Intragastric Balloon (BIB system) in the treatment of obesity and preparation of patients for surgery - own experience and literature review.

UNLABELLED: Despite the recognition of bariatric surgery as the only effective method of weight reduction, we remain in search of minimally invasive methods, both for the treatment of obesity and preparation of patients for surgical procedures. The aim of the study was to determine intragastric balloon (Allergan) implantation results as the only method of treating obesity, and patient preparation for further stages of abdominal hernia operations, as well as other surgical procedures. MATERIAL AND METHODS: The study presented own results considering the use of Bioenteric Intragastric Balloons (BIB system) in the treatment of pathological obesity, and preparation of patients for bariatric surgery and abdominal hernia operations. The study group comprised 18 female and 7 male patients. Average patient age amounted to 50.6 and 54 years, respectively. Indications for intragastric balloon insertion were as follows: preparation for hernia (10 cases) and bariatric (5 patients) operations, and weight reduction management (8 patients). In two cases the implantation of the intragastric balloon served the preparation for gynecological and orthopedic (vertebral column) operations. One female patient was prepared for both bariatric and hernial surgery. The procedure was performed under general anesthesia. Statistical analysis considered 22 patients (one female patient was excluded from analysis, due to death, two other were excluded because of lack of sufficient data).Results. In case of two patients the intragastric balloon system was removed before 6 months had elapsed because of intolerance. One female patient died during the observation period for reasons not related to the procedure. The obtained BMI reduction ranged between 2 and 6 kg/m2, which amounted to a maximum weight loss of 24 kg. In one patient a weight gain of 2 kg was observed. Considering patients prepared for abdominal hernia operations weight reduction was greater and better maintained after the removal of the BIB system. CONCLUSIONS: According to the authors of the presented study the intragastric balloon serves its role as a bridge to bariatric procedures and weight reduction, before planned extensive postoperative hernia operations. The use of the intragastric balloon only to reduce weight has no medical and economic justification.

[The results of screening program for cervical cancer in Lodz]. / Wyniki badania przesiewowego dla wczesnego wykrywania raka szyjki macicy u kobiet w regionie lódzkim.

OBJECTIVES: Despite effective screening methods, most often tumor of the urogenital tract is still cancer of the uterine cervix. Proven in many countries the value of widespread screening of the precancerous lesions and cervical cancer justifies carrying out such prophylactic tests in Poland. DESIGN: Assessment of results of screening as a method of early detection of cancer of the uterine cervix among inhabitants of Lódz area. MATERIAL AND METHODS: Study was done between 1.07.2000 and 31.12.2000 among 5,000 women aged from 30 to 59 years, inhabitants of Lódz area. Smears were evaluated in five-grade Papanicolaou scale and according to TBS system. In cases of detection of erosion of the uterine cervix or abnormal results of cytological test (> or = III degree) biopsies were taken to make pathological diagnosis. RESULTS: 459 smears were qualified to group I according to Papanicolaou (9.18%), 4435 smears to group II (88.7%), 38 smears to II/III (0.76%), 65 smears to group III (1.3%), 2 smears to IV (0.04%) and 1 smear to V (0.02%). Due to histopathological verification of the cytological results 53 low grade cervical dysplasia (1.06%) were diagnosed, 8 dysplasia of medium grade (0.16%), 7 high grade dysplasia (0.14%), 3 pre-invasive cancers (0.06%) and 3 invasive cancers (0.06%). CONCLUSIONS: Population of inhabitants of Lódz area aged 30 to 59 years old is characterised by a high frequency of incidence of pre-cancerous conditions and invasive cervical cancer. Number of detected pathologies of the uterine cervix proves purposefulness of this project.