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Bowel Lengthening by Serial Transverse Enteroplasty (STEP) in the Short Bowel Syndrome. Primary Experience

100%
Sroka M., Szlagatys A., Łosin M.
Polish Journal of Surgery
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2009
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vol. 81
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issue 2
113-117
EN
New technique of bowel lengthening- Serial Transverse Enteroplasty (STEP) in a case of patient with short bowel syndrome with great fluid losses accompanied with electrolyte disorders is presented. The patient was parenteral nutrition-dependent. After surgery total bowel length almost doubled and electrolyte disorders ceased. Intra-venous supply was reduced by half. This procedure in our opinion is easier than other techniques of bowel lengthening, but still very effective and may be a surgical option of choice in patients with short bowel syndrome. According to our knowledge it has been the first such procedure performed in Poland.
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Prognostic factors in acute mesenteric ischemia and evaluation with multiple logistic regression analysis effecting morbidity and mortality

75%
Ozturk S., Unver M., Ozdemir M., Bozbıyık O., Turk Y., Firat O., Calıskan C.
Polish Journal of Surgery
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2021
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vol. 93
|
issue 1
25-33
EN
Background: Acute mesenteric ischaemia (AMI) is a catastrophic abdominal emergency characterized by sudden critical interruption to the intestinal blood flow which commonly leads to bowel infarction and death. AMI still has a poor prognosis with an in-hospital mortality rate of 50-69 %. This high mortality rate is related to the delay in diagnosis which is often diffucult and overlooked. Early intervention is crucial and the potential for intestinal viability. Methods: The charts of 140 patients who were hospitalazed with AMI between May 1997 and August 2013 in Ege University Faculty of Medicine, department of general surgery were retrospectively reviewed. Demographical and clinical features of patients determining the best predictors which effect on morbidity and mortality were evaluated by Multiple Logistic Regression analysis by Enter method after adjustment for all possible confounding factors. Results: After Multiple LR analysis by Enter method after adjustment for all possible confounding factors affecting morbidity; shock, exploration and stay in hospital were statistically significant. Age, cardiac comorbidities, ASA scores, the time delay between onset of acute abdominal pain to surgery, the presence of acidosis and shock, the involved organs (small bowel and both), type of surgery and medical treatment and small bowel length under 100 cm were statistically significant on mortality. Conclusion: Risk factors related to mortality and morbidity have been poorly analyzed due to lack of prospective studies and smaller number of patients. Early diagnosis generally depends on clinical awareness and suspicion. Age and time of delay between onset of acute abdominal pain to surgery longer than 24 hours are the most important parameters that predict the mortality for patients presenting with shock and acidosis.
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