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    Tytuł:
    Recommendations for the standards of equipping of the Bariatric and Metabolic Surgery Center
    Autorzy:
    Sztuczka, Ewa
    Żukowska, Wioletta
    Jackowski, Marek
    Janik, Michał R
    Paśnik, Krzysztof
    Michalik, Maciej
    Powiązania:
    https://bibliotekanauki.pl/articles/1392894.pdf
    Data publikacji:
    2018
    Wydawca:
    Index Copernicus International
    Tematy:
    Obesity surgery
    laparoscopy
    recommendations
    Opis:
    Introduction: The prevalence of obesity in Poland and worldwide is constantly rising. High effectiveness of bariatric surgery has been proven in literature. It is recommended that bariatric procedures should be done by highly qualified surgeons with the appropriate, up-to-date medical equipment. Aim: The purpose of the study is to establish Polish recommendations and standards for the use of medical equipment for bariatric surgery centers. Materials and methods: The review of the present recommendations of the worldwide organizations and societies (including EAES, IFSO, SAGES) and guidelines was made. On the basis of current literature and authors’s clinical experience we proposed standardized protocol for bariatric surgical equipment. Conclusions: Relevant equipping of bariatric surgery centers and implementation of standardized perioperative and surgery protocols will result in significant improvements in bariatric treatment. This will ensure patients safety, a shorter length of hospital stay and considerably reduce the risk of morbidity. Moreover, it will contribute to the efficacy of the bariatric and metabolic surgery procedures, in accordance with the highest globally accepted standards.
    Źródło:
    Polish Journal of Surgery; 2018, 90, 5; 52-56
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Bariatric tourists. Foreign bariatric patients treated in Poland – a survey based study
    Autorzy:
    Kowalewski, Piotr
    Janik, Michał
    Kwiatkowski, Andrzej
    Paśnik, Krzysztof
    Walędziak, Maciej
    Powiązania:
    https://bibliotekanauki.pl/articles/1391735.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    bariatric surgery
    foreign
    obesity
    surgery
    tourism
    Opis:
    Introduction: Bariatric procedures are becoming more popular worldwide. We present a current situation of foreign patients treated by high-volume bariatric surgeons in Poland in 2016. Material and Methods: We sent an online survey to twenty high-volume bariatric surgeons. The questionnaire regarded the year 2016. We asked for number and types of bariatric procedures performed or supervised, number of foreign bariatric patients, their qualification process, country of origin, types of procedure, and post-op recommendations. Results: We received 9 surveys (45%). Five surgeons performed or supervised from 100 to 300 bariatric procedures, 2 performed or supervised over 300 procedures, 2 performed or supervised from 50 to 100 procedures. All of the respondents performed laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB), four carried out mini gastric bypass, two – gastric banding (LAGB), one – SADI-S and duodenal switch (DS). Six surgeons operated on the total of 64 foreign patients, mainly performing LSG, LRYGB and mini gastric bypass. Most of the patients were qualified based on international criteria [body mass index (BMI) over 40 kg/m2 or BMI over 35 kg/m2 with comorbidities]. United Kingdom was the most popular country of origin, followed by Germany, USA, Ireland and Sweden. Qualification for surgery was based on a personal visit. After surgery, 83.3% (n = 5) of the respondents gave out discharge documents in English, recommending long-term bariatric follow-up in the country of origin. Every respondent carried out 3-month personal follow-up of every foreign patient. Conclusions: Foreign bariatric patients travelling to Poland are qualified for surgery according to known international standards. Most of the patients receive post-op discharge documents in English, with a 3-month follow-up performed by their surgeon. Further bariatric supervision in the country of origin is routinely recommended.
