Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons. Bariatric and metabolic surgery care standards.

The Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons (Polish acronym: SCMiB TCHP) is a Polish specialist scientific society representing bariatric surgeons as well as specialists from other disciplines and professions cooperating with them during the provision of services in the field of bariatric and metabolic surgery, as well as the entire care process before and after surgery. The following standards constitute the minimum requirements set by the SCMiB TCHP for good practice of the basic process of bariatric care throughout its entire period, which ensure satisfactory safety and effectiveness of the obesity treatment and its metabolic complications.

Challenges associated with bariatric surgery - a multi-center report.

Introduction: Due to the constantly growing demand for surgical treatment of obesity, it is necessary to create new bariatric centers and further improve presently active ones.

Aim: To identify which stages of conducting peri-operative care and organizing a modern bariatric center currently pose the greatest challenge.

Material And Methods: An anonymous survey was designed and distributed to bariatric surgeons.

Present trends in bariatric surgery in Poland.

Introduction: As obesity has become a major health problem in Poland and bariatric procedures are the best way of treatment, an increasing trend has been observed in Polish bariatric surgery for the last decade.

Aim: Our purpose was to provide an updated overview of the bariatric surgical procedures performed in Polish institutions in comparison to the situation in Europe as well as to analyze the trends in Polish bariatric surgery over the last decades.

Material And Methods: A questionnaire about the number and type of bariatric procedures performed in 2016 was sent to all Polish surgical departments.

Case-Control Study of Postoperative Blood Pressure in Patients with Hemorrhagic Complications after Laparoscopic Sleeve Gastrectomy and Matched Controls.

Introduction: Laparoscopic sleeve gastrectomy is associated with a moderate risk of hemorrhagic complications (HC). There is a debate regarding the relationship between HC and high blood pressure in postoperative period.

Aim: The aim is to clarify whether the postoperative blood pressure is an independent risk factor for hemorrhagic complications after laparoscopic sleeve gastrectomy.

Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study.

Introduction: The goal of modern medical treatment is to provide high quality medical care in a cost-effective environment.

Aim: To assess the cost-effectiveness of laparoscopic colorectal surgery combined with the enhanced recovery after surgery protocol (ERP) in Poland.

Material And Methods: We designed a single-centre, case-matched study.

Reduction of the risk of rhabdomyolysis after bariatric surgery with lower fluid administration in the perioperative period: a cohort study.

INTRODUCTION    Obesity is a growing worldwide problem. One of the most effective treatments is a bariatric procedure; however, surgery is associated with the risk of complications, such as staple line leakage, suture line bleeding, and rhabdomyolysis (RML). OBJECTIVES    The objective of our study was to assess the risk of RML after bariatric surgery related to intravenous fluid administration in the perioperative period.

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors.

Background: Laparoscopic adrenalectomy is the gold standard for treatment of benign adrenal lesions. Tumor size is a factor that might influence decision-making concerning the use of laparoscopic approach. The aim of this study was to analyze the results of adrenalectomy for tumors ≥6 cm in diameter.

Is ERAS in laparoscopic surgery for colorectal cancer changing risk factors for delayed recovery?

There is evidence that implementation of enhanced recovery after surgery (ERAS) protocols into colorectal surgery reduces complication rate and improves postoperative recovery. However, most published papers on ERAS outcomes and length of stay in hospital (LOS) include patients undergoing open resections. The aim of this pilot study was to determine the factors affecting recovery and LOS in patients after laparoscopic colorectal surgery for cancer combined with ERAS protocol.

Elective Laparoscopic Cholecystectomy--Is It Safe In The Hands Of Residents During Training?

Unlabelled: The aim of the study was to assess safety of elective laparoscopic cholecystectomy (LC) performed by residents that are undergoing training in general surgery.

Material And Methods: A retrospective analysis was conducted on 330 patients operated electively due to cholelithiasis. Patients with acute cholecystitis, choledocholithiasis, undergoing cholecystectomy as a part of more extensive operation and patients with gall-bladder cancer were excluded.

Bipolar spectrum features in obese individuals.

Unlabelled: AIM : The relationships between obesity and bipolar spectrum disorders (BSD) are unclear. Thus, the aim of our study were to approximate the prevalence of soft bipolar features in patients seeking treatment for obesity.

Methods: We performed a nested case-control study (cases: 90 patients with the mean BMI=38.

Laparoscopic adrenalectomy for pheochromocytoma is more difficult compared to other adrenal tumors.

Introduction: Laparoscopic adrenalectomy is the gold standard for the treatment of benign adrenal tumors. However, some authors raise the problem of differences in surgery for pheochromocytoma in comparison to other lesions.

Aim: To compare laparoscopic adrenalectomy for pheochromocytoma and for other tumors.

Changes in levels of selected incretins and appetite-controlling hormones following surgical treatment for morbid obesity.

Introduction: The hormonal brain-gut axis is a crucial element in appetite control and the response to surgical treatment for super obesity. However, mechanisms underlying the metabolic response to surgical treatment for morbid obesity are still not clearly specified.

Aim: To evaluate and compare the effects of surgical treatment for super obesity by laparoscopic sleeve gastrectomy (LSG) and by laparoscopic Roux-en-Y gastric bypass (LRYGB) on selected incretins and appetite-controlling hormones.

Changing patterns in the surgical treatment of perforated duodenal ulcer - single centre experience.

