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Probiotics in Surgery

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The aim of the study was to describe the authors' experience in performing laparoscopic restorative proctocolectomy with the formation of an intestinal reservoir of the J-pouch type, anal anastomosis and protective ileostomy.Material and methods. Between 2004 and 2011, a total of 23 patients underwent laparoscopic restorative proctocolectomy with the formation of an intestinal reservoir of the J-pouch type, anal anastomosis and protective ileostomy for ulcerative colitis (n = 17) or familial adenomatous polyposis (n = 6). A statistical analysis of the treatment outcomes was performed.Results. No intraoperative complications were observed and none of the patients required conversion or blood transfusions. The mean duration of the procedure was 4.08 hours (2.5-6.0 hours). The mean duration of hospitalization was 15.4 days (8-24 days). We observed three major postoperative complications requiring intervention: two cases of small bowel obstruction (one due to postoperative adhesions and the other due to volvulus) and one case of infection of the surgical and ostomy wound healed following ileostomy closure.Conclusions. For such extensive procedures as restorative proctocolectomy, laparoscopic techniques prove safe and are characterised by a better patient acceptance thanks to the low invasiveness and good cosmetic effects. The technological progress and the increasing experience in performing laparoscopy provide more and more arguments to support the selection of this method as the preferred method of treatment.
EN
The aim of the study was to assess whether intraoperative use of the "wound scrubbing" technique (iodine solution lavage followed by intensive scrubbing of the wound with a surgical drape) reduces the number of surgical site infection (SSI) incidents, considering patients after colorectal surgery.Material and methods. The study group comprised 98 patients qualified towards colorectal surgery during the period between November, 2007 and November, 2008. Patients were divided into two groups: Fifty patients were subject to the "wound scrubbing" technique (group I), while 48 patients constituted the control group (group II) where the wound was treated traditionally-subcutaneous tissue hemostasis was assured, least traumatically. In case of both groups subcutaneous tissue swabs were collected before wound suturing. Primary cutaneous sutures were applied in all patients. The diagnosis of a surgical site infection was based on the criteria established by the National Nosocomial Infectious Surveillance (NNIS) group.Results. According to the NNIS criteria, superficial SSI was diagnosed in 12 patients (12.3%): 4 from the "wound scrubbing" group (8%) and 8 from the control group (16.7%). Deep tissue infections were not observed. Gram-negative bacteria were most often isolated, both in case of group II patients, and SSI cases. Considering the "wound scrubbing" group 66% of intraoperative swabs proved to be sterile.Conclusions. 1. The "wound scrubbing" technique reduces the risk of SSI in case of patients subject to colorectal surgery. 2. Microbial contamination of the postoperative wound (groups II-IV, according to the NNIS) before the introduction of cutaneous sutures directly influences the frequency of surgical site infections.
EN
Background Patients with cancer are at risk of malnutrition. The aim of this study is to assess the nutritional status of patients with cancer who are qualified for home enteral nutrition. Secondary aim is to compare the nutritional status of patients with gastric cancer and with esophageal cancer. Material and methods Retrospective analysis of medical documentation of 84 participants with cancer who were qualified for home enteral nutrition in Nutritional Counselling Center Copernicus in Gdansk in 2009-2015 was performed. Assessment of nutritional status included body mass index, the level of total protein and albumin in blood serum, total lymphocyte count, and Nutritional Risk Score 2002 method. Results Patients with gastric cancer most often presented albumin deficiency in comparison with patients with esophageal cancer (p=0.02). The low level of total lymphocyte count in 1mm3 of peripheral blood was observed in 47.6% participants. All the patients qualified for home enteral nutrition received at least 3 points in NRS 2002 method and most often 5 points (40.4%). Conclusions All patients required nutritional treatment. Notwithstanding, the nutritional status of patients varied. Hypoalbuminemia was observed more often in patients with gastric cancer in comparison with patients with esophageal cancer.
EN
Background: Patients with cancer are at risk of malnutrition. The aim of this study is to assess the nutritional status of patients with cancer who are qualified for home enteral nutrition. Secondary aim is to compare the nutritional status of patients with gastric cancer and with esophageal cancer. Material and methods: Retrospective analysis of medical documentation of 84 participants with cancer who were qualified for home enteral nutrition in Nutritional Counselling Center Copernicus in Gdansk in 2009-2015 was performed. Assessment of nutritional status included body mass index, the level of total protein and albumin in blood serum, total lymphocyte count, and Nutritional Risk Score 2002 method. Results: Patients with gastric cancer most often presented albumin deficiency in comparison with patients with esophageal cancer (p=0.02). The low level of total lymphocyte count in 1mm3 of peripheral blood was observed in 47.6% participants. All the patients qualified for home enteral nutrition received at least 3 points in NRS 2002 method and most often 5 points (40.4%). Conclusions: All patients required nutritional treatment. Notwithstanding, the nutritional status of patients varied. Hypoalbuminemia was observed more often in patients with gastric cancer in comparison with patients with esophageal cancer.
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