    Źródło:
    Polish Journal of Surgery; 2020, 92, 4; 12-16
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    XXL-type personality. Personality traits promoting excess body weight
    Autorzy:
    Sekula, Marzena
    Jarczewska –Gerc, Ewa
    Boniecka, Iwona
    Jędrzejewski, Emil
    Paśnik, Krzysztof
    Powiązania:
    https://bibliotekanauki.pl/articles/1392075.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    bariatric surgery
    morbid obesity
    personality traits
    Opis:
    The aim of the study: The study aimed to determine whether persons suffering from obesity may be characterised by specific personality traits which promote the development of excess body weight. Additionally, the aim involved finding whether persons suffering from morbid obesity differed from healthy individuals and somatic patients as regards selected personality traits. Material and methods: The study enrolled 34 patients with the diagnosis of morbid obesity in the process of qualification for surgical treatment of obesity. The patients’ BMI ranged from 35 to 54 kg/m2. Study participants completed NEO-FFI personality inventory (Costa, McCare; 1998) and the authors’ questionnaire designed to collect demographic data and anthropometric measurements. R esults: The study showed that patients with morbid obesity significantly differed from healthy individuals and somatic patients as regards the analysed measurements of the Big Five. C onclusions: The traits which were significantly distinctive in morbidly obese patients included lowered conscientiousness and increased neuroticism. The results indicate that the above pattern of personality traits may promote the development of excessive body weight.
    Źródło:
    Polish Journal of Surgery; 2019, 91, 5; 1-4
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Withdrawal from bariatric treatment - an analysis under various demographic conditions
    Autorzy:
    Szeliga, Jacek
    Kupczyk, Wojciech
    Kupczyk, Kinga
    Chojnowski, Jacek
    Jackowski, Marek
    Ponikowska, Irena
    Powiązania:
    https://bibliotekanauki.pl/articles/991166.pdf
    Data publikacji:
    2016
    Wydawca:
    Instytut Medycyny Wsi
    Tematy:
    morbid obesity
    general practitioner
    bariatric surgery
    Opis:
    Poland is high on a list of countries affected by epidemics of obesity, a problem that has especially suddenly increased in the post-transformation period. Materials and method. Documentation of 115 subsequent patients diagnosed with grade 3 obesity, considered eligible for surgical treatment, was analysed since 2015. A subgroup of 68 patients was selected from this group and the included patients who decided to cancel their treatment at various stages. Their history since presentation at the obesity treatment centre, BMI with its history, age, education and place of residence were analysed, followed by a telephone survey. 42 patients were finally contacted. Special attention was placed on the analysis of patients taking into account their place of residence. Patients were divided into inhabitants of rural and urban areas. Results. In the study group of 68 patients, 19 (27.9%) were inhabitants of rural areas and 49 (72.1%) of urban areas. Women accounted for 67.6%, and men for 32.4%. The mean age of patients when they presented for treatment was 43 years. On average, men presented 5 years later compared to women. The mean BMI on qualification for treatment of obesity was 47.6 kg/m2. The mean BMI max – 49.6 kg/m2. There were no differences regarding education in both populations. Despite the lack of differences regarding changes in the BMI since withdrawal from treatment, as many as 63% of patients from rural areas reached the BMI max in this time. Conclusions. There were demographic differences between the degree of obesity observed among patients receiving bariatric treatment, and inhabitants of urban areas were favoured. Patients from rural areas who withdrew from bariatric treatment and were left without medical care significantly more often achieved their maximum body weight, when compared to those living in urban areas. The active participation of physicians, both specialists and general practitioners, in the life of obese patients is imperative.
