A. A. Krekoten, A. V. Grebneva, A. V. Sokolova, and R. A. Goncharuk. "Vacuum-aspiration system in the treatment of urethrorectal fistula after laparoscopic radical prostatectomy." Pacific Medical Journal, no. 2 (June 15, 2023): 77–80. http://dx.doi.org/10.34215/1609-1175-2023-2-77-80.

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Prevailing complications of radical prostatectomy include rectal injuries and urethrorectal fistulas. Their surgical treatment is highly invasive with 25% recurrence rate. The most commonly used techniques include the York-Mason procedure and transperineal fistuloplasty using local tissue or gracilis muscle flap of thigh. In addition, endoscopic vacuum-aspiration therapy has been used to treat failed anastomoses of digestive tract since 2006. The therapy involves continuous active aspiration through a monoporous foam material of the required size fixed to the aspiration tube. The paper presents a clinical case of successful treatment of urethrorectal fistula by means of a vacuum-aspiration system, which enables the fistula to be completely separated and urethral and anal continence to be preserved. On the 45th day after radical prostatectomy, the cystoscopy and rectoromanoscopy detected closure of the defect; independent urination was restored. 6 months later, independent defecation came back. Relapse-free period for the underlying disease and its complications comprised 32 months.

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Stojanovic, Dragos, Mirjana Stojanovic, Predrag Milojevic, Zorica Caparevic, Djordje Lalosevic, and Dragan Radovanovic. "Strategies for endoscopic and surgical management of common bile duct stones." Medical review 56, no. 1-2 (2003): 69–75. http://dx.doi.org/10.2298/mpns0302069s.

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Introduction Common bile duct calculi represent a pathologic entity involving obstructive icterus, cholangitis, hepatic cirrhosis or pancreatitis. Common bile duct calculi mostly have a secondary origin (from gallbladder) in 95% of cases, while primary choledocholithiasis is rare. Classification From surgical aspect, common bile duct calculi can be: 1. Asymptomatic, without manifested symptoms or signs,2. Mobile, with intermittent biliar obstruction and disobstruction, 3. Fixed, with obstruction and signs of hepato-biliary and/or bilio-pancreatic duct, 4. Transitory, microcalculi which pass through Vater's Papilla by propulsion into duodenum with symptoms. Discussion Modern biliary surgery includes diagnosis of common bile duct calculi, and if possible preoperative endoscopic (endoluminal) surgery, which is less invasive for patients. If such approach is not possible, it is necessary to perform stone extraction and cholecystectomy. Conclusion Common bile duct calculi represent a common disease of the digestive system. Endoscopic diagnostic procedure is very important in management of choledocholithiasis Endoscopic treatment of common bile duct calculi prior to cholecystectomy is a method of choice and a strategy for associated cholecysto-choledocholithiasis.

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Chen, Yingju, and Jeongkyu Lee. "A Review of Machine-Vision-Based Analysis of Wireless Capsule Endoscopy Video." Diagnostic and Therapeutic Endoscopy 2012 (November 13, 2012): 1–9. http://dx.doi.org/10.1155/2012/418037.

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Wireless capsule endoscopy (WCE) enables a physician to diagnose a patient's digestive system without surgical procedures. However, it takes 1-2 hours for a gastroenterologist to examine the video. To speed up the review process, a number of analysis techniques based on machine vision have been proposed by computer science researchers. In order to train a machine to understand the semantics of an image, the image contents need to be translated into numerical form first. The numerical form of the image is known as image abstraction. The process of selecting relevant image features is often determined by the modality of medical images and the nature of the diagnoses. For example, there are radiographic projection-based images (e.g., X-rays and PET scans), tomography-based images (e.g., MRT and CT scans), and photography-based images (e.g., endoscopy, dermatology, and microscopic histology). Each modality imposes unique image-dependent restrictions for automatic and medically meaningful image abstraction processes. In this paper, we review the current development of machine-vision-based analysis of WCE video, focusing on the research that identifies specific gastrointestinal (GI) pathology and methods of shot boundary detection.

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20

Ngoumfe, Joseph Cyrille Chopkeng. "Evaluate the delay in the management of acute abdomen at the Yaounde central hospital: a prospective cohort study." MOJ Clinical & Medical Case Reports 11, no. 6 (2021): 155–58. http://dx.doi.org/10.15406/mojcr.2021.11.00404.

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Background: Early surgical treatment remains the first factor of good prognosis for the management of acute abdominal diseases. The aim of this study was to evaluate the delay in the management of these pathologies in our context. Material and methods: We conducted a prospective cross-sectional study at the Yaoundé Central Hospital (HCY) over 7 months. All patients over 15 years of age presenting with an acute non-traumatic digestive surgical abdomen were included. The follow-up was done during the entire hospital stay of the patients. The dates and times of the different stages of management were recorded. Results: We collected 63 patients, 37 men, with a sex ratio M/F of 1.42. The mean age was 41.06±18 years. The mean time between arrival in the emergency room and the indication for surgery was 16.9 hours. Acute generalized peritonitis (n=26) was the most common diagnosis with 41.3% of cases. The average time between the indication for surgery and the availability of the surgical kit was 19 hours. The average time between the availability of the operating kit and the start of the surgical procedure was 6.2 hours. The complication rate was 33.3%. The mortality rate was 15.9%. Conclusion: Our delays in the management of acute abdomens are relatively long. A better organisation of the system and continuous training of the medical staff of peripheral hospitals would improve the prognosis of our patients.

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Soriano de Souza Jesuíno Rodrigues, Paula Aparecida, Gabriella Barros dos Santos, and Jandesson Mendes Coqueiro. "Diagnóstico tardio e infecção de sítio cirúrgico em sujeitos submetidos a apendicectomia." Revista de Enfermagem UFPE on line 12, no. 6 (June 2, 2018): 1539. http://dx.doi.org/10.5205/1981-8963-v12i6a230986p1539-1545-2018.

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RESUMOObjetivo: verificar a associação grau evolutivo da apendicite com a infecção de sítio cirúrgico em sujeitos submetidos a apendicectomia. Método: estudo quantitativo retrospectivo e descritivo, a partir do exame dos prontuários médicos de sujeitos submetidos a apendicectomia. A análise estatística foi feita através da Análise de variância. Resultados: a amostra foi constituída por 60 pacientes, com predomínio do sexo masculino, a sintomatologia clássica da apendicite registrada na maioria dos sujeitos, incluiu a dor abdominal na região epigástrica ou periumbilical que irradiava para fossa ilíaca direita. A distribuição dos sujeitos segundo a classificação laparoscópica foi: grau 1 (18,33%); 2 (28,33%); 3 (26,67%); 4A (8,33%); 4C (10%); 5 (5%); não especificado (3,33%). A taxa de infecção de sítio cirúrgico foi de 15%. Conclusão: grau evolutivo e infecção de sítio cirúrgico são variáveis dependentes, pois as complicações foram mais frequentes em fases mais avançadas da apendicite (Grau 4). É fundamental a atuação da enfermagem através de medidas direcionadas à prevenção e controle das infecções hospitalares, sobretudo, da infecção de sítio cirúrgico. Descritores: Apendicectomia; Procedimentos Cirúrgicos do Sistema Digestório; Infecção da ferida cirúrgica; Sistema Único de Saúde; Enfermagem Perioperatória; Enfermagem.ABSTRACT Objective: to assess the association between evolutionary degree of appendicitis with surgical site infection in subjects after appendectomy. Method: retrospective, descriptive and quantitative study, from the examination of the medical records of subjects that underwent appendectomy. The statistical analysis was done through Variance analysis. Results: the sample consisted of 60 patients, with a predominance of males, the classic symptoms of appendicitis registered in most subjects included abdominal pain in the epigastric or periumbilical region that radiated to the right iliac fossa. The distribution of the subjects according to the laparoscopic classification was: degree 1 (18.33%); 2 (28.33%); 3 (26.67%); 4A (8.33%); 4C (10%); 5 (5%); not specified (3.33%). The rate of surgical site infection was 15%. Conclusion: evolutionary degree and surgical site infection are dependent variables, because the complications were more frequent in more advanced phases of appendicitis (degree 4). The nursing performance through measures directed to preventing and controlling nosocomial infections, especially surgical site infections, is essential. Descriptors: Appendectomy; Digestive System Surgical Procedures; Surgical Wound Infection; Unified Health System; Perioperative Nursing; Nursing. RESUMEN Objetivo: evaluar la asociación entre el grado evolutivo de la apendicitis con infección de sitio quirúrgico en sujetos sometidos a apendicectomía. Método: estudio retrospectivo, descriptivo y cuantitativo, a partir del examen de los registros médicos de los sujetos sometidos a apendicectomía. El análisis estadístico se realizó mediante el Análisis de varianza. Resultados: la muestra estuvo constituida por 60 pacientes, con un predominio del sexo masculino, los síntomas clásicos de apendicitis registrados en la mayoría de los sujetos incluyeron dolor abdominal en la región epigástrica o periumbilical, que irradia a la fosa iliaca derecha. La distribución de los temas según la clasificación laparoscópica fue: grado 1 (18,33%); 2 (28.33%); 3 (26,67%); 4A (8,33%); 4C (10%); 5 (5%); no especificado (3,33%). La tasa de infección del sitio quirúrgico fue de 15%. Conclusión: grado evolutivo y la infección de sitio quirúrgico son variables dependientes, porque las complicaciones fueron más frecuentes en fases más avanzadas de la apendicitis (grado 4). Es esencial el desempeño de la enfermería a través de medidas dirigidas a la prevención y el control de las infecciones nosocomiales, especialmente de la infección del sitio quirúrgico. Descriptores: Apendicectomía; Procedimientos Quirúrgicos del Sistema Digestivo; Infección de la Herida Quirúrgica; Enfermería Perioperatoria; Sistema Único de Salud; Enfermería.

