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Gastrointestinal Surgery (gastrointestinal + surgery)

Distribution by Scientific Domains
Medical Sciences94%

Kinds of Gastrointestinal Surgery

  • upper gastrointestinal surgery
    		•

    Selected Abstracts

    Atlas of Gastrointestinal Surgery, 2nd edn, Volume 1.

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2008

    No abstract is available for this article. [source]

    Patients' subjective symptoms, quality of life and intake of food during the recovery period 3 and 12 months after upper gastrointestinal surgery

    EUROPEAN JOURNAL OF CANCER CARE, Issue 1 2007
    U. OLSSON rnt, phd student
    Few studies describe patients' quality of life and their experienced symptoms during the recovery period after having undergone upper gastrointestinal surgery at 3 and 12 months. The aims of this study were to explore patients' quality of life and symptoms preoperatively and at 3 and 12 months following upper gastrointestinal surgery and to describe and compare patients' experiences of appetite, food intake, weight changes, tiredness and sleeping patterns. A descriptive and comparative quantitative design was used. Three instruments were used: the Gastrointestinal Symptom Rating Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and the Eating Dysfunction Scale. A questionnaire was used to investigate symptoms such as mood, appetite, sleep, activities and well-being. Twenty-four patients were included in the study. The major results were that anxiety levels and global health status decreased and that patients felt more disappointed after 12 months compared with after 3 months. Four patients at 3 months after surgery and eight patients at 12 months regained their weight compared with the situation before surgery. The contribution of nursing care activities focusing on the importance of food intake and the patients' current and historical medical records in relation to their health status should continue to be examined and researched over a longer period of time. [source]

    Exocrine pancreatic insufficiency and malnutrition after gastrointestinal surgery

    HPB, Issue 2009
    Christos Dervenis
    No abstract is available for this article. [source]

    Pancreatic enzyme replacement therapy: exocrine pancreatic insufficiency after gastrointestinal surgery

    HPB, Issue 2009
    J. Enrique Domínguez-Muñoz
    Abstract Exocrine pancreatic insufficiency (EPI) and resultant maldigestion occurs in up to 80% of patients following gastric, duodenal or pancreatic surgery. Accurate diagnosis is required to determine the appropriate intervention, but the conventional method of faecal fat quantification is time-consuming and not always readily available. The optimized 13C-mixed triglyceride (13C-MTG) breath test is an accurate alternative post-surgery. Pancreatic enzyme replacement therapy (PERT) is indicated post-surgery in patients with clinically evident steatorrhoea, weight loss or maldigestion-related symptoms. Given its favourable safety profile, PERT is also appropriate in asymptomatic patients with high faecal fat excretion as such patients are at high risk for nutritional deficits. However, published data evaluating PERT in this setting are limited. Uncoated powder preparations may be preferred in cases of low gastric acidity and partial or total gastric resection. In clinical studies, enteric-coated microspheres were associated with greater weight gain after surgery vs. uncoated preparations. This was confirmed in a recent study using the 13C-MTG breath test; fat absorption increased from <40% without therapy to almost 60% with enteric-coated minimicrospheres (40 000 lipase units/meal), with >60% of patients achieving normal breath test results (i.e. normal fat digestion) during PERT. A therapeutic algorithm for the treatment of EPI after surgery is also discussed. [source]

    Japanese guidelines for prevention of perioperative infections in urological field

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2007
    Tetsuro Matsumoto
    Abstract: For urologists, it is very important to master surgical indications and surgical techniques. On the other hand, the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, the evidence and the number of guidelines are limited. Among them, the preparation of guidelines has progressed, especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections, which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. The Japanese Society of UTI Cooperative Study Group has thus framed these guidelines supported by The Japanese Urological Association. The guidelines consist of the following nine techniques: open surgeries, laparoscopic surgeries, transurethral resection of bladder tumor, ureterorenoscope and transurethral lithotripsy, transurethral resection of the prostate, prostate biopsy, cystourethroscope, pediatric surgeries in the urological field, and extracorporeal shock wave lithotripsy and febrile neutropenia. These are the first guidelines for the prevention of perioperative infections in the urological field in Japan. Although most of these guidelines were made using reliable evidence, there are parts without enough evidence. Therefore, if new reliable data is reported, it will be necessary for these guidelines to be revised in the future. [source]