    Źródło:
    Annals of Agricultural and Environmental Medicine; 2016, 23, 4
    1232-1966
    Pojawia się w:
    Annals of Agricultural and Environmental Medicine
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Validity and efficacy of diets used for preoperative weight reduction among patients qualified for bariatric surgery
    Autorzy:
    Jastrzębska, Weronika
    Boniecka, Iwona
    Szostak-Węgierek, Dorota
    Powiązania:
    https://bibliotekanauki.pl/articles/1391328.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    bariatric surgery
    obesity
    preoperative weight loss
    Opis:
    Introduction: Bariatric surgery is the most effective method of weight reduction among patients suffering from morbid obesity. Reduction of body weight before surgery is an important element. Aim: The aim of the study was to present the current knowledge on preoperative weight reduction and diet for this purpose. Material and methods: To achieve the aims of the paper, we used articles available in the PubMed/MEDLINE database published in 2005–2020, as well as the guidelines of societies such as Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons, American Association of Clinical Endocrinologists, The Obesity Society and American Society for Metabolic & Bariatric Surgery, International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter and European Association for the Study of Obesity. Results: Studies show that even a modest reduction in weight in the early preoperative period facilitates surgery and reduces the number of complications. The available data do not support the effect of preoperative weight loss on increased postoperative weight loss. The use of balanced, energy-restricted diet in the preoperative period prepares the patient for changes in the way of nutrition, which improves the nutritional status of patient. Low calorie (LCD) or very low calorie (VLCD) diet can be an effective method of weight loss before surgery, however, this approach does not allow to modify eating habits. The use of a very low calorie ketogenic diet (VLCKD) remains under discussion. Conclusion: There is a need for large randomized trials to assess short- and long-term benefits of preoperative weight loss and methods of weight loss among patients qualified for bariatric surgery, also the standardization of nutritional management in the preoperative period.
    Źródło:
    Polish Journal of Surgery; 2021, 93, 2; 52-57
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Obesity in work-up of kidney transplant candidates – review of clinical practice guidelines
    Autorzy:
    Dobrzycka, Małgorzata
    Spychalski, Piotr
    Łącka, Monika
    Proczko-Stepaniak, Monika
    Dębska-Ślizień, Alicja
    Kaska, Łukasz
    Kobiela, Jarosław
    Powiązania:
    https://bibliotekanauki.pl/articles/1196784.pdf
    Data publikacji:
    2020-11-16
    Wydawca:
    Gdański Uniwersytet Medyczny
    Tematy:
    obesity
    end-stage kidney disease
    bariatric surgery
    Opis:
    Background: Incidence of morbid obesity is rising worldwide. Current clinical practice guidelines for the pre-transplant evaluation of end-stage kidney disease (ESKD) patients lack clear recommendations on morbid obesity. Material and methods: The aim of this review was to summarize the current guidelines on the role and treatment of obesity in kidney transplant recipients. Eight current national and international clinical practice guidelines were identified in a comprehensive literature search. Results: All guidelines underline early detection of obesity and obesity-related comorbidities in ESKD patients. Only two guidelines explored the role of weight-loss surgery, however due to the lack of sufficient evidence no formal recommendation of surgical procedure was given. Conclusions: Diagnosis and treatment of obesity remains underappreciated in the current guidelines, most of which do not include pharmacological and surgical interventions. High-quality evidence is warranted to assess the role of weight-loss including surgery in ESKD patients and to update the recommendations in future guidelines.
    Źródło:
    European Journal of Translational and Clinical Medicine; 2020, 3, 2; 72-79
    2657-3148
    2657-3156
    Pojawia się w:
    European Journal of Translational and Clinical Medicine
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Serum Cystatin C in Relation to Fat Mass Loss After Bariatric Surgery
    Autorzy:
    Śledziński, Tomasz
    Proczko-Markuszewska, Monika
    Kaska, Łukasz
    Stefaniak, Tomasz
    Świerczyński, Julian
    Powiązania:
    https://bibliotekanauki.pl/articles/1396727.pdf
    Data publikacji:
    2012-04-01
    Wydawca:
    Index Copernicus International
    Tematy:
    bariatric surgery
    cystatin C
    fat mass
    obesity
    weight loss
    Opis:
    Serum cystatin C concentration, generally accepted as renal function marker, is associated with cardiovascular risk and metabolic syndrome. Recent studies indicate that cystatin C increases in human obesity and that adipose tissue contributes to enhanced serum cystatin C concentration in obese subjects.The aim of the study was to assess whether a reduction in body and fat mass after bariatric surgery has any impact on serum cystatin C concentrations.Material and methods. Serum from 27 obese patients were tested before and 6 months after bariatric surgery. Twenty healthy subjects with normal body weight served as controls. Serum cystatin C concentrations were assayed by ELISA.Results. Serum cystatin C concentrations were significantly higher in obese patients compared with non-obese subjects. Decrease of body and fat mass after bariatric surgery resulted in improvement of several parameters associated with cardiovascular risk and metabolic syndrome, like serum lipids, blood pressure and insulin sensitivity. Surprisingly the mean postoperative serum cystatin C concentration was not significantly different from that before surgery. Serum creatinine and GFR also remained unchanged.Conclusion. The results presented here suggest that serum cystatin C concentration is not tightly associated with body and fat mass loss in obese patients after bariatric surgery.