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22

Głuszek, Stanisław, and Jarosław Matykiewicz. "Closing a temporary stoma - the tactics of the procedure." Polish Journal of Surgery 94, no. 6 (March 3, 2022): 1–5. http://dx.doi.org/10.5604/01.3001.0015.7782.

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The paper presents the results of clinical trials and meta-analyzes regarding the closing time: ileostomy (protective) after primary colorectal resection with anastomosis and colostomy - after Hartman's surgery. In rectal cancer surgery and anastomosis of the ileum with rectum (IPAA) in inflammatory bowel diseases, an ileostomy (temporary protective, preventive) is often performed, which in a significant proportion of cases is eliminated at different times from the initial surgery. There is a discussion in the literature regarding the selection of the appropriate time of stoma closure, taking into account the experience of many clinical centers. An ileostomy is performed when the entire colon and rectum must be removed, or to protect the colon or ileo-rectal anastomosis. The creation of a protective stoma reduces the frequency of clinically significant anastomotic leakages and the need for surgical revisions in patients at increased risk of leakage. Also, the time of digestive system reconstruction, i.e. colostomy elimination, after Hartman's surgery depends on many factors, including the stage of the disease and indications for adjuvant treatment. Should it be standard practice to close the stoma early? Based on previous studies and meta-analyzes and own experience - it is advisable to individualize the procedure, taking into account many factors determining the clinical and oncological status (selection of the date - early or deferred, but not as a standard!)

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Shehzad, Sofia. "Bariatric Surgery: Cosmesis or Therapy." Journal of Gandhara Medical and Dental Science 3, no. 2 (March 1, 2017): 1. http://dx.doi.org/10.37762/jgmds.3-2.281.

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Few surgical procedures have caught public imagination and expectations the way, weight loss intervention has done during the recent past. This is compounded by the fact that relevant procedures are now available through minimal access surgical approach offering a quick recovery and return to routine life. Moreover surgeons look upon these bariatric surgeries as a new and challenging modality that they are keen to add to their repertoire offering better reputation and financial incentives in addition to established benefits to their patients. The concept was infact introduced in the early 1950's with intestinal bypass acting through inducing malabsorption. However it was not until 1965 that Dr Edward E. Mason and Dr. Chikashi Ito at the University of Iowa developed the original gastric bypass which has since shown more promise with fewer complications and it is by virtue of this that the former has come to be known as the 'father of obesity surgery'. The boom in different procedures to be adopted has however led to a number of queries not only in the minds of those seeking intervention but the ones offering benefits related to ideal body weight and redressal of co-morbidities, that is the doctors as well. Technical debates are raging and recommendations changing as the concept continue to gain acceptability andmomentum. Contrary to the general perception that these procedures are meant primarily for cosmetic reasons, the actual benefits are now believed to be health related. Studies have shown that bariatric surgery contributes to diabetic control, psychological benefits, reduced risk of cardiac events and reduction in mortality of 23% from 40%1 . A lot of research has been afoot for more than half a century looking into possible surgical cures for metabolic diseases such as high lipid , cholesterol and blood sugar. In 1995 Dr Walter Pories et al published a paper2 concluding that gastric bypass is an established and effective therapy for morbid obesity and its associated morbidities, producing a durable and complete control of diabetes mellitus. In 2007, encouraged by the significant impact of bariatric procedures on actual cure of metabolic upsets as described, the American Society for Bariatric Surgery (ASBS) which was established in 1983 changed its name to the American Society for Metabolic and Bariatric Surgery (ASMBS). Given the recent public interest in the visible benefits of weight loss surgery and much wider availability of doctors and centres offering various procedures it is essential to have some consensus on standardization of indications for the said intervention. The American College of Physicians recommend that those with a BMI of at least 40 Kg/m2 who have failed an adequate exercise and diet programme and with co morbidities such as hypertension, impaired glucose tolerance , diabetes mellitus , hyperlipidemia and obstructive sleep apnoea should be offered the procedure after consultation with the prime surgeon3 . The American Society for Metabolic and Bariatric Surgery (ASBMS) in its recent guidelines however has suggested a BMI of 30 Kg/m2 with co morbidities as an indication for bariatric surgical intervention. Procedures recommended for affecting weight loss act by way of altering the anatomy of gastrointestinal tract (stomach and digestive system) and inducing physiologic changes in the body that affects energy balance and fat metabolism. They can be classified broadly into three types4 ;Predominantly malabsorptive :These procedures are mainly reliant on creating a physiological upset of normal absorptive mechanisms. They include biliopancreatic bypass, jejunoileal bypass and endoluminalsleeve. None of these are however in vogue given the metabolic and nutritional upset theycreate. Predominantly restrictive :Procedures such as adjustable gastric banding, vertical banded gastroplasty , intragastric balloon, gastric plication and sleeve gastrectomy result in a limited gastric volume thereby producing early satiety and reduced oral intake . Moreover since the continuity of the alimentary canal is not disturbed metabolic complications are not much of an issue5. Mixed:Gastric bypass, sleeve gastrectomy with duodenal switch and implantable gastric stimulation are procedures that apply both techniques simultaneously. Bariatric Surgery is usually supported by a dietary plan in the immediate post operative period, consisting of a clear liquid diet, followed by a blended or pureed sugar free diet for at least two weeks. The restrictive element of these procedures limits the capacity of the stomach inducing nausea and vomiting in case of excessive intake. Vitamin and mineral supplements are needed to compensate for decreased absorption of these essential items. High protein diets are usually recommended in light of the decreased consumption of food. The actual success of weight loss surgery depends on factors other than surgery alone such as long term nutrition and dietary habits, exercise and life style changes. Although there are demonstrable health benefits linked to bariatric interventions, the patient seems more concerned with the visible degree of weight loss. A meta-analysis6 from University of California Los Angeles looked at weight loss as a result of different procedures at thirty-six months and concluded that Biliopancreatic diversion offered maximum benefit at 117 pounds followed by Roux en Y gastric bypass and then vertical banded gastroplasty. Studies7 have also shown that bariatric surgery improved diabetic status in more than 85% of the affected and afforded remission in 78%. One of the key questions related to bariatric surgery is the amount of risk associated with this intervention. Complications related to the procedure as reported from time to time include gastric dumping syndrome, anastomotic leaks, incisional hernias, infections, pneumonia, osteopnia, secondary hyperparathyroidism, rhabdomyolysis, gallstones and hyperoxaluria. Studies have shown a mortality of less than 0.3% in individual undergoing surgery and a lower risk of death in the later group as compared to those plagued by obesity and its co-morbidities who do not have the procedure. Taking all the facts into consideration bariatric surgery certainly promises to attract headlines with introduction of modified interventional procedures from time to time as research into the best possible modality with maximum benefits and least risk continues. Patient variation and surgeon's expertise has its bearing on the ultimate choice in this respect as improvement in health,longevity and quality of life tops the list of core determinants acting as a guiding principle in making the ultimate decision regarding the intervention indicated.

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24

Topaloglu, Omer, Kubra Nur Kılıc, Sami Karapolat, Yener Aydın, Atila Turkyilmaz, Aysen Taslak Sengul, Atilla Eroglu, and Ahmet Basoglu. "Diagnosis, treatment, and management of esophageal foreign bodies in patients with mental retardation: A retrospective study from three centers." Turkish Journal of Thoracic and Cardiovascular Surgery 32, no. 2 (April 1, 2024): 179–84. http://dx.doi.org/10.5606/tgkdc.dergisi.2024.25724.

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Background: This study aims to assess the outcomes and prognosis of surgical interventions aimed at removing esophageal foreign bodies in patients with mental retardation. Methods: Between January 2010 and January 2021, a total of 30 consecutive patients (20 males, 10 females; median age: 29.5 years; range, 2 to 57 years) with mental retardation who were diagnosed with esophageal foreign bodies and underwent surgical treatment were retrospectively analyzed. Age and sex of the patients, symptoms, type of the foreign body, esophageal stricture level, methods used for preoperative diagnosis, type of surgical procedure, postoperative complications, and length of hospital stay were recorded. Results: Seventeen (56.6%) patients had a foreign body in the first narrowing, 12 (40%) in the second narrowing, and one (3.3%) in the third narrowing. A rigid esophagoscopy was performed in all cases. However, successful removal was not achieved in two (6.6%) cases, and foreign bodies were removed through cervical esophagotomy in one (3.3%) patient and through esophagotomy with right thoracotomy in one (3.3%) patient. Postoperative complications included esophagitis in seven patients (23.3%) and wound infection and pneumonia in two patients (6.6%). The median length of hospital stay after treatment was 1.09 days in patients without complications and 3.3 days in patients with complications. There was a significant correlation between the occurrence of complications and the length of hospital stay (p=0.002). The foreign body was successfully removed in all patients, and no mortality was observed. Conclusion: Early diagnosis and emergency intervention can reduce complications, particularly considering the possibility of non-food and sharp-edged foreign bodies that pose a higher risk of damaging the digestive system, in patients with mental retardation than those without such conditions.