    Postoperative taste and smell deficit after upper gastrointestinal cancer surgery,an unreported complication

    JOURNAL OF SURGICAL ONCOLOGY, Issue 3 2003
    Adrian M. Harris FRCS(Ed)
    Abstract Background and Objectives Patients undergoing upper gastrointestinal cancer surgery were noted to suffer loss of taste and/or smell, a previously unreported problem. Our aim was to investigate the extent of this phenomenon, quantify recovery time, and identify potentially associated factors. Methods In this retrospective study, a postal questionnaire was sent to all patients still alive after oesophagectomy or gastrectomy, with a minimum 1-year follow-up and no clinical or radiological evidence of recurrence. Data were analysed for prevalence of deficit in relation to operation, age, sex, respiratory complications, and disease stage. Results A total of 109/119 (92%) patients completed the questionnaire: 50 gastrectomies and 69 oesophagectomies. Ten patients were excluded with prior sensory deficit. Overall, 45/99 patients (45%) suffered deficit (M:F,=,1.6:1). No association was found with type of surgery: deficits for subtotal gastrectomy, total gastrectomy, and oesophagectomy were 44, 46 and 46% respectively (,2,=,0.355, 2 df P,>,0.5). No other parameter was associated, and full recovery occurred in 30 patients (67%) within a mean of 6 months. Conclusions Loss of taste and smell occurs in nearly one-half of all cases after upper gastrointestinal surgery. The pathophysiology is unknown, but it resolves in most patients within 6,12 months. This complication should be discussed as part of informed consent for patients undergoing oesophagogastric cancer surgery. J. Surg. Oncol. 2003;82:147,150. © 2003 Wiley-Liss, Inc. [source]

    Intestinal and hepatic metabolism of glutamine and citrulline in humans

    THE JOURNAL OF PHYSIOLOGY, Issue 2 2007
    Marcel C. G. Van De Poll
    Glutamine plays an important role in nitrogen homeostasis and intestinal substrate supply. It has been suggested that glutamine is a precursor for arginine through an intestinal,renal pathway involving inter-organ transport of citrulline. The importance of intestinal glutamine metabolism for endogenous arginine synthesis in humans, however, has remained unaddressed. The aim of this study was to investigate the intestinal conversion of glutamine to citrulline and the effect of the liver on splanchnic citrulline metabolism in humans. Eight patients undergoing upper gastrointestinal surgery received a primed continuous intravenous infusion of [2- 15N]glutamine and [ureido- 13C,2H2]citrulline. Arterial, portal venous and hepatic venous blood were sampled and portal and hepatic blood flows were measured. Organ specific amino acid uptake (disposal), production and net balance, as well as whole body rates of plasma appearance were calculated according to established methods. The intestines consumed glutamine at a rate that was dependent on glutamine supply. Approximately 13% of glutamine taken up by the intestines was converted to citrulline. Quantitatively glutamine was the only important precursor for intestinal citrulline release. Both glutamine and citrulline were consumed and produced by the liver, but net hepatic flux of both amino acids was not significantly different from zero. Plasma glutamine was the precursor of 80% of plasma citrulline and plasma citrulline in turn was the precursor of 10% of plasma arginine. In conclusion, glutamine is an important precursor for the synthesis of arginine after intestinal conversion to citrulline in humans. [source]

    Endoscopic surgical skill qualification system in Japan: Five years of experience in the gastrointestinal field