    Źródło:
    Polish Journal of Surgery; 2012, 84, 4; 202-207
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Impact of bariatric surgery on non-alcoholic fatty liver disease
    Autorzy:
    Major, Piotr
    Pędziwiatr, Michał
    Rubinkiewicz, Mateusz
    Stanek, Maciej
    Głuszewska, Anna
    Pisarska, Magdalena
    Małczak, Piotr
    Budzyński, Andrzej
    Budzyński, Piotr
    Powiązania:
    https://bibliotekanauki.pl/articles/1393188.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    non-alcoholic fatty liver disease
    bariatric surgery
    morbid obesity
    Opis:
    Introduction; p to 300 million people have the body mass index (BMI) greater than 30 kg/m2. Obesity is the cause of many serious diseases, such as type 2 diabetes, hypertension, and non-alcoholic fatty liver disease (NAFLD). Bariatric surgery is the only effective method of achieving weight loss in patients with morbid obesity. Objectives: The aim of the study was to assess the impact of bariatric surgery on non-alcoholic fatty liver disease in patients operated on due to morbid obesity. Material and Methods: We included 20 patients who were qualified for bariatric procedures based on BMI > 40 kg/ m2 or BMI > 35kg/m2 with the presence of comorbidities. The average body weight in the group was 143.85kg, with an average BMI of 49.16kg/m2. Before the procedure, we evaluated the severity of non-alcoholic fatty liver disease in each patient using the Sheriff-Saadeh ultrasound scale. We also evaluated the levels of liver enzymes. Follow-up evaluation was performed twelve months after surgery. Results: Twelve months after surgery, the average weight was 102.34 kg. The mean %WL was 33.01%, %EWL was 58.8%, and %EBMIL was 61.37%. All patients showed remission of fatty liver disease. Liver damage, evaluated with ultrasound imaging, decreased from an average of 1.85 on the Sheriff-Saadeh scale, before surgery, to 0.15 twelve months after surgery (p < 0.001). As regards liver enzymes, the level of alanine aminotransferase decreased from 64.5 (U/l) to 27.95 (U/l) (p < 0.001), and the level of aspartate aminotransferase decreased from 54.4 (U/l) to 27.2 (U/l). Conclusions: Bariatric procedures not only lead to a significant and lasting weight loss, but they also contribute to the reduction of fatty liver disease and improve liver function.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 2; 1-4
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Initial experience with endoscopic sleeve gastroplasty in Poland
    Autorzy:
    Pyda, Przemysław
    Sowier, Aleksander
    Sowier, Sebastian
    Borucka, Anna-Maria
    Kapturzak, Joanna
    Białecki, Jacek
    Wójtowicz, Stanisław
    Powiązania:
    https://bibliotekanauki.pl/articles/1392415.pdf
    Data publikacji:
    2018
    Wydawca:
    Index Copernicus International
    Tematy:
    endoscopic sleeve gastroplasty
    ESG
    obesity
    bariatric surgery
    minimally invasive surgical procedures
    Opis:
    Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.
    Źródło:
    Polish Journal of Surgery; 2018, 90, 4; 35-40
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Initial experience with endoscopic sleeve gastroplasty in Poland
    Autorzy:
    Sowier, Aleksander
    Pyda, Przemysław
    Borucka, Anna-Maria
    Sowier, Sebastian
    Białecki, Jacek
    Kapturzak, Joanna
    Wójtowicz, Stanisław
    Powiązania:
    https://bibliotekanauki.pl/articles/1392875.pdf
    Data publikacji:
    2018
    Wydawca:
    Index Copernicus International
    Tematy:
    endoscopic sleeve gastroplasty
    ESG
    obesity
    bariatric surgery
    minimally invasive surgical procedures
    Opis:
    Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.