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25

Shehzad, Sofia. "BARIATRIC SURGERY:COSMESIS OR THERAPY." Journal of Gandhara Medical and Dental Science 3, no. 2 (September 2, 2017): 1. http://dx.doi.org/10.37762/jgmds.3-2.228.

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Abstract:

Few surgical procedures have caught public imagination and expectations the way, weight loss intervention has done during the recent past. This is compounded by the fact that relevant procedures are now available through minimal access surgical approach offering a quick recovery and return to routine life. Moreover surgeons look upon these bariatric surgeries as a new and challenging modality that they are keen to add to their repertoire offering better reputation and financial incentives in addition to established benefits to their patients. The concept was infact introduced in the early 1950's with intestinal bypass acting through inducingmalabsorption. However it was not until 1965 that DrEdward E. Mason and Dr. Chikashi Ito at theUniversity of Iowadevelopedthe original gastric bypasswhich has since shown more promise with fewer complications and it is by virtue of this that the former has come to be known as the 'father of obesity surgery'.The boom in different procedures to be adopted has however led to a number of queries not only in the minds of those seeking intervention but the ones offering benefits related to ideal body weight and redressal of co-morbidities, that is the doctors as well. Technical debates are raging and recommendations changing as the concept continueto gain acceptability and momentum. Contrary to the general perception that these procedures are meant primarily for cosmetic reasons, the actual benefits are now believed to be health related. Studies have shown that bariatric surgery contributes to diabetic control, psychological benefits,reduced risk of cardiac events and reduction in mortality of 23% from 40%1. A lot of research has been afoot for more than half a century looking into possible surgical cures for metabolic diseases such as high lipid , cholesterol and blood sugar. In 1995 Dr Walter Pories et al published a paper2concluding that gastric bypass is an established and effective therapy for morbid obesity and its associated morbidities, producing a durable and complete control of diabetes mellitus.In 2007, encouraged by the significant impact of bariatric procedures on actual cure of metabolic upsets as described, the American Society for Bariatric Surgery (ASBS) which was established in 1983 changed its name to the American Society for Metabolic and Bariatric Surgery (ASMBS).Given the recent public interest in the visible benefits of weight loss surgery and much wider availability of doctors and centres offering various procedures it is essential to have some consensus on standardization of indications for the said intervention. The American College of Physicians recommend that those with a BMI of at least 40 Kg/m2 who have failed an adequate exercise and diet programme and with co morbidities such as hypertension, impaired glucose tolerance , diabetes mellitus , hyperlipidemia and obstructive sleep apnoea should be offered the procedure after consultation with the prime surgeon3. The American Society for Metabolic and Bariatric Surgery (ASBMS) in its recent guidelines however has suggested a BMI of 30 Kg/m2with co morbidities as an indication for bariatric surgical intervention. Procedures recommended for affecting weight loss act by way of altering the anatomy of gastrointestinal tract (stomach and digestive system) and inducing physiologic changes in the body that affects energy balance and fat metabolism. Theycan be classified broadly into three types4;Predominantly malabsorptive :These procedures are mainly reliant on creating a physiological upset of normal absorptive mechanisms. They include biliopancreatic bypass, jejunoileal bypass and endoluminalsleeve. None of these are however in vogue given the metabolic and nutritional upset they create.Predominantly restrictive :Procedures such as adjustable gastric banding, vertical banded gastroplasty , intragastric balloon, gastric plication and sleeve gastrectomy result in a limited gastric volume thereby producing early satiety and reduced oral intake . Moreover since the continuity of the alimentary canal is not disturbed metabolic complications are not much of an issue5.Mixed:Gastric bypass, sleeve gastrectomy with duodenal switch and implantable gastric stimulation are procedures that apply both techniques simultaneously.Bariatric Surgery is usually supported by a dietary plan in the immediate post operative period, consisting of a clear liquiddiet, followed by a blended or pureed sugar free diet for at least two weeks. The restrictive element of these procedures limitsthe capacity of the stomach inducing nausea and vomiting in case of excessive intake. Vitamin and mineral supplements are needed to compensate for decreased absorption of these essential items. High protein diets are usually recommended in light of the decreased consumption of food. The actual success of weight loss surgery depends on factors other than surgery alone such as longterm nutrition and dietary habits, exercise and life style changes. Although there are demonstrable health benefits linked to bariatric interventions, the patient seems more concerned with the visible degree of weight loss. A meta-analysis6from University of California Los Angeles looked at weight loss as a result of different procedures at thirty-six months and concluded that Biliopancreatic diversion offered maximum benefit at 117 pounds followed by Roux en Y gastric bypass and then vertical banded gastroplasty. Studies7 have also shown that bariatric surgery improved diabetic status in more than 85% of the affected and afforded remission in 78%.One of the key questionsrelated to bariatric surgery is the amount of risk associated with this intervention. Complications related to the procedure as reported from time to time include gastric dumping syndrome, anastomotic leaks, incisional hernias, infections, pneumonia, osteopnia, secondary hyperparathyroidism,rhabdomyolysis, gallstones and hyperoxaluria. Studies have shown a mortality of less than 0.3% in individual undergoing surgery and a lower risk of death in the later group as compared to those plagued by obesity and its co-morbidities who do not have the procedure.Taking all the facts into consideration bariatric surgery certainly promises to attract headlines with introduction of modified interventional procedures from time to time as research into the best possible modality with maximum benefits and least risk continues. Patient variation and surgeon's expertise has its bearing on the ultimate choice in this respect as improvement in health, longevity and quality of life tops the list of core determinants acting as a guiding principle in making the ultimate decision regarding the interventionindicated.

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26

Shehzad, Sofia. "BARIATRIC SURGERY:COSMESIS OR THERAPY." Journal of Gandhara Medical and Dental Science 3, no. 2 (September 2, 2017): 1. http://dx.doi.org/10.37762/jgmds.3-2.228.

Full text

Abstract:

Few surgical procedures have caught public imagination and expectations the way, weight loss intervention has done during the recent past. This is compounded by the fact that relevant procedures are now available through minimal access surgical approach offering a quick recovery and return to routine life. Moreover surgeons look upon these bariatric surgeries as a new and challenging modality that they are keen to add to their repertoire offering better reputation and financial incentives in addition to established benefits to their patients. The concept was infact introduced in the early 1950's with intestinal bypass acting through inducingmalabsorption. However it was not until 1965 that DrEdward E. Mason and Dr. Chikashi Ito at theUniversity of Iowadevelopedthe original gastric bypasswhich has since shown more promise with fewer complications and it is by virtue of this that the former has come to be known as the 'father of obesity surgery'.The boom in different procedures to be adopted has however led to a number of queries not only in the minds of those seeking intervention but the ones offering benefits related to ideal body weight and redressal of co-morbidities, that is the doctors as well. Technical debates are raging and recommendations changing as the concept continueto gain acceptability and momentum. Contrary to the general perception that these procedures are meant primarily for cosmetic reasons, the actual benefits are now believed to be health related. Studies have shown that bariatric surgery contributes to diabetic control, psychological benefits,reduced risk of cardiac events and reduction in mortality of 23% from 40%1. A lot of research has been afoot for more than half a century looking into possible surgical cures for metabolic diseases such as high lipid , cholesterol and blood sugar. In 1995 Dr Walter Pories et al published a paper2concluding that gastric bypass is an established and effective therapy for morbid obesity and its associated morbidities, producing a durable and complete control of diabetes mellitus.In 2007, encouraged by the significant impact of bariatric procedures on actual cure of metabolic upsets as described, the American Society for Bariatric Surgery (ASBS) which was established in 1983 changed its name to the American Society for Metabolic and Bariatric Surgery (ASMBS).Given the recent public interest in the visible benefits of weight loss surgery and much wider availability of doctors and centres offering various procedures it is essential to have some consensus on standardization of indications for the said intervention. The American College of Physicians recommend that those with a BMI of at least 40 Kg/m2 who have failed an adequate exercise and diet programme and with co morbidities such as hypertension, impaired glucose tolerance , diabetes mellitus , hyperlipidemia and obstructive sleep apnoea should be offered the procedure after consultation with the prime surgeon3. The American Society for Metabolic and Bariatric Surgery (ASBMS) in its recent guidelines however has suggested a BMI of 30 Kg/m2with co morbidities as an indication for bariatric surgical intervention. Procedures recommended for affecting weight loss act by way of altering the anatomy of gastrointestinal tract (stomach and digestive system) and inducing physiologic changes in the body that affects energy balance and fat metabolism. Theycan be classified broadly into three types4;Predominantly malabsorptive :These procedures are mainly reliant on creating a physiological upset of normal absorptive mechanisms. They include biliopancreatic bypass, jejunoileal bypass and endoluminalsleeve. None of these are however in vogue given the metabolic and nutritional upset they create.Predominantly restrictive :Procedures such as adjustable gastric banding, vertical banded gastroplasty , intragastric balloon, gastric plication and sleeve gastrectomy result in a limited gastric volume thereby producing early satiety and reduced oral intake . Moreover since the continuity of the alimentary canal is not disturbed metabolic complications are not much of an issue5.Mixed:Gastric bypass, sleeve gastrectomy with duodenal switch and implantable gastric stimulation are procedures that apply both techniques simultaneously.Bariatric Surgery is usually supported by a dietary plan in the immediate post operative period, consisting of a clear liquiddiet, followed by a blended or pureed sugar free diet for at least two weeks. The restrictive element of these procedures limitsthe capacity of the stomach inducing nausea and vomiting in case of excessive intake. Vitamin and mineral supplements are needed to compensate for decreased absorption of these essential items. High protein diets are usually recommended in light of the decreased consumption of food. The actual success of weight loss surgery depends on factors other than surgery alone such as longterm nutrition and dietary habits, exercise and life style changes. Although there are demonstrable health benefits linked to bariatric interventions, the patient seems more concerned with the visible degree of weight loss. A meta-analysis6from University of California Los Angeles looked at weight loss as a result of different procedures at thirty-six months and concluded that Biliopancreatic diversion offered maximum benefit at 117 pounds followed by Roux en Y gastric bypass and then vertical banded gastroplasty. Studies7 have also shown that bariatric surgery improved diabetic status in more than 85% of the affected and afforded remission in 78%.One of the key questionsrelated to bariatric surgery is the amount of risk associated with this intervention. Complications related to the procedure as reported from time to time include gastric dumping syndrome, anastomotic leaks, incisional hernias, infections, pneumonia, osteopnia, secondary hyperparathyroidism,rhabdomyolysis, gallstones and hyperoxaluria. Studies have shown a mortality of less than 0.3% in individual undergoing surgery and a lower risk of death in the later group as compared to those plagued by obesity and its co-morbidities who do not have the procedure.Taking all the facts into consideration bariatric surgery certainly promises to attract headlines with introduction of modified interventional procedures from time to time as research into the best possible modality with maximum benefits and least risk continues. Patient variation and surgeon's expertise has its bearing on the ultimate choice in this respect as improvement in health, longevity and quality of life tops the list of core determinants acting as a guiding principle in making the ultimate decision regarding the interventionindicated.

