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Upper Gastrointestinal Surgery (upper + gastrointestinal_surgery)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

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]

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]

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]