    Źródło:
    Polish Journal of Surgery; 2018, 90, 2; 16-22
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The Impact of Obesity on the Perioperative, Clinicopathologic, and Oncologic Outcomes of Robot Assisted Total Mesorectal Excision for Rectal Cancer
    Autorzy:
    Pai, Ajit
    Alsabhan, Fahad
    Park, John J
    Melich, George
    Sulo, Suela
    Marecik, Slawomir J
    Powiązania:
    https://bibliotekanauki.pl/articles/1392975.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    obesity
    Rectal cancer
    Robotic surgery
    Body mass index
    Total Mesorectal Excision
    Opis:
    Purpose: To analyze the feasibility and outcomes of robotic rectal cancer surgery in obese patients. Methods: From 2005 to 2012, 101 consecutive rectal cancers operated robotically were enrolled in a prospective database. Patients were stratified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups. Operative, perioperative parameters, and pathologic outcomes were compared. Data were analyzed using SPSS 22.0, while statistical significance was defined as a p value ≤ .05. Results: There were 33 obese patients (mean BMI 33.8 kg/m2). Patients were comparable regarding gender, T stage, and type of operation. Operative time and blood loss were higher in the obese group; only operative time was statistically significant. The conversion rate, length of stay, and anastomotic leak rates were similar. Circumferential margin positivity and lymph node yield were comparable. Disease free and overall survivals at 3 years were 75.8% versus 80.9% and 84.8% versus 92.6%, respectively for obese and non-obese subgroups. Conclusions: Robotic surgery for curative treatment of rectal cancer in the obese is safe and feasible. BMI does not influence conversion rates, length of stay, postoperative complications, and quality of the specimen or survival when the robotic platform is used.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 4; 23-28
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Chirurgiczne leczenie otyłości – nowa metoda leczenia cukrzycy typu 2?
    Surgical treatment of obesity – a new method of treatment for diabetes?
    Autorzy:
    Łącka-Gaździk, Beata
    Grabowski, Dariusz
    Grzeszczak, Władysław
    Powiązania:
    https://bibliotekanauki.pl/articles/1034727.pdf
    Data publikacji:
    2013
    Wydawca:
    Śląski Uniwersytet Medyczny w Katowicach
    Tematy:
    operacje bariatryczne
    cukrzyca typu 2
    otyłość
    bariatric surgery
    type 2 diabetes
    obesity
    Opis:
    At present, about 2 million people all over the world suffer from diabetes mellitus and it is estimated that this number will even reach over 300 million people in 2025. Diabetes is related to cardio-vascular complications, blindness, chronic kidney disease and is a reason for 60% of all non-traumatic lower limb amputations. Treating diabetes may lead to good metabolic control, but it cannot cure anyone from the disease. Obesity plays an important role in the pathogenesis of diabetes. A positive correlation between obesity and the development of diabetes is well known. One the most effective methods of treating obesity is bariatric surgery. The Roux-en-Y Gastric Bypass (RYGB) is the most popular surgical method of obesity treatment. Performing this procedure leads to a decrease in food intake as well as in disorders of food absorption and digestion. The results of several studies suggest that RYGB may be an effective method in assessing good metabolic control in patients suffering from morbid obesity. Moreover, a remission of diabetes occurs in the majority of patients on which bariatric surgery has been performed. The exact mechanism of this phenomenon remains not fully clear. It seems that the association of decreased food intake, changes in incretin hormone levels produced in the digestive system, and delayed stomach emptying is responsible for glycaemia reduction. This fact results in significant clinical implications, nevertheless, it is too early to perform a bariatric surgery procedures in non-obese type 2 diabetic patients. Plenty of long-term, well-documented clinical studies must be performed before surgical treatment will perhaps be an accepted method of type 2 diabetes treatment.