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27

Ramzan, Rabia, Danish Afzal, Abeera Ishaq Butt, Muhammad Hassaan, Muhammad Zeeshan Sarwar, and Syed Asghar Naqi. "Outcome of Laparoscopic Cholecystectomy as a Day Case Procedure." Pakistan Journal of Medical & Health Sciences 16, no. 10 (October 30, 2022): 262–63. http://dx.doi.org/10.53350/pjmhs221610262.

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Introduction: Gallstone disease, a condition caused by the development of stones in gall bladder, usually presents with pain in upper abdomen, is one of the most common diseases of digestive system. It can be treated by the surgical removal of gall bladder, either through open cholecystectomy or by laparoscopic cholecystectomy (key hole surgery); the latter allows patients to be discharged from hospital on the day of their surgery, a concept known as day case surgery. Material and Methods: It was a descriptive case series in which 100 patients were selected through non probability, consecutive sampling. Inclusion and exclusion criteria were applied. Patients were assessed by anesthetist and consultant surgeon before undergoing laparoscopic cholecystectomy. After surgery, patients were encouraged intake of liquids and were discharged from the hospital as soon as they fulfilled the discharge criteria. Unplanned overnight admissions determined the outcome of this study. Results: 86% patients were discharged on the same day of surgery and 14% patients had an overnight stay after surgery. There were no readmissions but 3% of the patients presented for an unexpected consultation. Post stratification values of overnight admissions with age and BMI were found to be statistically significant while those for gender and duration of symptoms were found to be statistically insignificant. Conclusion: Patient selection is an important factor that affects the outcome of laparoscopic cholecystectomy, which is mostly an effective procedure. This study will help in the adoption of laparoscopic cholecystectomy as a day case procedure which is an effective way of reducing burden on health care resources. Keywords: Cholecystectomy, day case laparoscopic cholecystectomy (DCLC), laparoscopic surgery (LC).

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Reitano, Elisa, Simone Famularo, Bernard Dallemagne, Kohei Mishima, Silvana Perretta, Pietro Riva, Pietro Addeo, et al. "Educational Scoring System in Laparoscopic Cholecystectomy: Is It the Right Time to Standardize?" Medicina 59, no. 3 (February 23, 2023): 446. http://dx.doi.org/10.3390/medicina59030446.

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Background and Objectives: Laparoscopic cholecystectomy (LC) is one of the most performed surgeries worldwide. Procedure difficulty and patient outcomes depend on several factors which are not considered in the current literature, including the learning curve, generating confusing and subjective results. This study aims to create a scoring system to calculate the learning curve of LC based on hepatobiliopancreatic (HPB) experts’ opinions during an educational course. Materials and Methods: A questionnaire was submitted to the panel of experts attending the HPB course at Research Institute against Digestive Cancer-IRCAD (Strasbourg, France) from 27–29 October 2022. Experts scored the proposed variables according to their degree of importance in the learning curve using a Likert scale from 1 (not useful) to 5 (very useful). Variables were included in the composite scoring system only if more than 75% of experts ranked its relevance in the learning curve assessment ≥4. A positive or negative value was assigned to each variable based on its effect on the learning curve. Results: Fifteen experts from six different countries attended the IRCAD HPB course and filled out the questionnaire. Ten variables were finally included in the learning curve scoring system (i.e., patient body weight/BMI, patient previous open surgery, emergency setting, increased inflammatory levels, presence of anatomical bile duct variation(s), and appropriate critical view of safety (CVS) identification), which were all assigned positive values. Minor or major intraoperative injuries to the biliary tract, development of postoperative complications related to biliary injuries, and mortality were assigned negative values. Conclusions: This is the first scoring system on the learning curve of LC based on variables selected through the experts’ opinions. Although the score needs to be validated through future studies, it could be a useful tool to assess its efficacy within educational programs and surgical courses.

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Kadhim, Alaa, and Haleema Kadhim. "Assessment of Postoperative Nurses' Interventions for the Patients with Laparoscopic Cholecystectomy at Baghdad Teaching Hospitals." Iraqi National Journal of Nursing Specialties 27, no. 1 (June 30, 2014): 11–22. http://dx.doi.org/10.58897/injns.v27i1.189.

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Objective: The study aimed to assess the postoperative nurses' intervention for the patients with laparoscopiccholecystectomy and to determine the relationship between Nurses' interventions and their demographiccharacteristics.Methodology: Quantitative design (a descriptive study) was started from 20th November 2012 up to 1stSeptember 2013. Non-probability (purposive sample) of (50) nurses, who were working in surgical wards, wereselected from Baghdad teaching hospitals (Baghdad Teaching Hospital, Digestives System and Liver TeachingHospital, AL-Kindy Teaching Hospital, and AL-Kadhimiyia Teaching Hospita). The data were collected throughthe use of a constructed questionnaire, which consisted of two parts; the first part includes the page ofdemographic data which contains (10) items and the second part which includes (5) domains in (46) subdomainof postoperative nurses' interventions for the patients with laparoscopic cholecystectomy, throughdirect observant approach by the mean of the designed interventions checklist, Reliability of the questionnairewas determined through a pilot study and the validity through a panel of (12) experts. Descriptive statisticalanalysis procedures (frequency, percentage, mean of score, Standard Deviation and Relative Sufficiency), andinferential statistical analysis procedures (Reliability Coefficient, contingency coefficient and chi- square test)were used for the data analysis under application of the statistical package of social science (SPSS) ver. (10.0).Results: The findings of the study indicated that there is a weak assessment of postoperative nurses'interventions for the patients with laparoscopic cholecystectomy at Baghdad teaching hospitals, and thefindings indicated that the most of study items responding of questionnaire were (84.78%) significantdifferences. There was no significant relationship between nurses' gender, age, years of experience and theirassessment, while there was significant relationship between the level of education, sharing in training sessionswhich established (by the hospital, by other hospitals, or by other institutions), duration of the training session,Number of training sessions and assessment of postoperative nurses' interventions Recommendations: The study recommended that special training session, concerning all nurses' surgical wardsfor postoperative nursing interventions (Laparoscopic Cholecystectomy Patient) at inside or outside Iraq, andbooklets should be designated and presented to all nurses' surgical wards, in addition to increasing the numberof professional nurses' graduate from the colleges of nursing to the enrolled in surgical wards.

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ÖZÇELİK, Zerrin, İlknur BANLI CESUR, and Didem GÜLCÜ TAŞKIN. "Complications of percutaneous endoscopic gastrostomy in children: a single-center experience." Cukurova Medical Journal 48, no. 2 (June 30, 2023): 317–22. http://dx.doi.org/10.17826/cumj.1234116.

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Purpose: Percutaneous endoscopic gastrostomy is the most preferred method for feeding in children with intact gastrointestinal system functions when oral nutrition is insufficient due to neurological, neuromuscular, or oncological diseases. This study aimed to evaluate the indications for percutaneous endoscopic gastrostomy and associated complications in the patients we followed up. Materials and Methods: In this descriptive study, the records of 130 patients who underwent percutaneous endoscopic gastrostomy for nutritional support between January 1st 2013- December 30th 2020 were retrospectively reviewed. Demographic data, indications, complications, and follow-up periods of the patients were examined. Results: Of the patients, 75 were male and 55 were female. The mean age of the patients was 48 months (min 1 month-max 211 months). The evaluation of the patients with percutaneous endoscopic gastrostomy in terms of diagnosis revealed that 95 patients required nutritional support due to neuromotor retardation associated with neurological disease, 19 patients due to central nervous system tumor, and 13 patients due to metabolic disease. Considering complications, the most frequent minor complication was leakage in 11of the 33 patients, while the most frequent major complication was colonic fistulation in 6 of the 9 patients. Two patients required open surgery in the early period due to intra abdominal leak. Conclusion: Although enteral nutrition with a percutaneous endoscopic gastrostomy tube seems to be an appropriate and reliable method to meet the nutritional needs of pediatric patients who have normal digestive system functions but cannot be fed orally due to swallowing disorders, it is necessary to pay attention to its complications like any surgical procedure.

