Introduction: Bariatric surgery, as the only effective treatment of obesity, has strong effects on the metabolism, and nervous and endocrine systems. Thus, based on the different opinions about the efficaciousness of morbid obesity treatments, the aim of the present study was to estimate the association of serum ghrelin and Met-enkephalin (native, five amino acids and cryptic, precursor of enkephalin) concentrations with body mass index (BMI) value in bariatric patients within 30 postoperative days. Material and methods: The study was performed on 38 female patients divided into two groups: I -BMI lower than 40 kg/m 2 (n = 18) and II -BMI higher than 40 kg/m 2 (n = 20). Blood was taken before (-24 h), and 72 h and 30 days after the sleeve gastrectomy. Routine haematological, anthropometric, and metabolic parameters as well as thyroid-stimulating hormone (TSH), ghrelin, and Met-enkephalin values were measured in all patients. Results: There were statistically significant differences between the two groups before the surgery in terms of TSH, both forms of Metenkephalin, triglycerides concentrations, and activity of alanine transaminase (ALT), gamma-glutamyltransferase (GGTP), and C-reactive protein (CRP). After 72 h, the serum levels of cryptic Met-enkephalin and CRP, and activity of enzymes varied between the two groups of patients. Thirty days after the surgery, some metabolic and immune parameters were still different in both female groups in favour of patients with lover BMI. However, significant differences were noticed in the levels of ghrelin (increase), and native (decrease) and cryptic Met-enkephalins (increase). Conclusions: The activity of endogenous peptides in bariatric patients is connected with the degree of obesity. Ghrelin level increases are negatively correlated with native Met-enkephalin changes shortly after bariatric surgery. The interplay of ghrelin and opioids might be considered as a predictor of postoperative weight loss success. (Endokrynol Pol 2020; 71 (1): 27-33) 28 ORIGINAL PAPER Opioids and ghrelin affect bariatrics Michał Dyaczyński et al.
Introduction. The study compared the effects of surgical treatment of grade III and IV haemorrhoids achieved with a conventional operative technique and by using a thermal tissue fusion instrument based on offset electrode technology. A total of 60 patients with grade III and IV haemorrhoids were operated on in the Department of General and Oncologic Surgery, Municipal Hospital in Siemianowice Śląskie, and in the On-Clinic Medical Centre in Chorzów, between October 2011 and September 2015. Aim. The aim of the study was to compare the outcomes of treatment of haemorrhoidal disease using KLS Martin maXium marClamp® CUT IQ thermal tissue fusion instrument based on offset electrode technology and the Milligan-Morgan surgical procedure with bipolar coagulation for the excision of grade III and IV haemorrhoids. Material and methods. The patients were divided into two groups: Group 1 – patients operated on using KLS Martin maXium marClamp® CUT IQ thermal tissue fusion instrument based on offset electrode technology. Group 2 – patients operated on using the conventional Milligan-Morgan technique with electrocoagulation. The evaluated parameters included the length of hospital stay after surgery, duration of the surgical procedure, level of pain on the postoperative days 1 and 2 rated on a 10-point VAS scale, and postoperative wound healing time. Results. A reduction in postoperative pain, shorter procedure duration and hospital stay, and more rapid postoperative wound healing were observed in Group 1 compared to Group 2. Conclusions. In our study material, the application of a thermal tissue fusion instrument using offset electrode technology in surgeries to remove grade III and IV haemorrhoids, compared to the conventional Milligan-Morgan procedure with electrocoagulation, brought the following results: – less postoperative pain, – shorter duration of surgical procedure, – reduced length of hospital stay, – faster healing of postoperative wound.
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