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2010
    T Kimura
    Abstract Introduction: To reduce the complications of endoscopic surgery, the Japan Society for Endoscopic Surgery formed a committee that established the Endoscopic Surgical Skill Qualification System (ESSQS). Here we report on the methods employed and results obtained with the ESSQS over five years in the field of gastrointestinal surgery. Methods: The first ESSQS review was performed in 2004, and examinations have been conducted once a year since then. Applicants must submit a list of patients on whom they have performed surgery (including complications) and an unedited video showing one of the relevant surgical procedures. To assess the applicants' videos, the judging committee prepared "common criteria" (60 points) and "procedure-specific criteria" (40 points). Assessment of videos was done independently by two judges, and the applicant passed the test if both judges assigned a score of 70 points or more. Results: There have been 1369 applicants, and 641 (46.8%) have been successful. The main problem with this system has been a relatively low rate of agreement between the two judges (, value: 0.29,0.40). However, the incidence of complications is significantly lower in patients treated by successful applicants (4.3±6.8%) than in those treated by failed applicants (5.6±8.4%) (P=0.0096). Conclusion: Although the ESSQS could be further improved, this system promotes training and decreases complications. [source]

    Randomized clinical trial of the influence of local water-filtered infrared A irradiation on wound healing after abdominal surgery

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2006
    M. Hartel
    Background: Postoperative local water-filtered infrared A (wIRA) irradiation improves tissue oxygen partial pressure, tissue perfusion and tissue temperature, which are important in wound healing. Methods: The effect of wIRA irradiation on abdominal wound healing following elective gastrointestinal surgery was evaluated. Some 111 patients undergoing moderate to major abdominal surgery were randomized into one of two groups: wIRA and visible light irradiation (wIRA group) or visible light irradiation alone (control group). Uncovered wounds were irradiated twice a day for 20 min from days 2,10 after operation. Results: Irradiation with wIRA improved postoperative wound healing in comparison to visible light irradiation alone. Main variables of interest were: wound healing assessed on a visual analogue scale (VAS) by the surgeon (median 88·6 versus 78·5 respectively; P < 0·001) or patient (median 85·8 versus 81·0; P = 0·040), postoperative pain (median decrease in VAS score during irradiation 13·4 versus 0; P < 0·001), subcutaneous oxygen tension after irradiation (median 41·6 versus 30·2 mmHg; P < 0·001) and subcutaneous temperature after irradiation (median 38·9 versus 36·4 °C; P < 0·001). The overall result, in terms of wound healing, pain and cosmesis, measured on a VAS by the surgeon (median 79·0 versus 46·8; P < 0·001) or patient (79·0 versus 50·2; P < 0·001) was better after wIRA irradiation. Conclusion: Postoperative irradiation with wIRA can improve normal postoperative wound healing and may reduce costs in gastrointestinal surgery. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

    Manipulation of the small intestine as a cause of the increased inflammatory response after open compared with laparoscopic surgery,,

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2006
    N. Hiki
    Background: Laparoscopic surgery of the gastrointestinal tract involves a reduced immune response compared with open surgery. The aim of this study was to assess manual handling of the gut in open procedures as the principal cause of the enhanced immune response. Methods: Eighteen Landrace pigs underwent gastrectomy by three different methods: conventional open wound with bowel manipulation, laparoscopically assisted gastrectomy, and gastrectomy without manipulation using a combination of open wound and laparoscopic surgical devices. Local inflammatory changes were assessed by ascites formation, intestinal adhesion development and intestinal inflammatory gene expression. Associated systemic inflammatory changes were determined by measuring portal and systemic plasma endotoxin levels, plasma inflammatory cytokine levels, liver inflammatory gene expression and transaminase levels. Results: Significantly more postoperative intra-abdominal fluid and adhesions were seen in the open group. The expression of inflammatory cytokines was significantly greater in the intestine and liver in the open group. Portal and systemic levels of endotoxin, inflammatory cytokines and transaminases were also higher. Conclusion: Manual handling of organs during gastrectomy is an important contributor to the molecular and humoral inflammatory response to surgery, supporting the use of minimally invasive techniques in gastrointestinal surgery. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