    Na cukrzycę typu 2 choruje około 200 mln ludzi na całym świecie, a szacuje się, że do 2025 r. liczba ta wzrośnie do ponad 300 mln. Choroba ta jest związana ze zwiększoną umieralnością z powodu schorzeń układu sercowo-naczyniowego, a także z niewydolnością nerek i ślepotą, ponadto stanowi przyczynę 60% nieurazowych amputacji kończyn dolnych. Stosowane powszechnie metody leczenia cukrzycy typu 2 poprawiają czasowo wyrównanie metaboliczne, ale nie prowadzą do wyleczenia. W patogenezie cukrzycy typu 2 istotną rolę odgrywa otyłość. Ścisła zależność między otyłością a cukrzycą jest dobrze udokumentowana. Jedną z najskuteczniejszych metod leczenia otyłości znacznego stopnia są zabiegi chirurgiczne – bariatryczne. Najczęściej przeprowadzanym obecnie zabiegiem tego rodzaju jest wyłączenie żołądkowe (Roux-en-Y gastric bypass – RYGB), prowadzące do ograniczenia ilości spożywanego pokarmu oraz upośledzenia trawienia i wchłaniania substancji pokarmowych. Wyniki licznych badań wskazują, że postępowanie takie może być skuteczne w kontroli glikemii u chorobliwie otyłych chorych na cukrzycę typu 2. U większości chorych operowanych tą metodą dochodzi nawet do remisji cukrzycy. Zjawiska leżące u podstaw remisji cukrzycy są w tych przypadkach nie do końca poznane. Prawdopodobnie to połączenie diety niskokalorycznej, zmian w poziomie hormonów wydzielanych przez przewód pokarmowy, modyfikacji opróżniania żołądkowego, a być może samego obniżenia masy ciała, skutkuje normalizacją glikemii, czasem nawet trwałą. Wynikają z tego istotne implikacje kliniczne, za wcześnie jednak, by podejmować taką terapię u chorych na cukrzycę typu 2 bez towarzyszącej otyłości. Potrzeba jeszcze wielu wnikliwych, dobrze udokumentowanych, wieloletnich obserwacji klinicznych, zanim cukrzycę typu 2 będzie można, być może, leczyć operacyjnie.
    Źródło:
    Annales Academiae Medicae Silesiensis; 2013, 67, 1; 40-46
    1734-025X
    Pojawia się w:
    Annales Academiae Medicae Silesiensis
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Dietetic recommendations after bariatric procedures in the light of new guidelines regarding metabolic and bariatric surgery
    Autorzy:
    Jastrzebska-Mierzynska, M.
    Ostrowska, L.
    Wasiluk, D.
    Konarzewska-Duchnowska, E.
    Powiązania:
    https://bibliotekanauki.pl/articles/874576.pdf
    Data publikacji:
    2015
    Wydawca:
    Narodowy Instytut Zdrowia Publicznego. Państwowy Zakład Higieny
    Tematy:
    dietetic recommendation
    bariatric procedure
    diet
    human nutrition
    obesity
    human disease
    metabolic disease
    bariatric surgery
    Opis:
    The frequency of obesity occurrence is constantly increasing all over the world and becoming global epidemic. Facing the lack of the efficiency of conservative treatment, patients with II and III degree of obesity are qualified for surgical treatment; however, the efficiency of surgical treatment is connected with permanent change of nutritional habits and previous lifestyle of the patient. Modification of the way of nutrition, regardless of the type of bariatric procedure, should especially include the lowering of food energetic value and change of type, consistency and size of consumed food. Nutritional treatment after bariatric procedures is multistage. It includes clear liquid diet, full liquid diet, pureed diet, mechanically altered soft diet and regular diet. Gradual expanding of the diet protects gastrointestinal tract from chemical, mechanical and thermal irritation by the food. It also should prevent nutritional deficiencies. Significant influence on the result of surgical treatment of obesity has also regular intake of food, consuming products with high nutritional value, avoiding confectionery and fat products, consuming proper amounts of protein (60-80 g/day) and vitamin-mineral supplementation.