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Nath, Sutia Indra, Baruah Anuradha, Deb Baruah Pritanu, and Borah Ankita. "Exploring the Intricacies of Pancreatic Duct Tributaries: Variations in Length, Angle of Entry, and Alternating Patterns in Human Cadavers by Dissection." International Journal of Anatomy and Research 12, no. 1 (March 5, 2024): 8849–54. http://dx.doi.org/10.16965/ijar.2023.267.

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Background: The pancreatic duct system plays a pivotal role in human physiology, facilitating the transport of digestive enzymes and secretions essential for gastrointestinal function. While anatomists have extensively investigated the pancreas's ductal network, the intricacies of pancreatic duct tributaries, including variations in length, angle of entry, and alternating patterns, have continued to captivate scientific inquiry. Aim: To find out the variations in length, angle of entry, and alternating patterns of pancreatic duct tributaries, and discuss the potential clinical implications of our discoveries. Materials and Methods: This study, conducted on 50 human cadavers (comprising 35 perinates and 15 adults), aimed to comprehensively explore the complexities of pancreatic duct tributaries through meticulous dissection. Results: Our research unveiled the following key findings: Variations in Length and Angle of Entry: We observed a remarkable diversity in the number and length of tributaries that join the main pancreatic duct. Additionally, the entry angle exhibited substantial variation, with right-angled tributaries prevalent in 70% of specimens and acute angles in 30%. Understanding these anatomical nuances is crucial for surgical procedures to mitigate inadvertent ductal injury. Alternating and Herringbone Patterns: In 98% of specimens, tributaries alternated between superior and inferior positions along the main pancreatic duct. This alternating pattern may influence the flow of pancreatic secretions and the pathogenesis of pancreatic diseases. In contrast, the rare Herringbone pattern was observed in only 2% of cases, highlighting the unique nature of this anatomical variant. Conclusion: This study contributes valuable insights into the intricate world of pancreatic duct tributaries. By elucidating their anatomy and characteristics, we enhance the safety and efficacy of clinical interventions and expand our understanding of pancreatic physiology and pathology. Further research may delve into the functional implications of these anatomical variations, paving the way for advancements in pancreatic healthcare. KEYWORDS: Pancreatic Duct Tributaries, Anatomical Variations, Pancreatic Surgery, Pancreatic Physiology, Dissection, Herring Bone Pattern, Gastrointestinal Function.

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Guys, J. M., G. Hery, M. Haddad, and C. Borrionne. "Neurogenic Bladder in Children: Basic Principles, New Therapeutic Trends." Scandinavian Journal of Surgery 100, no. 4 (December 2011): 256–63. http://dx.doi.org/10.1177/145749691110000405.

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Diagnosis of neurogenic bladder is straightforward in children with myelomeningocele. However, recognition is more difficult in patients with occult dysraphism or central nervous system disorders since clinico-anatomical correlations are poor. Careful clinical examination and urodynamic exploration are mandatory for diagnosis and follow-up. Even if urinary leak is the first symptom, the main goal of the pediatric surgeon must be to preserve the upper urinary tract. The ideal protection strategy consists of ensuring that micturition is voluntary and complete and that the bladder capacity is sufficient with adequate compliance and sphincter outlet resistances. Balancing these functions requires a combination of medical and surgical treatment. A variety of techniques can be used depending on gender and age of the patient and social environment. In most cases, intermittent bladder catheterization is necessary to obtain complete evacuation of the bladder. Bladder capacity can be increased by anticholinergic drugs, injection of botulinum toxin into the bladder, and augmentation cystoplasty. Augmentation of bladder outlet resistances requires endoscopic injection of bulking agents, surgical bladder neck reconstruction and urethral lengthening, bladder neck suspension, and artificial urinary sphincter. In difficult cases, continent cystostomy with closure of the bladder neck can achieve definitive continence. At the beginning endoscopic treatment combining anti reflux procedure, injection of the bladder neck and botulinum toxin can be considered as a “total endoscopic management” and should be our first line. Other techniques are under evaluation. Sacral neuromodulation has given promising results. Artificial tissue engineering will probably be used in the next future. Management of neurogenic bladder is not limited to urological considerations. Orthopedic, digestive, and sexual problems must also be taken into account in order to obtain an “acceptable quality of life”.

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Balbale, Salva, Lynn Huang, and Mehul Raval. "DEVELOPING A SCORING SYSTEM TO PREDICT CHRONIC OPIOID USE AMONG ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE." Inflammatory Bowel Diseases 30, Supplement_1 (January 25, 2024): S45. http://dx.doi.org/10.1093/ibd/izae020.095.

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Abstract BACKGROUND Chronic, or long-term, opioid use is associated with higher risk of addiction and death as well as poor inflammatory bowel disease (IBD) outcomes. Recent data estimate that up to 20% of adolescents and young adults (AYA) with IBD may be chronic opioid users. Models to predict chronic opioid use among AYA with IBD may support identification, clinical management, and follow-up of patients at high risk of opioid dependence. We aimed to develop a clinical predictive model based on administrative data for chronic opioid use among AYA with IBD. METHODS We performed a retrospective analysis of AYA patients between 15-29 years treated at a tertiary academic center for IBD management from 3/2018-12/2021. Univariate regression was performed to identify individual predictors of chronic opioid use. Multivariate regression was performed using variables with p-values <0.15 in univariate regression. Variables significant after adjustment were included in a simple scoring system. Point estimates for chronic opioid use risk probabilities were derived using the percentage of chronic opioid users in our analytic cohort assigned that prognostic score. 95% confidence intervals were estimated using a bootstrapping technique with 1000 replications. RESULTS Our final cohort included 575 unique AYA patients with IBD. Patients were, on average, 23 years old (IQR 20-26) and 69% of the cohort was female. 41% had a diagnosis of Crohn’s disease, 25% with ulcerative colitis and 64% with indeterminate colitis. Patients’ mean age at index IBD diagnosis was approximately 22 years and over half (56%) had undergone prior IBD surgery. Following adjustment, eleven factors were associated with the highest odds of chronic opioid use, including: public insurance coverage, non-digestive or non-gastrointestinal (GI) surgery, outpatient prescription receipt for weaker opioids (i.e. codeine/tramadol), and concurrent depression and post-traumatic stress disorder (PTSD) diagnoses (Figure 1). Prognostic scores ranged from 1-9 (mean: 5, SD=2.7). Patients were stratified into three risk categories by prognostic score (1-4; 5-7; 8-9) with associated risk scores of 52.1% (95% CI: 48.9-55.2%), 68.6% (66.5-71.1%), 86.2% (76.6%-94.4%), respectively (Figure 2). CONCLUSIONS We developed a practical scoring system to stratify AYA with IBD by chronic opioid use risk. Future directions include understanding the relationship between these risk factors and their influence on chronic use. Risk factors most associated with chronic opioid use among AYA with IBD included: public insurance coverage, undergoing a non-digestive surgical procedure, and having concurrent diagnoses of depression and PTSD. Findings will directly inform targeted opioid reduction initiatives for this vulnerable population. Figure 1 Final risk factors associated with development of prognostic score. Figure 2 Percent of chronic opioid users by prognostic score.

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Dronova, V. L., O. I. Dronov, O. M. Mokrik, P. P. Bakunets, and Yu P. Bakunets. "Clinical case of sharp bowel obstruction during pregnancy for a patient with an extracorporal impregnation and large intergenic interval." UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS, no. 3(87) (September 29, 2021): 77–82. http://dx.doi.org/10.15574/pp.2021.87.77.

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The great importance in the development of acute intestinal obstruction (AIO) is the change in intestinal kinetics during pregnancy. In pregnant women, the rhythmic function of the intestine slows down due to an increase in the threshold of excitability of its receptors to biologically active substances. The article provides an overview of modern literary sources on the problem of acute intestinal obstruction in pregnant women. According to foreign literature sources, the incidence of intestinal obstruction in pregnant women is 1:3600–1:66000, and complications of diseases of the digestive system rank 4th among the causes of maternal mortality during pregnancy — 9%. According to domestic scientific sources, the frequency with which intestinal obstruction occurs in pregnant women is 1:40000–1:50000 births, mortality reaches 35–50%, stillbirth — 60–75%. The development of the disease is caused by physiological changes in the body of a pregnant woman. With increasing gestational age there are changes in the anatomical arrangement of the abdominal organs. From the second trimester of pregnancy, the uterus extends beyond the pelvis and gradually occupies the entire abdominal cavity. The increase in the size of the uterus due to hypertrophy and hyperplasia of muscle fibers, amniotic fluid, fetal growth, leads to increased intraabdominal pressure, displacement of the small intestine and lumbar colon up, thereby creating conditions for compression of intestinal loops, nodules, development. The modern classification, clinic, diagnostics and methods of treatment of this surgical pathology are presented. The author presents his own clinical case of acute intestinal obstruction in a 51-year-old pregnant woman with the sixth desired pregnancy, which occurred as a result of assisted reproductive technologies and a large intergenetic interval. Both surgeon and obstetrician-gynecologist treat intestinal obstruction in pregnant women. Conservative treatment is carried out simultaneously with diagnostic procedures. No effect of conservative therapy for 2 hours is an indication for surgery. The main purpose of surgery is to eliminate the causes of intestinal obstruction and restore bowel function. The scope of surgery is determined in each case individually and depends on the type of AIO and the age of the disease. The chosen tactics of the preoperative period, the volume of surgery, anesthesia and adequate management of the postoperative period can cure acute surgical pathology, maintain the desired pregnancy, avoid the development of obstetric and surgical purulent-septic complications. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: sharp bowel obstruction, pregnancy, extracorporal impregnation, large intergenic interval.

