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Influence of the Classic and Laparoscopic Bariatric Operations For the Ventilation Lung Activity

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Świαtkowska M., Cywiński J., Hedayati M., Drozda R., Wieloch M., Kołomecki K.
Polish Journal of Surgery
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2008
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vol. 80
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issue 12
659-663
EN
The obese patient constitute the group with high perioperative risk due to more respiratory and cardiovascular disorders. The respiratory disorders deepen during postoperative period.The aim of the study was an assessment of changes in ventilation lung activity after classic and laparoscopic bariatric operations.Material and methods. For the lung activity assessment the measurement of pick expiratory flow was used before operation, in the first and third twenty-four hours after operation. Moreover, before and in the first twenty-four hours after operation a spirometry was performed. The forced vital capacity (FVC), 1 second forced expiratory volume (FEV1) and Tiffenau index (FEV1/FVC) were estimated in the study. 54 persons were included in batriatric operations. The first group was formed by the patients after vertical banded gastroplasty (VBG), the second after laparoscopic vertical banded gastroplasty (LVBG), the third one after laparoscopic adjustable gastric banding (LABG).Results. The following average results were gained: first group-PEF before operation 399 liter per minute, in the first twenty-four hours after operation 195 liter per minute and in the third twenty-four hours 282 liter per minute. FEV1 before operation 2.6 liter, in the first twenty-four hours 1.5 liter, FVC before 3.5 liter and after operation 2liter. Tiffenau index before 86%, after 85%. The second group PEF before operation 446 liter per minute, in the first twenty-four hours 326 liter per minute in the third twenty-four hours 409 liter per minute, FEV1 before 3.6 liter, after 2.6 liter, FVC before 3.9 liter, after 2.7 liter, Tiffenau index before 92%, after 96%. The third group PEF before 460 liter per minute, in the first twenty-four hours 340 liter per minute, in the third twenty-four hours 430 liter per minute, FEV1 before 3.2 liter, after 3.1 liter, FVC before 4.5 liter, after 3.6 liter, Tiffenau index before 90%, after 90%.Conclusions. The bariatric operations reduce ventilation lung activity. After classic bariatric surgery respiratory disorders are longer and become more intense. Independently of bariatric operation's method all respiratory disorders have a restrict type.
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Evaluation of Selected Indicators of Apoptosis in Patients with Thyroid Tumors

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Kołomecki K., Maciaszczyk P., Stępień H., Cywiński J., Cielecka J., Stępień T., Kuzdak K.
Polish Journal of Surgery
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2007
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vol. 79
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issue 2
85-91
EN
The aim of the study. Estimatation of p53 protein and soluble FasL ligand level concentration in serum of patients with benign and malignant primary follicular thyroid tumors as indicators of apoptosis and evaluation of their usefulness for early diagnosis of thyroid tumors.Material and methods. 42 patients were qualified for the study. 28 patients were diagnosed with follicular neoplasm (NF) in preoperative fine-needle biopsy. The final verification was postoperative histopathology. Control group consisted of 14 patients with euthyroid goiter, with no cancerous cells detected in cytologic examination. All patients underwent surgical procedures. Levels of p53 and sFasL were marked on the day of admission, before surgery. Destinationes were made in the serum using the ELISA immunoenzymatic method. Obtained data underwent computer statistical analysis.Results. The analysis revealed significantly higher sFasL and p53 concentration in blood of patients with follicular thyroid cancer in comparison with the control group. Similarly, p53 serum level was significantly higher in case of patients with benign thyroid adenoma than in the control group. Comparison between p53 and sFasL serum level in cases of patients with follicular cancer and follicular adenoma showed statistically higher sFasL blood concentration in cases of patients with follicular cancer; there was no statistically significant connection in case of p53 concentration.Conclusions. 1. sFasL and p53 serum concentration are significantly higher in patients with follicular thyroid cancer than in the control group. 2.The p53 serum concentration is significantly higher in cases of all patients with benign thyroid adenoma than in the control group. There was no such correlation for sFasL concentration. 3. sFasL serum concentration is significantly higher in cases of patients with follicular thyroid cancer than in patients with benign thyroid adenoma. There was no such correlation with serum levels of p53.
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The relationship between features of metabolic syndrome and blood adipocytokine concentrations in the morbid obese patients during dynamic weight loss

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Jankiewicz-Wika J., Kołomecki K., Cywiński J., Piestrzeniewicz K., Stępień H., Komorowski J.
Open Medicine
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2006
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vol. 1
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issue 2
136-147
EN
Bariatric surgery is the most effective method to achieve weight loss in obese subjects. The aim of this study was to evaluate some adipocytokines and insulin, as well as parameters of metabolic syndrome of the obese patients, for three and six months after vertical banded gastroplasty, in the time of dynamic weight loss. Seven males and two females aged 28 to 49 years, with long lasting simple obesity and the presence of metabolic syndrome, were studied. After surgical treatment the values of the body mass index, waist circumference, systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, triglycerides, and blood concentrations of leptin decreased significantly. Before surgical operation of all obese patients no statistically significant correlations between studied parameters were noted. Three and six months later a lot of correlations between studied parameters appeared. In conclusion, (a) vertical-banded gastroplasty is a valuable method in treatment of obese subjects, leading to a significant decrease in body weight and improvement in some parameters of metabolic syndrome in a few months after surgery, (b) adipocytokines, together with an unknown gastric factor, may be key factors in the control of some features of the metabolic syndrome.
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