From adjustable gastric banding to Roux-en-Y gastric bypass - case report.

Introduction: Adjustable gastric banding (AGB) used to be a popular bariatric procedure. However, it fails in more than half of those operated on in the long term, becomes ineffective and must be removed. Therefore, the use of AGB has been in decline globally.

Sleeve gastrectomy - still popular bariatric method.

Introduction: Obesity is currently the most common multifactorial disease affecting almost all social strata of the population. Conservative therapy of obesity usually succeeds in reducing excess weight by an average of 10-15%. After surgical treatment of severe obesity (bariatric surgery), the average decrease in excess weight is several times greater and, in most cases, has a long-term positive effect on the overall clinical condition of the patients.

Ten years of laparoscopic sleeve gastrectomy at the Military University Hospital in Prague.

Introduction: The aim of this study was to evaluate a group of bariatric patients operated at the Military University Hospital in Prague during the last 10 years (20112020), in whom laparoscopic sleeve gastrectomy was performed.

Methods: Retrospective survey of the internal operation database. The search used the following combination of keywords: “sleeve“, “LSG“ and the diagnosis “E6*“.

[Bariatry - surgical therapy of the severe obesity].

When conservative therapy of the morbid obesity repeatedly fails bariatric surgery begins. Adults patients from 18 to 60 age with obesity 3rd grade (BMI > 40 kg/m2 ), respectively 2nd grade (BMI > 35 kg/m2 ), with symptomatic diseases caused by obesity as type 2 diabetes, hypertension, dyslipidaemia or heavy failure of the joints, in which conservative therapy failed, are indicate for bariatric surgery. Nearly all of the bariatric procedures are providing by laparoscopy at present.

SADIS Single anastomosis duodeno-ileal bypass with sleeve gastrectomy as a second step after sleeve gastrectomy.

Introduction: Sleeve gastrectomy (SG) is the most popular bariatric method at present. In case of unsatisfactory effect of the SG, i.e.

An alternatively activated macrophage marker CD163 in severely obese patients: the influence of very low-calorie diet and bariatric surgery.

CD163 is a marker of macrophages with anti-inflammatory properties and its soluble form (sCD163) is considered a prognostic predictor of several diseases including type 2 diabetes mellitus (T2DM). We explored sCD163 levels at baseline and after very low-calorie diet (VLCD) or bariatric surgery in 32 patients with obesity (20 undergoing VLCD and 12 bariatric surgery), 32 obese patients with T2DM (22 undergoing VLCD and 10 bariatric surgery), and 19 control subjects. We also assessed the changes of CD163 positive cells of monocyte-macrophage lineage in peripheral blood and subcutaneous adipose tissue (SAT) in subset of patients.

[10 years of sleeve gastrectomy in the Czech Republic in terms of the surgical procedure].

Introduction: Sleeve gastrectomy (SG) as a single bariatric/metabolic procedure has been performed since 2003 in the world, and since 2006 in the Czech Republic. We report 10 years experience with SG in the Czech Republic from 2006 to 2015.

Method: Prospectively collected data from 14 surgical departments was evaluated retrospectively using descriptive statistics for every year from 2006 to 2015 and subsequently evaluated and compared for the entire period.

Plasma concentrations and subcutaneous adipose tissue mRNA expression of clusterin in obesity and type 2 diabetes mellitus: the effect of short-term hyperinsulinemia, very-low-calorie diet and bariatric surgery.

Clusterin is a heterodimeric glycoprotein with wide range of functions. To further explore its possible regulatory role in energy homeostasis and in adipose tissue, we measured plasma clusterin and its mRNA expression in subcutaneous adipose tissue (SCAT) of 15 healthy lean women, 15 obese women (OB) and 15 obese women with type 2 diabetes mellitus (T2DM) who underwent a 2-week very low-calorie diet (VLCD), 10 obese women without T2DM who underwent laparoscopic sleeve gastrectomy (LSG) and 8 patients with T2DM, 8 patients with impaired glucose tolerance (IGT) and 8 normoglycemic patients who underwent hyperinsulinemic euglycemic clamp (HEC). VLCD decreased plasma clusterin in OB but not in T2DM patients while LSG and HEC had no effect.

[Urgent surgical treatment of gastric volvulus related to upside-down stomach syndrome].