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SANTO, Marco Aurelio, Carlos Eduardo DOMENE, Ary NASI, Pedro ONARI, Paula VOLPE, and Henrique Walter PINOTTI. "Videolaparoscopic cholecystectomy. Analysis of the clinical and functional aspects of mechanical lifting of the abdominal wall." Arquivos de Gastroenterologia 38, no. 1 (January 2001): 32–39. http://dx.doi.org/10.1590/s0004-28032001000100007.

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Background - Mechanical lifting of the abdominal wall, a method based on traction and consequent elevation of the abdominal wall, is an alternative procedure to create enough intra-abdominal space necessary for videolaparoscopic surgery, dispensing the need for intraperitoneal gas insufflation. Objective - This study aims to evaluate the technical feasibilility of this procedure to carry out a videolaparoscopic cholecystectomy, while analyzing the clinical and functional aspects of this technique. Patients and Methods - In the Digestive Tract Surgery Discipline of the Medical School at the University of São Paulo, São Paulo, SP, Brazil, was created the equipment to perform videolaparoscopic surgery using this method. The equipment has two sections: an external part which consisted of a frame attached to the operating table, inside which there is a sliding steel cable, moved by a ratched which is located at the lower end of one of the frame rods; the internal rod, the support, has an "L" shape, and its horizontal branch is made up of three turning rods and which is connected to the steel cable after insertion into the abdominal cavity. Ten patients underwent videolaparoscopic cholecystectomy using this equipment. The time taken to install the equipment, the operating area characteristics, the interference from the lifting equipment on surgical movements and on the intra-operative cholangiography, the measurements made of the force used during traction and extension of the abdominal wall elevation, and the medication required for post-operative analgesia were all evaluated. Results - There were no intra-operative complications, and in none of the cases was it found necessary to convert to open surgery. We considered the insertion a safe and uncomplicated procedure, and the traction system efficient. Apart from the elevation of the abdominal wall, the distribution of the viscera inside the abdominal cavity is fundamental for the operating area. Depending on the position of the epigastric trocar, the lifting equipment can interfere with the surgical instruments mobility. It may be necessary to reposition the support to perform the intra-operative cholangiography. The tensional force applied to the peritoneal surface by the lifting rods is small, and no additional post-operative pain was observed using this procedure. Conclusion - These results show that using the equipment described in this study, mechanical lifting of the abdominal wall is a feasible alternative for undertaking videolaparoscopic cholecystectomy.

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Kajihara, Toshiki, Koji Yahara, Aki Hirabayashi, Yumiko Hosaka, Norikazu Kitamura, Motoyuki Sugai, and Keigo Shibayama. "Association between the proportion of laparoscopic approaches for digestive surgeries and the incidence of consequent surgical site infections, 2009–2019: A retrospective observational study based on national surveillance data in Japan." PLOS ONE 18, no. 2 (February 17, 2023): e0281838. http://dx.doi.org/10.1371/journal.pone.0281838.

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Background Surgical site infections (SSIs) are among the most common healthcare-associated infections. Laparoscopy is increasingly being used in various surgical procedures. However, no study has examined the association between the proportion of laparoscopic procedures and the incidence of SSIs in digestive surgery using nationwide surveillance data. Methods We retrospectively investigated national SSI surveillance data from the Japan Nosocomial Infections Surveillance between 2009 and 2019. The annual trend of the SSI rate and the proportion of laparoscopic procedures were assessed, focusing on five major digestive surgeries. This was based on data from 109,544 (appendix surgery), 206,459 (gallbladder surgery), 60,225 (small bowel surgery), 363,677 (colon surgery), and 134,695 (rectal surgery) procedures. The effect of a 10% increase in the proportion of laparoscopic procedures on the reduction of the SSI rate was estimated using mixed-effect logistic regression. Findings The average SSI rate of the five digestive surgeries decreased from 11.8% in 2009 to 8.1% in 2019. The proportion of laparoscopic procedures in each of the five digestive surgeries increased continuously (p<0.001). The SSI rate for laparoscopic procedures was always lower than that for open procedures. The results were consistent between all and core hospitals participating in the surveillance. The odds ratios of the 10% increase in the proportion of laparoscopic procedures for five digestive surgeries were always <0.950 (p<0.001). Conclusion An increase in the proportion of laparoscopic procedures was associated with a reduction in the SSI rate in digestive surgeries.

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Peretz, David, Surachai Supattapone, Kurt Giles, Julie Vergara, Yevgeniy Freyman, Pierre Lessard, Jiri G. Safar, et al. "Inactivation of Prions by Acidic Sodium Dodecyl Sulfate." Journal of Virology 80, no. 1 (January 1, 2006): 322–31. http://dx.doi.org/10.1128/jvi.80.1.322-331.2006.

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ABSTRACT Prompted by the discovery that prions become protease-sensitive after exposure to branched polyamine dendrimers in acetic acid (AcOH) (S. Supattapone, H. Wille, L. Uyechi, J. Safar, P. Tremblay, F. C. Szoka, F. E. Cohen, S. B. Prusiner, and M. R. Scott, J. Virol. 75:3453-3461, 2001), we investigated the inactivation of prions by sodium dodecyl sulfate (SDS) in weak acid. As judged by sensitivity to proteolytic digestion, the disease-causing prion protein (PrPSc) was denatured at room temperature by SDS at pH values of ≤4.5 or ≥10. Exposure of Sc237 prions in Syrian hamster brain homogenates to 1% SDS and 0.5% AcOH at room temperature resulted in a reduction of prion titer by a factor of ca. 107; however, all of the bioassay hamsters eventually developed prion disease. When various concentrations of SDS and AcOH were tested, the duration and temperature of exposure acted synergistically to inactivate both hamster Sc237 prions and human sporadic Creutzfeldt-Jakob disease (sCJD) prions. The inactivation of prions in brain homogenates and those bound to stainless steel wires was evaluated by using bioassays in transgenic mice. sCJD prions were more than 100,000 times more resistant to inactivation than Sc237 prions, demonstrating that inactivation procedures validated on rodent prions cannot be extrapolated to inactivation of human prions. Some procedures that significantly reduced prion titers in brain homogenates had a limited effect on prions bound to the surface of stainless steel wires. Using acidic SDS combined with autoclaving for 15 min, human sCJD prions bound to stainless steel wires were eliminated. Our findings form the basis for a noncorrosive system that is suitable for inactivating prions on surgical instruments, as well as on other medical and dental equipment.

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Germain, A., and L. Bresler. "Robotic-assisted surgical procedures in visceral and digestive surgery." Journal of Visceral Surgery 148, no. 5 (October 2011): e40-e46. http://dx.doi.org/10.1016/j.jviscsurg.2011.04.001.

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Watanabe, Satoshi, Ichiro Honda, Kazuo Watanabe, Matsuo Nagata, Hiroshi Yamamoto, Hiroaki Soda, and Kentaro Tasaki. "Surgical Procedures for Digestive Fistulae Caused by Radiation Therapy." Surgery Today 32, no. 9 (September 1, 2002): 789–91. http://dx.doi.org/10.1007/s005950200151.

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Wu, Yushan, and Shuping Wu. "FROM SOCIAL MEDIA USE TO WILLINGNESS FOR BARIATRIC SURGERY IN CHINESE INDIVIDUALS: UNRAVELING THE PSYCHOLOGICAL MECHANISM." International Journal of Modern Trends in Social Sciences 6, no. 25 (December 17, 2023): 39–65. http://dx.doi.org/10.35631/ijmtss.625004.

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Social media has become increasingly significant in life with its convenience and communicative vividness, shaping users' perceptions and reinforcing social norms, including socially accepted beauty standards. In China, the development of domestic social platforms has fueled a desire for achieving thin or muscular ideal bodies. Bariatric surgery, a procedure on the digestive system with substantial post-surgical weight loss, enjoys great popularity for individuals concerned about weight and shape. Given that prior studies have primarily explored the relationship between social media use and willingness for bariatric surgery in Western settings, a notable gap exists regarding this association in the Chinese context. Drawing upon social learning theory and social comparison theory, the current study aims to pioneer an investigation into social media’s impact on Chinese individuals' willingness for bariatric surgery and its underlying mechanisms. Unlike previous studies that evaluated social media use by duration, the researcher innovatively assesses social media use from multiple dimensions: intensity, appearance-related preoccupation, and photo-based activities. Using a quantitative approach, a cross-sectional survey involving 385 Chinese participants who use Chinese social platforms and have body weight or shape concerns was conducted. Results reveal a positive relationship between social media use intensity and photo-based activities with willingness for bariatric surgery, while the effect of appearance-related preoccupation is insignificant. Psychological mechanisms include upward social comparison, body dissatisfaction, body ideal internalization, and low self-esteem. While this study primarily focuses on direct relationships, it leaves room for future exploration of mediation and moderation. These findings address the literature gap on how Chinese individuals perceive and contemplate bariatric surgery under social media influence. The study suggests preventive interventions through promoting rational social media use to alleviate body image concerns and disseminating accurate information about bariatric surgery.