    Predicting postoperative morbidity by clinical assessment

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2005
    P. M. Markus
    Background: The aim of this study was to determine the accuracy of prediction of the surgeon's ,gut-feeling' in estimating postoperative outcome. Methods: A prospective series of 1077 consecutive patients undergoing major hepatobiliary or gastrointestinal surgery were studied. Patients having elective (n = 827) and emergency (n = 250) procedures were included. The surgeon predicted the development of postoperative complications immediately after completion of surgery on a scale from 0 to 100 per cent. These predictions were compared with the actual outcome and with predictions made using the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM). The Portsmouth predictor equation (P-POSSUM) was applied for the estimation of mortality. Results: The observed morbidity and mortality rates were 29·5 and 3·4 per cent respectively. POSSUM predicted a morbidity rate of 46·4 per cent and P-POSSUM a mortality rate of 6·9 per cent. The surgeon's gut-feeling was more accurate in the prediction of morbidity at 32·1 per cent. On the basis of gut-feeling, surgeons overpredicted morbidity in elective surgery, but underestimated the risk of complications in the emergency setting. The (P)-POSSUM scoring system overpredicted morbidity and mortality for elective and emergency operations. Conclusion: The surgeon's gut-feeling is a good predictor of postoperative outcome, especially after elective surgery. (P)-POSSUM overpredicted morbidity and mortality in this series of major gastrointestinal and hepatobiliary operations. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

    Mayo Clinic gastrointestinal surgery.

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 10 2004

    No abstract is available for this article. [source]

    An Internist's illustrated guide to gastrointestinal surgery.

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2004

    No abstract is available for this article. [source]

    Experience of pancreaticoduodenectomy in a district general hospital

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2000
    K. Akhtar
    Aims: Long-term survival after surgery for pancreatic cancer remains very low and it is particularly important that minimal surgery-related morbidity and mortality rates are achieved. It has been stated that centres performing small numbers of proximal pancreaticoduodenectomies are likely to have high morbidity and mortality rates. The results of pancreatic surgery in a district general hospital are reported. Methods: This was a retrospective analysis of all pancreaticoduodenectomies over 4 years. Results: Twenty-one selected patients underwent proximal pancreaticoduodenectomy and two patients total pancreatectomy over a 4-year period from 1995 to 1999. The operations were performed by two surgeons with a special interest in upper gastrointestinal surgery. The median age was 62 (38,83) years. There were 14 men and nine women. Fifteen patients had adenocarcinoma of the head of the pancreas, five had ampullary carcinoma, one duodenal carcinoma and there was one case of chronic pancreatitis. Six patients had pylorus-preserving pancreaticoduodenectomy (PPPD) and 15 had a standard Whipple procedure. The median stay in hospital was 20 (13,26) days. Two patients had a pancreatic leak, one of whom developed an intra-abdominal abscess which was treated successfully by percutaneous drainage. Six patients experienced delayed gastric emptying, two of whom had PPPD. Both the 30-day and in-hospital mortality rates were zero. The median number of lymph nodes dissected was 12 and in 11 patients no nodal metastasis was found. Conclusions: It is possible to perform pancreatic surgery in a district general hospital and achieve results that are comparable to those of specialist centres. © 2000 British Journal of Surgery Society Ltd [source]

    Bacteraemia as a result of Campylobacter species: a population-based study of epidemiology and clinical risk factors

    CLINICAL MICROBIOLOGY AND INFECTION, Issue 1 2010
    H. Nielsen
    Abstract Invasive disease as a result of Campylobacter is rarely reported. We reviewed 46 cases of blood stream infection with Campylobacter in a Danish population with complete follow-up. The incidence was 2.9 per 1 million person-years with a peak incidence in the age group above 80 years. In the population, the ratio of notified bacteraemia/enteritis patients with Campylobacter infection was 0.004. Patients with bacteraemia were older and had higher comorbidity, e.g. alcoholism, immunosuppression, previous gastrointestinal surgery or HIV infection. We found 26% of blood isolates resistant to ciprofloxacin. The length of hospitalization was significantly longer in bacteraemia patients, whereas the outcome was favourable with 28-day mortality of 4% in bacteraemia patients and 1% in enteritis patients. None of the bacteraemia patients relapsed within 365-day follow-up. [source]