Upside-down stomach syndrome is a rare type of a large paraoesophageal hiatal hernia, which requires an immediate surgical treatment in case of incarceration. The authors present a case report of a 53-year-old male patient with gastric volvulus related to the upside-down stomach syndrome. Surgical treatment was complicated by an injury to distal oesophagus, which was successfully treated using a self-expandable metallic stent among other methods.

[Surgery of the hiatal hernia and gastroesophageal reflux dinase, Nissen or Toupet?].

Introduction: In 2016 60 years will have elapsed from the first publication by Nissen about his surgical method of 360° fundoplication around distal esophagus and its final effect. Nissens fundoplication is currently the most common surgical method for the gastroesophageal reflux (GER) and hiatal hernia (HH) probably. Incidence of HH ranges between 25-50% in the western population.

Laparoscopic sleeve gastrectomy without over-sewing of the staple line is effective and safe.

Introduction: Laparoscopic sleeve gastrectomy (LSG) is a bariatric procedure with very good long-term weight-reducing and metabolic effects.

Aim: Here we report 6 years' experience with LSG performed in morbidly obese patients by one surgical team focusing on the impact of the degree of sleeve restriction and safety of the procedure without over-sewing the staple line.

Material And Methods: From 2006 to 2012, 207 morbid obese patients with average age of 43.

Serum concentrations and subcutaneous adipose tissue mRNA expression of omentin in morbid obesity and type 2 diabetes mellitus: the effect of very-low-calorie diet, physical activity and laparoscopic sleeve gastrectomy.

Omentin is a novel adipokine with insulin-sensitizing effects expressed predominantly in visceral fat. We investigated serum omentin levels and its mRNA expression in subcutaneous adipose tissue (SCAT) of 11 women with type 2 diabetes mellitus (T2DM), 37 obese non-diabetic women (OB) and 26 healthy lean women (C) before and after various weight loss interventions: 2-week very-low-calorie diet (VLCD), 3-month regular exercise and laparoscopic sleeve gastrectomy (LSG). At baseline, both T2DM and OB groups had decreased serum omentin concentrations compared with C group while omentin mRNA expression in SCAT did not significantly differ among the groups.

Laparoscopic sleeve gastrectomy ameliorates mRNA expression of inflammation-related genes in subcutaneous adipose tissue but not in peripheral monocytes of obese patients.

Low-grade inflammation links obesity, insulin resistance, and cardiovascular diseases. We investigated the effects of laparoscopic sleeve gastrectomy (LSG) on expression profile of genes involved in inflammatory pathways in subcutaneous adipose tissue (SCAT) and peripheral monocytes (PM). At baseline, obese group had significantly increased mRNA expression of proinflammatory chemokines (CCL-3, -17, -22), chemokine receptor CCR1 and cytokines (IL-10, IL-18) in SCAT and chemokine and other proinflammatory receptors (CCR-1, -2, -3, TLR-2, -4) in PM relative to control group.

Laparoscopic sleeve gastrectomy differentially affects serum concentrations of FGF-19 and FGF-21 in morbidly obese subjects.

Objective: Fibroblast growth factor (FGF)-19 and FGF-21 are novel metabolic regulators that improve insulin resistance and obesity in rodents. The aim of the study was to assess the effects of laparoscopic sleeve gastrectomy (LSG) on serum concentrations of FGF-19 and FGF-21 along with circulating bile acids and other relevant hormonal and biochemical parameters.

Design And Methods: Seventeen females with obesity undergoing LSG and 15 lean healthy females were included into the study.

Radical resection of the pyloric antrum and its effect on gastric emptying after sleeve gastrectomy.

Background: The surgical technique of laparoscopic sleeve gastrectomy (LSG) has not been fully standardized yet and there is the unresolved question of what is the optimum size of retained pyloric antrum. The aim of our research was to prove that even after a radical resection of the pyloric antrum the physiological stomach evacuation function can still be preserved.

Methods: Our study was based on 12 patients, who were randomly divided into two groups.

[Contemporary overview of the bariatric-metabolic surgery].

Introduction: The increasing prevalence of obesity and type 2 diabetes mellitus (T2DM) worldwide may nowadays be regarded as a "twin" metabolic pandemic, causing the number of patients with the metabolic syndrome (MS) to rise rapidly. MS is a combination of several interrelated medical disorders such as obesity, T2DM, hypertension, dyslipidaemia etc. These conditions very frequently result in atherosclerosis, ischaemic heart disease, liver steatosis or even steatofibrosis.

