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Content available remote Endoscopic Treatment of obesity with an Intragastric balloon
Anterior resection for rectal cancer carries the risk of serious complications, especially fistulas at the site of anastomosis. Numerous factors have been shown to impact anastomotic leakage. The results of studies on the influence of obesity on the frequency of anastomotic leakage after rectal resection performed due to cancer have been contradictory. The aim of the study was to evaluate the relationship between body mass index (BMI) and frequency of anastomotic leakage after anterior rectal resection performed due to cancer. Material and methods. This retrospective analysis included 222 subsequent patients who had undergone anterior resection due to cancer with an anastomosis formed with a mechanical suture. The patients were divided into 3 groups depending on their BMI quartile as follows: Group I, BMI < 23.8 kg/m2 (lower quartile); group II, BMI between 23.8 and 29.38 kg/m2 (middle quartile); and group III, BMI > 29.38 kg/m2 (upper quartile). Results. Anastomotic leakage occurred in 8 (3.6%) patients. Fistulas occurred in 4 out of 61 patients (6.56%) in group I, which was the highest incidence of fistulas for all 3 groups. In group II, fistulas occurred in 2 out of 55 patients (3.63%), and similarly, in group III, they occurred in 2 out of 106 patients (1.87%). The differences found in the frequency of fistulas between groups were not statistically significant (p=0.31). The logistic regression analysis did not show any relationship between leakage and age (p = 0.55; OR = 1.02; 95% CI: 0.95 - 1.1), sex (p = 0.97; OR = 0.97; 95% CI: 0.22 - 4.25) or BMI (p = 0.27; OR = 0.58; 95% CI: 0.22 - 1.53). Conclusions. The results of our study show that BMI did not have any influence on the frequency of anastomotic leakage after anterior rectal resection performed due to cancer.
"Bile reflux" is a common term to denote a process of placing duodenal contents in the stomach and/or lower oesophagus. It is most often associated with functional or organic failure of the pylorus and is a not uncommon postoperative condition after pyloric section, resection or by-passing.Gastrotoxicity of the replaced small intestinal mixture leading to lesions in gastric mucosal barrier, is caused by an increased ability to reabsorb hydrogen ions along with migration of blood proteins and electrolytes towards lumen of the stomach. Consequently, histamine secretion becomes increased, leading to inflammatory and haemorrhagic changes or ulcer niches.The aim of the study was to demonstrate histological and microscopic changes in the gastric mucosa following reflux and to determine if long-term exposure to refluxed duodenal contents will produce tumorous changes in the organs tested.Material and methods. The study consisted of 25 mature female Wistar rats weighing 180-200 g. Bile reflux to the stomach was produced experimentally by surgical drainage. Final evaluation was performed after 55 weeks.Results. Findings were as follows: gastric changes were noted in basal and parietal cells, no tumorous foci were found in histological samples. Slight morphological changes can be caused by short periods of gastric mucosa exposure to the gastrotoxic small intestinal mixture.Conclusions. Endogenous bile acids cause morphological changes in the stomach mucosa of rats. In particular, these changes affect the ultrastructure of basal and parietal cells. No neoplastic foci were found in the examined organs.
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