Gastric band migration to gastrointestinal lumen and possibilities of its surgical treatment

BACKGROUND

Due to numerous late complications after laparoscopic adjustable gastric banding (LAGB), leading to band removal, a significant decrease of its application has been observed.

OBJECTIVES

The objective of this study was to present complications after LAGB in our own material.

MATERIAL AND METHODS

The study included 152 obese patients who underwent LAGB between 2005 and 2012. The group of women consisted of 91 patients (60%) with the following preoperative parameters: average body mass index (BMI) 42 ±3.66 kg/m2 and average body mass 122 ±12.8 kg. The group of men included 61 patients (40%) with a preoperative average BMI 43 ±3.81 kg/m2 and average body mass 125 ±13.02 kg. The average age of women was 35.02 ±11.6 years and of men 36.18 ±10.5 years.

RESULTS

Among 152 patients after LAGB due to morbid obesity, in 7 (4.6%) migration of the band to the stomach lumen was observed, in 4 port wound purulence occurred, in 3 stomach mucosa ulceration was diagnosed in the band pressure area, 3 reported heartburn and hyperacidity, and 4 suffered from emesis. In all aforementioned patients, body mass loss stopped and they reported lack of restriction after last band regulation.

CONCLUSIONS

Surgical or endoscopic treatment in patients with a migrated band is an individual matter depending on the type and size of band dislocation, its clinical symptoms and the general state of the patient, but also on the experience of the operating team and the quality of the equipment.

Surgical treatment of malignant and benign colorectal neoplasms based on authors' clinical data

BACKGROUND

Colorectal cancer remains a huge diagnostic and therapeutic issue in Poland and worldwide. World epidemiological data indicates a constant increase in morbidity in recent decades.

OBJECTIVES

The aim of this research was to present surgical procedures in malignant and benign colorectal neoplasms based on authors' clinical data.

MATERIAL AND METHODS

Between 2001 and 2010, in the 1st Department of General and Endocrinological Surgery in Bialystok, 754 patients with malignant colorectal cancer were hospitalized. Precancerous conditions which included polyps and non-specific bowel inflammations were observed in 491 and 52 patients, respectively.

RESULTS

The most frequent location of a malignant colorectal tumor was the rectum - 271 (35%) cases and sigmoid colon - 235 (31%) cases. In 8 cases (1%), a multifocal location of colorectal neoplasm was observed. Similar locations were observed in the case of polyps. They were observed the most frequently in the sigmoid colon - 144 (29.3%) cases and rectum - 122 (24.8%) cases. In the cases of colorectal cancer located in the rectum (271), the most frequently applied procedure was abdomino-perineal amputation - 102 (37.6%) patients (T1-3 N1-2 M0). In sigmoid colon cancer (235 cases), sigmoid colon resection was performed most frequently - in 175 patients (74.5%) (T1-3 N0-2 M0-1). Right hemicolectomy was performed in 120 (T1-4 N0-2 M0-1) patients and left hemicolectomy in 52 (T1-4 N02 M0-1) patients. In 482 cases, endoscopic resection of polyps was performed and in 9 patients resection through laparotomy. The majority of operations were performed according to plan, however, many of them were performed in emergency.

CONCLUSIONS

Colorectal cancers, irrespectively to their location, develop secretly without any symptoms in the early stages which is the reason why patients contact a doctor in the late stadium of the disease. It is also the cause for a majority of the procedures performed in emergency. The best prognosis and long-term results are obtained with treatment combined with radio- and chemotherapy.