Discrepant results of adrenal venous sampling in seven patients with primary aldosteronism.

Background: Adrenal venous sampling serves as a discrimination between uni- and bilateral forms of primary aldosteronism (PA). Even correctly performed adrenal venous sampling may lead to non-diagnostic results in some cases.

Results: We describe 7 subjects with PA in whom correct cannulation of adrenal veins (high selectivity index defined as cortisol((adrenal))/cortisol((periphery)) ratio) was associated with aldosterone (ALDO) suppression (ALDO/cortisol((adrenal))/ALDO/cortisol((periphery)) ratio <1) in the left adrenal gland and in whom all subjects underwent a successful adrenalectomy on the right side.

[Czech bariatry in 2010].

Introduction: It is only during the past two decades, when obesity has become to be considered a pandemic disorder. However, in 1953 Varco performed jejunoileal bypass as the world's first bariatric surgical procedure. 30 years later, Pesková performed the first bariatric surgery--a gastroplasty--in Czechoslovakia.

Factors influencing arterial stiffness in pheochromocytoma and effect of adrenalectomy.

The aim of the study was to evaluate arterial stiffness and its modulating factors measured by carotid-femoral pulse wave velocity (PWV) and central augmentation index (AI) in patients with pheochromocytoma (PHEO) before and after surgery. Forty-five patients with PHEO and 45 healthy controls were investigated using an applanation tonometer (SphygmoCor, AtCor Medical). The gender, age, BMI and lipid profiles were comparable among both groups.

[120 laparoscopic adrenalectomies with a harmonic scalpel].

Background: Presently the laparoscopic adrenalectomy (LA) becomes most popular since 1992 when it was performed for the first time by laparoscopic method by Gagner. Typical indication for LA is the aldosteron-secreting adenoma, Cushing's syndrome, feochromocytoma or scarcity tumors such as adrenal cyst or myelolipomas.

Aim: The evaluation of the laparoscopic adrenalectomy as safe method for adrenals tumout's extirpation to the sizes 10 cm.

Life-threatening arrhythmia caused by primary aldosteronism.

Background: Arrhythmias are one of the typical complications of primary aldosteronism (PA), is commonly characterized by hypertension and hypokalemia.

Case Report: In this report, we present 3 cases of subjects in whom primary aldosteronism manifested with life-threatening arrhythmias. In 2 subjects, after excluding organic heart disease, an implantable cardioverter defibrillator was inserted and, only after the second episode of polymorphic ventricular tachycardia accompanied with low plasma potassium levels, the diagnosis of primary aldosteronism was made.

[Pheochromocytoma: diagnosis and treatment].

Pheochromocytoma (pheo) is adrenal or less frequently extraadrenal tumour of chromafine tissue. Pheos are rare, but cardiovascular and metabolic abnormalities are common. Unrecognised pheo may lead to fatal hypertensive crisis during anesthesia or other stresses.

Serum concentrations and tissue expression of a novel endocrine regulator fibroblast growth factor-21 in patients with type 2 diabetes and obesity.

Objective: Fibroblast growth factor-21 (FGF21) is a novel endocrine and paracrine regulator of metabolic homeostasis. The aim of our study was to measure its serum concentrations in patients with obesity, obesity and type 2 diabetes mellitus (T2DM) and healthy subjects (C), and to assess the changes of its circulating levels and mRNA expression after dietary and pharmacological interventions.

Design: We measured biochemical parameters, serum FGF21, adiponectin, leptin and insulin levels by commercial ELISA and RIA kits, and mRNA expression in the liver, subcutaneous and visceral fat by RT PCR in 26 obese patients, 11 T2DM patients and 32 control subjects.

Increased serum concentrations of macrophage inhibitory cytokine-1 in patients with obesity and type 2 diabetes mellitus: the influence of very low calorie diet.

Objective: Macrophage inhibitory cytokine-1 (MIC-1) is a novel regulator of energy homeostasis. We explored whether alterations in MIC-1 levels contribute to metabolic disturbances in patients with obesity and/or obesity and type 2 diabetes mellitus (T2DM).

Design: We measured serum MIC-1 levels and its mRNA expression in subcutaneous and visceral adipose tissue of 17 obese nondiabetic women, 14 obese women with T2DM and 23 healthy lean women.