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Haxhirexha, Kastriot, Aferdita Ademi, Agron Dogjani, Roland Alili, Ferizat Dika – Haxhirexha, Blerim Fejzuli, and Teuta Emini – Rushiti. "Management of Perforated Sigmoid Diverticulitis with Associated Retroperitoneal Abscess and Generalized Peritonitis." Albanian Journal of Trauma and Emergency Surgery 8, no. 1 (January 20, 2024): 1397–401. http://dx.doi.org/10.32391/ajtes.v8i1.379.

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Introduction: Diverticulitis represents a relatively common pathology within the gastrointestinal tract. While diverticula can occur throughout the digestive system, their prevalence is notably higher in the left colon, particularly in the sigmoid region. This condition predominantly affects middle-aged and elderly males. The most effective diagnostic methods for this disease are colonoscopy and computed tomography (CT) with contrast. Although severe complications of diverticulitis are infrequent, the optimal classification of these complications has been described by Hinchey. The article aims to show the case of a young patient with complicated diverticulitis with perforation and generalized peritonitis, classified as stage III-IV, according to Hinchey. Case report: A 43-year-old female patient was urgently admitted to the General Surgery Clinic at Tetovo Clinical Hospital, presenting with severe generalized abdominal pain and signs of peritoneal irritation. Comprehensive diagnostic imaging revealed a large retroperitoneal abscess located above the psoas muscle, accompanied by a significant accumulation of free fluid, suspected to be pus, in the abdominal cavity. Following initial resuscitation, surgical intervention was undertaken. Intraoperative findings included advanced inflammatory changes in the sigmoid colon, characterized by thickened fibrotic walls and a partially constricted lumen. A large abscess was also identified in the retroperitoneal space between the spleen and left kidney. Given these findings, resectioning the distal descending colon and most of the sigmoid colon was considered necessary. The retroperitoneal abscess was incised, its contents aspirated, and a thorough cavity debridement was performed. Subsequently, the Hartmann procedure was executed. Postoperatively, due to the patient's deteriorating condition, she was transferred to the intensive care unit for continued treatment. The patient was discharged from the hospital in stable condition on the tenth day following the surgery. Conclusion: While complications from sigmoid diverticula are uncommon, they can occasionally be extremely severe and pose a significant risk to patient survival.

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Nacir, Oussama, Adil Ait Errami, Sofia Oubaha, Zouhour Samlani, Khadija Krati, and Abbas Riyad. "Severe Acute Colitis: A Countdown Diagnostic Challenge." International Journal of Innovative Research in Medical Science 7, no. 11 (November 17, 2022): 611–16. http://dx.doi.org/10.23958/ijirms/vol07-i11/1530.

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Introduction: Severe acute colitis (SAC) complicates 10-15% of ulcerative colitis and more rarely Crohn's disease or infectious colitis [1]. It is a medical and surgical emergency requiring rapid diagnosis and early management. It can lead to major digestive mutilation, which can cause sequelae that often alter the quality of life of patients for decades [2]. In this study, spread over 10 years, we propose a descriptive analysis of the epidemiological, clinico-paraclinical and evolutionary aspects of a series of cases of SAC admitted to the Mohammed VI University Hospital of Marrakech. We will then review the diagnostic procedures that preceded, but did not prevent, recourse to surgery, discussing them in the light of the current literature. Materials and Methods: This is a retrospective observational study with a descriptive and analytical aim, spread over 10 years, from January 2011 to December 2020, including all patients admitted to the Mohammed VI University Hospital of Marrakech and operated on for acute severe colitis and whose diagnosis was retained on the basis of a set of arguments. An exploitation form was chosen as a means of investigation. Data collection was based on hospitalization registers, patients' medical records, the "Hosix" computerized system, and the collaboration of the medical and paramedical staff of the department and the operating room. Statistical analysis was performed using SPSS version 19.0 software. Results: Out of a total of 550 inflammatory bowel disease (IBD) cases admitted to the Mohammed VI University Hospital of Marrakech, 100 patients (18.2%) presented with severe acute colitis during the period of our study. The operated SACs meeting the inclusion criteria of our study represented 20% (20 cases) of the total number of targeted SACs. The mean age of the patients was 34 years. The age group between 20 and 40 years represented 65% of the cases with a sex ratio of 0.81. The SAC was inaugural in 7 patients (35%) and had complicated a known inflammatory bowel disease in 13 patients (65%). The clinical picture consisted of bloody glutinous emissions and abdominal pain in 100% of cases. Abdominal examination on admission revealed abdominal sensitivity in 85% of cases, and tenderness in 15% of cases. The Blood count was normal in 25% of cases with an average hemoglobin of 12 g/dl. the c-reactive protein was elevated in 85% of patients (17 cases) with an average of 120 mg/l. Hypoalbuminemia was noted in 17 patients (85%). The unprepared abdominal X-ray (UAP), performed in 80% of the patients, was normal in 60% of the cases, with pneumoperitoneum in 10% and colectasis in 10%. Abdominal ultrasound was performed in 95% of the patients and revealed digestive thickening in 75% of the cases and a medium-sized peritoneal effusion in 30% of the cases. Abdominal CT scan was performed in 75% (15 patients), confirmed digestive thickening in 73% of cases, a medium-sized effusion in 33% of cases, pericolic fat infiltration in 33% of cases, right iliac fossa abscess (6%) and colectasis in two cases (12%). Left colonoscopy was performed in 18 patients (96%). Endoscopic signs of severity were found in 77% of patients. The diagnosis of severe acute colitis was made on the basis of the criteria of Truelove and Witts. In terms of therapeutic management, rest of the digestive tract with parenteral nutrition was indicated in 7 patients (35%). Antibiotic treatment was initiated in 65% of cases. The first-line medical treatment of SAC consisted of intravenous corticosteroid therapy in 16 patients (85%). Local treatment with mesalazine or salazopyrin was used in 65% of cases (13 patients). Failure of first-line medical treatment in 9 patients (45%) led to emergency colectomy, and 6 non-operated patients were put on cyclosporine. Six patients underwent colectomy for failure of second-line treatment. In contrast, two patients were treated with third-line infliximab with poor clinical tolerance which also led to colectomy. At 2 years after colectomy, 3 of our patients (15%) had recurrence on the remaining rectal stump. The functional outcome was marked by an average of 2 to 3 daytime bowel movements, and 0 to 1 nighttime bowel movement in most patients, only one case of rectal imperiousness (5%) and no case of sexual disorders or infertility. Conclusion: Acute severe colitis is a alarming complication of chronic inflammatory bowel disease. Its management must be rapid, reasoned and coordinated from the outset, based on multidisciplinary collaboration. Our study focuses on the initial diagnostic and therapeutic difficulties of GAC, which always constitute a challenge in reverse count.

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CAMBI, Maria Paula Carlini, Simone Dallegrave MARCHESINI, and Giorgio Alfredo Pedroso BARETTA. "Post-bariatric surgery weight regain: evaluation of nutritional profile of candidate patients for endoscopic argon plasma coagulation." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 28, no. 1 (2015): 40–43. http://dx.doi.org/10.1590/s0102-67202015000100011.

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BACKGROUND: Bariatric surgery is effective treatment for weight loss, but demand continuous nutritional care and physical activity. They regain weight happens with inadequate diets, physical inactivity and high alcohol consumption. AIM: To investigate in patients undergoing Roux-Y-of gastroplasty weight regain, nutritional deficiencies, candidates for the treatment with endoscopic argon plasma, the diameter of the gastrojejunostomy and the size of the gastric pouch at the time of treatment with plasma. METHODS: A prospective 59 patients non-randomized study with no control group undergoing gastroplasty with recurrence of weight and candidates for the endoscopic procedure of argon plasma was realized. The surgical evaluation consisted of investigation of complications in the digestive system and verification of the increased diameter of the gastrojejunostomy. Nutritional evaluation was based on body mass index at the time of operation, in the minimum BMI achieved after and in which BMI was when making the procedure with plasma. The laboratory tests included hemoglobin, erythrocyte volume, ferritin, vitamin D, B12, iron, calcium, zinc and serum albumin. Clinical analysis was based on scheduled follow-up. RESULTS: Of the 59 selected, five were men and 51 women; were included 49 people (four men and 44 women) with all the complete data. The exclusion was due to the lack of some of the laboratory tests. Of this total 19 patients (38.7%) had a restrictive ring, while 30 (61.2%) did not. Iron deficiency anemia was common; 30 patients (61.2%) were below 30 with ferritin (unit); 35 (71.4%) with vitamin B12 were below 300 pg/ml; vitamin D3 deficiency occurred in more than 90%; there were no cases of deficiency of protein, calcium and zinc; glucose levels were above 99 mg/dl in three patients (6.12%). Clinically all had complaints of labile memory, irritability and poor concentration. All reported that they stopped treatment with the multidisciplinary team in the first year after the operation. CONCLUSION: The profile of patients submitted to argon plasma procedure was: anastomosis in average with 27 mm; multiple nutritional deficiencies with predominance of iron deficiency anemia; ferritin below 30; vitamin B12 levels below 300 pg/ml; labile memory complaints, irritability and poor concentration.