    Częstość występowania otyłości zwiększa się na całym świecie przyjmując rozmiar globalnej epidemii. Wobec braku skuteczności leczenia zachowawczego, osoby z otyłością II i III stopnia poddawane są leczeniu chirurgicznemu. Warunkiem efektywności leczenia chirurgicznego jest trwała zmiana nawyków żywieniowych i dotychczasowego stylu życia pacjenta. Modyfikacja sposobu żywienia niezależnie od rodzaju zastosowanego zabiegu operacyjnego polega w szczególności na znaczącym obniżeniu wartości energetycznej diety oraz zmianie rodzaju, konsystencji i wielkości spożywanych posiłków. Leczenie żywieniowe po operacjach bariatrycznych jest wieloetapowe. Obejmuje ono: dietę płynną, dietę półpłynną, dietę papkowatą, pokarmy miękkie rozdrobnione oraz zbilansowaną dietę niskoenergetyczną. Stopniowe rozszerzanie diety ma na celu ochronę przewodu pokarmowego przed drażnieniem chemicznym, mechanicznym i termicznym spożywanych pokarmów. Ma jednocześnie zapobiegać niedoborom żywieniowym. Istotny wpływ na skuteczność chirurgicznego leczenia otyłości ma także regularne spożywanie posiłków, spożywanie produktów o wysokiej wartości odżywczej, unikanie słodyczy oraz produktów i potraw tłustych, spożywanie odpowiedniej ilości białka (60-80 g/dobę) oraz stosowanie suplementacji preparatami mineralno-witaminowymi.
    Źródło:
    Roczniki Państwowego Zakładu Higieny; 2015, 66, 1
    0035-7715
    Pojawia się w:
    Roczniki Państwowego Zakładu Higieny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Effects of bariatric surgery on cardiovascular risk factors among morbidly obese patients
    Autorzy:
    Major, Piotr
    Kowalczuk, Aleksandra
    Wysocki, Michał
    Osadnik, Sonia
    Pędziwiatr, Michał
    Głuszewska, Anna
    Pisarska, Magdalena
    Małczak, Piotr
    Lasek, Anna
    Kisielewski, Michał
    Budzyński, Andrzej
    Powiązania:
    https://bibliotekanauki.pl/articles/1393464.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    morbid obesity
    bariatric surgery
    laparoscopic sleeve gastrectomy
    laparoscopic Roux-en-Y Gastric Bypass cardiovascular risk factors
    SCORE
    Framingham
    Opis:
    Aim of the study: The aim of this study was to evaluate the influence of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric by-pass on risk factors of cardiovascular diseases. Material and methods: We analyzed prospectively collected data of patients operated for morbid obesity who were qualified for laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric by-pass (LRYGB). Risk factors for wyłączecardiovascular diseases were assessed with the SCORE scale and both full and hard Framingham cardiovascular risk scores (FCRs). The data were collected on admission and one year after the procedures. We enrolled 264 patients (119 females, 116 males, 40.2±9.9 years old), of whom 117 underwent LRYGB and 118 LSG, respectively. Results: Preoperatively, 12% of patients were in the high-risk category of the SCORE scale, 65% were in the moderate risk category, and 24% were in the low-risk category. The median score of the SCORE scale was 1 (1-2). Lipid-based full FCR was 34.5% (24%-68%) and the hard FCR was 17.5% (10%-52%), while the respective BMI-based FCRs were 59% (31%-84%) and 37% (15%-67%). One year after the procedures, the mean %EBMIL (62.88%±20.02%) and %EWL (53.18%±15.87) were comparable between both procedures. Hypertension treatment was not necessary in 33 patients after LSG and in 55 after LRYGB. Diabetes mellitus remitted in 9 and 29 patients, respectively. Both procedures significantly reduced high and moderate risk prevalence in the SCORE scale in favor of the low risk category. Surgical interventions resulted in significant reductions of FCRs 1 year after surgery ( p<0.001). Conclusions: Both LSG and LRYGB lead to a significant and comparable body mass reduction. Both procedures significantly decrease of the risk of cardiovascular diseases, based on SCORE and Framingham scales.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 1; 41-49
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
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