ABSTRACT
Authors report a case of mesenteric fibromatosis, not associated to familial adenomatous polyposis or Gardner's syndrome. It is generally considered benign lesion without metastases, though local recurrences are very frequent. No symptoms are usually referred until compression of the surrounding organs, due to the mass growing, takes place. Surgical therapy is considered treatment of choice.
Subject(s)
Fibroma , Mesentery , Female , Fibroma/diagnosis , Fibroma/surgery , Humans , Middle Aged , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/surgeryABSTRACT
BACKGROUND: The Bariatric Analysis and Reporting Outcome System (BAROS) has been recently introduced to assess the modifications of weight, comorbidities and quality of life (QOL) after bariatric surgery, in order to achieve a standard for comparison in the treatment of obesity. This study reports the Authors' experience, analyzing with BAROS a consecutive series of morbidly obese patients. METHODS: From November 1998 to February 2001, 30 patients with morbid obesity underwent biliopancreatic diversion (BPD) in our Department. Patients were followed-up after 1, 3, 6, 9, 12 months and than yearly. Modifications of the Body Mass Index (BMI), percentage of the initial excess weight loss (IEW%L), comorbidities and type and incidence of complications were measured. The course and QOL were assessed using BAROS after a minimum follow-up of 18 months, or in absence of IEW%L modification at two consecutive scheduled visits. RESULTS: According to the BAROS, the outcome was classified as Excellent in 10% of cases, Very Good in 63.3%, Good in 20%, Fair in 6.7%; no patients had Failure course. Ninety-three percent of patients had resolution of at least one of their major comorbidities, and an improvement of the medical conditions was registered in all the cases. The QOL was greatly improved in 55%, improved in 35% and did not change in 10% of the patients. CONCLUSION: BPD provides effective weight loss, improvement or resolution of major co-morbidities and increases the QOL of morbidly obese patients. BAROS is an useful tool to assess the outcome after bariatric surgery.
Subject(s)
Bariatrics , Biliopancreatic Diversion , Obesity, Morbid/surgery , Adult , Body Mass Index , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Quality of Life , Time Factors , Treatment Outcome , Weight LossABSTRACT
We present our experience in malabsorbitive procedure in bariatric surgery based on Biliopancreatic Diversion (BPD) with transitory gastroplasty. Since 1995 we operated on 74 patients with BPD coupled with gastroplasty which is transitory due to the presence of a band in polidioxanone (PDS). The technique, proposed by Vassallo et al. in 1992, involve the respect of the duodenal bulb (5 centimeter from the pylorous) making an end-to-side duodeno-ileal isoperistaltic anastomosis. The initial excess weight loss was satisfactory (69.8% +/- 11.4% after 1 year) and it kept being stable during all the follow-up (75.2% +/- 6.4% after 5 years). The mortality was absence. We didn't observe ipoalbuminemia, diarrhea or halitosis in any patients. Only 1 patient (1.3%) developed an anastomotic ulcer. After 5 years follow-up we observed 2 cases (12.5%) of chronic hypochromic anemia and 1 case (6.2%) of hypocalcemia. We didn't perform any restorative operation. We consider this technique a good malabsortive procedure able to obtain a satisfactory and stable weight loss, with a low incidence of complications. Moreover it could be applied in patients previously treated by an ineffective gastroplasty.