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Bacalbasa, Nicolae, Olivia Ionescu, Paris Ionescu, and Irina Balescu. "Digestive resections in advanced-stage ovarian cancer." Advances in Modern Oncology Research 2, no. 3 (June 16, 2016): 132. http://dx.doi.org/10.18282/amor.v2.i3.87.

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The standard frontline treatment for advanced-stage ovarian cancer (ASOC) consists of maximal cytoreduction surgery associated with platinum/paclitaxel-based chemotherapy. Several studies have proven that patients with no gross residual disease (RD) have better survival rates than those with optimal but visible RD (RD ≤1 cm). In order to achieve this, more radical cytoreductive procedures such as radical pelvic resection and extensive upper abdominal procedures are performed. However, some investigators have suggested that, although effective, radical surgery cannot fully compensate tumor biology, which is a major determinant in survival and in turn influences the likelihood of surgical cytoreduction. The aim of this review was to present the procedures defining ultra-radical (extensive) surgery and to evaluate its feasibility and morbidity in the management of ASOC.

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Mohiuddin, AK. "Alternative Treatments for Minor GI Ailments." INNOVATIONS in pharmacy 10, no. 3 (July 5, 2019): 2. http://dx.doi.org/10.24926/iip.v10i3.1659.

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About 80% of the population worldwide use a variety of traditional medicine, including herbal medicines, for the diagnosis, prevention and treatment of illnesses, and for the improvement of general well-being. Total consumer spending on herbal dietary supplements in the United States reached an estimated $8.085 billion in 2017. In addition, the 8.5% increase in total sales from 2016 is the strongest growth for these products in more than 15 years. The main reason to use herbal products in these countries is the assumption of a better tolerability compared to synthetic drugs. Whereas in developing countries herbal medicines are mostly the only available and affordable treatment option. Surveys from industrialized countries reveal as main health areas in which herbal products are used for upper airway diseases including cough and common cold; other leading causes are gastrointestinal, nervous and urinary complaints up to painful conditions such as rheumatic diseases, joint pain and stiffness. Gastrointestinal disorders are the most widespread problems in health care. Many factors may upset the GI tract and its motility (or ability to keep moving), including: eating a diet low in fiber; lack of motion or sedentary lifestyle; frequent traveling or changes in daily routine; having excessive dairy products; anxiety and depression; resisting the urge to have a bowel movement habitually or due to pain of hemorrhoids; misuse of laxatives (stool softeners) that, over time, weaken the bowel muscles; calcium or aluminum antacids, antidepressants, iron pills, narcotics; pregnancy. About 30% to 40% of adults claim to have frequent indigestion, and over 50 million visits are made annually to ambulatory care facilities for symptoms related to the digestive system. Over ten million endoscopies and surgical procedures involving the GI tract are performed each year. Community-based studies from around the world demonstrate that 10% to 46% of all children meet the criteria for RAP. Gastrointestinal disorders such as chronic or acute diarrhea, malabsorption, abdominal pain, and inflammatory bowel diseases can indicate immune deficiency, present in 5% to 50% of patients with primary immunodeficiencies. The gastrointestinal tract is the largest lymphoid organ in the body, so it is not surprising that intestinal diseases are common among immunodeficient patients. Gastroenterologists therefore must be able to diagnose and treat patients with primary immunodeficiency. Further, pathogens do influence the gut function. On the other hand, dietary habits and specific food types can play a significant role in the onset, treatment, and prevention of many GI disorders. Many of these can be prevented or minimized by maintaining a healthy lifestyle, and practicing good bowel habits. Article Type: Review

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Rudant, Jérémie, Axelle Dupont, Yann Mikaeloff, Francis Bolgert, Joël Coste, and Alain Weill. "Surgery and risk of Guillain-Barré syndrome." Neurology 91, no. 13 (August 24, 2018): e1220-e1227. http://dx.doi.org/10.1212/wnl.0000000000006246.

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ObjectiveTo assess the association between Guillain-Barré syndrome (GBS) and recent surgery based on French nationwide data.MethodsData were extracted from the French health administrative databases (SNIIRAM/PMSI). All patients hospitalized for GBS between 2009 and 2014 were identified by ICD-10 code G61.0 as main diagnosis. Patients previously hospitalized for GBS in 2006, 2007, and 2008 were excluded. Surgical procedures were identified from the hospital database. Hospitalizations for surgery with no infection diagnosis code entered during the hospital stay were also identified. The association between GBS and a recent surgical procedure was estimated using a case-crossover design. Case and referent windows were defined as 1–60 days and 366–425 days before GBS hospitalization, respectively. Analyses were adjusted for previous episodes of gastroenteritis and respiratory tract infection, identified by drug dispensing data.ResultsOf the 8,364 GBS cases included, 175 and 257 patients had undergone a surgical procedure in the referent and case windows, respectively (adjusted odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.25–1.88). A slightly weaker association was observed for surgical procedures with no identified infection during the hospitalization (OR = 1.40, 95% CI: 1.12–1.73). Regarding the type of surgery, only surgical procedures on bones and digestive organs were significantly associated with GBS (OR and 95% CI = 2.78 [1.68–4.60] and 2.36 [1.32–4.21], respectively).ConclusionIn this large nationwide epidemiologic study, GBS was moderately associated with any type of recent surgery and was more strongly associated with bone and digestive organ surgery.

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&NA;, &NA;. "“HEALTH FOCUS: UNDERSTANDING YOUR DIGESTIVE SYSTEM”." Journal of Wound, Ostomy and Continence Nursing 12, no. 2 (March 1985): 29A. http://dx.doi.org/10.1097/00152192-198503000-00012.

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Khlusova, M. Yu, I. A. Khlusov, S. A. Antipov, and G. Ts Dambayev. "Pathophysiological and clinical problems of cellular immunotherapy of digestive system cancer. Critical review." Bulletin of Siberian Medicine 8, no. 3 (June 28, 2009): 105–12. http://dx.doi.org/10.20538/1682-0363-2009-3-105-112.

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The review is devoted to the methods of bioimmunotherapy of oncological pathology used in the clinic for the recent 20—25 years and, to the higher extent, the principles of cellular immunotherapy of cancerous epithelial tumors of the digestive system. The surgical method is recognized as a «gold standard» in the therapy of the digestive system cancer. Bioimmunotherapy of the digestive system cancer has not achieved the sufficient clinical efficiency. In this connection, new pathophysiological approaches to biotherapy of the digestive system cancer based, in particular, on original results of Russian scientists are analyzed.

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Zurawin, RK. "Innovative Robotic System for Transvaginal Surgical Procedures." Journal of Minimally Invasive Gynecology 26, no. 7 (November 2019): S18. http://dx.doi.org/10.1016/j.jmig.2019.09.502.

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Palibrk, I., V. Rankovic, V. Masirevic, Lj Marcetic, M. Matic, M. Milenkovic, and V. Pantic-Palibrk. "Anaesthesia in colorectal carcinoma surgery at the clinic for digestive surgery from 1997 to 2007." Acta chirurgica Iugoslavica 56, no. 2 (2009): 33–39. http://dx.doi.org/10.2298/aci0902033p.

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BACKGROUND: Colorectal cancers are one of the most present neoplasms in human population. This pathology is one of the most frequent ones at the Clinic for Digestive Surgery in Belgrade. AIM: To investigate if there were any changes in both number and structure of patients with colorectal cancers (age, gender, co-morbidity) as well as in both type and duration of surgical procedures and in providing and maintaining anaesthesia in patients with this disease. METHODS: This is a retrospective study. Research materials were anaesthesiological cards written for patients undergoing surgery in order to treat colorectal cancers at the Clinic for Digestive surgery in both 1997 and 2007. Demographics, co-morbidity, ASA score were the parameters we followed in our survey as well as the type of the resection and duration of these surgical interventions. Besides that providing and maintaining anaesthesia and balance of circulatory volume were considered too. RESULTS: The number of the colorectal surgical interventions has been increased up to 489 (13.1% of all) in 2007 comparing to the number of 379 (13.55% of all) in 1997. The percentage has remained the same because the number of all surgical procedures has been increased. The percentage of the rectal resections is increased highly significant in 2007 (50.1% in 1997; 62.6% in 2007). During the same year the duration of the operations was shortened (mean value 176.31 minutes in 1997, 157.5 minutes in 2007). In 2007 highly statistically significant is bigger amount of colloid and crystalloid infusions that were given for supplementation of circulatory volume (mean value 3294.89 ml in 2007; 2552.22 ml in 1997) . On the other hand lower amount of blood was given in 2007 than in 1997 (mean value 102.76 opposite to 488.07) what is statistically significant. The number of the patients with co-morbidities is not statistically importantly changed in these two followed years. Anaesthesiology technique has been changed and is monitored by higher use of inhalation anesthetics. They were used more in 2007 (29.65 %) for these types of surgical procedures than in 1997 when they had been used almost never. CONCLUSION: In these two followed years there have been significant changes in surgical interventions (type and duration of the operation). Surgical teams are higher specialized for the procedures they use modern technology such as stapplers have better equipment for diagnosing the illness. The use of modern inhalation anaesthetics has been increased along with reduced amount of blood and derivates used for supplementation of circulatory volume.

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Journal articles on the topic 'Digestive system surgical procedures'

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