Introduction: Although the surgical treatment of patients with perforated duodenal ulcer is the method of choice, the introduction of effective pharmacotherapy has changed the surgical strategy. Nowadays less extensive procedures are chosen more frequently. The introduction of laparoscopic procedures had a significant impact on treatment results.

Enhanced Recovery After Surgery (ERAS®) protocol in patients undergoing laparoscopic resection for stage IV colorectal cancer.

Background: There is strong evidence for the use of Enhanced Recovery After Surgery (ERAS) protocol with colorectal surgery. However, in most studies on ERAS, patients with stage IV colorectal cancer (CRC) are commonly excluded. It is not certain if the ERAS protocol combined with laparoscopy improves outcomes in this group of patients as well.

Randomized Clinical Trial To Compare The Effects Of Preoperative Oral Carbohydrate Loading Versus Placebo On Insulin Resistance And Cortisol Level After Laparoscopic Cholecystectomy.

Unlabelled: Postoperative insulin resistance, used as a marker of stress response, is clearly an adverse event. It may induce postoperative hyperglycemia, which according to some authors can increase the risk of postoperative complications. One of the elements of modern perioperative care is preoperative administration of oral carbohydrate loading (CHO-loading), which shortens preoperative fasting and reduces insulin resistance.

Comparison of efficacy and safety of first-line palliative chemotherapy with EOX and mDCF regimens in patients with locally advanced inoperable or metastatic HER2-negative gastric or gastroesophageal junction adenocarcinoma: a randomized phase 3 trial.

The aim of the study was to compare efficacy and safety of first-line palliative chemotherapy with (EOX) epirubicin/oxaliplatin/capecitabine and (mDCF) docetaxel/cisplatin/5FU/leucovorin regimens for untreated advanced HER2-negative gastric or gastroesophageal junction adenocarcinoma. Fifty-six patients were randomly assigned to mDCF (docetaxel 40 mg/m(2) day 1, leucovorin 400 mg/m(2) day 1, 5FU 400 mg/m(2) bolus day 1, 5FU 1000 mg/m(2)/d days 1 and 2, cisplatin 40 mg/m(2) day 3) or EOX (epirubicin 50 mg/m(2) day 1, oxaliplatin 130 mg/m(2) day 1, capecitabine 1250 mg/m(2)/d days 1-21). The primary endpoint was overall survival.

Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours.

Background: Laparoscopic adrenalectomy is still controversial in cases where malignancy is suspected. However, many proponents of this technique argue that in the hands of an experienced surgeon, laparoscopy can be safely performed. The aim of this study is to present our own experience with the application of laparoscopic surgery for the treatment of malignant and potentially malignant adrenal tumours.

Preoperative pancreatic duct stenting in patients undergoing laparoscopic pancreatic surgery – a preliminary report.

Unlabelled: Laparoscopic surgery is becoming an approved technique in pancreatic surgery. It offers some advantages over an open approach due to shorter hospital stay and decreased complication rate. Regardless the technique the most significant problem of pancreatic surgery is postoperative pancreatic fistula.

The usefulness of the Mannheim Peritonitis Index score in assessing the condition of patients treated for peritonitis.

Unlabelled: The aim of the study was to verify the Mannheim Peritonitis Index (MPI) suitability to determine the probability of death among patients in Polish population operated due to peritonitis and to assess the possibility of using the Index to determine the risk of postoperative complications, relaparotomy and need for postoperative hospitalization in intensive care unit.

Material And Methods: Retrospective analysis covered 168 patients (M: F = 83: 85, mean age = 48.45 years, SD ± 22.

Laparoscopic removal of gastrointestinal stromal tumors of uncinate process of pancreas.

The pancreas is an extremely rare location for gastrointestinal stromal tumors (GIST). We present a case of a patient with a GIST located in the uncinate process of the pancreas that was treated successfully with a laparoscopic technique. Computed tomography, magnetic resonance imaging and scintigraphy suggested a neuroendocrine tumor.

Modification of internal hernia classification system after laparoscopic Roux-en-Y bariatric surgery.

Introduction: The occurrence of internal hernia is not an uncommon late complication following the laparoscopic bariatric Roux-en-Y gastric bypass procedure. In some instances, it can be life threatening if not treated in a timely manner. Although there are numerous publications in the literature addressing internal hernia, they are mostly retrospective, and focus mainly on describing the different reconstructive orientation as far as the bowel is concerned.

Early implementation of Enhanced Recovery After Surgery (ERAS®) protocol - Compliance improves outcomes: A prospective cohort study.

Enhanced Recovery After Surgery protocol in colorectal surgery allows shortening length of hospital stay and reducing complication rate. Despite the clear guidelines and conclusive evidence their full implementation and putting them into daily practice meets certain difficulties, especially in the early stage. The aim of the study was to analyse the course of implementation of the ERAS protocol into daily practice on the basis of adherence to the protocol.

Endoscopic Insertion Of A Self-Expandable Stent Combined With Laparoscopic Rinsing Of Peritoneal Cavity As A Method For Staple Line Leaks Treatment In Patients Post Laparoscopic Sleeve Gastrectomy.

Unlabelled: Currently, laparoscopic sleeve gastrectomy is one of bariatric surgeries most commonly performed in the world. The most frequent complications of surgeries of this type, with the highest mortality rate, include bleeding into the GI tract and peritoneal cavity, and sleeve staple line leaks. These severe complications prolong the hospital stay, and often are a cause of patient's death.

Single center outcomes of laparoscopic transperitoneal lateral adrenalectomy--Lessons learned after 500 cases: A retrospective cohort study.

Introduction: Although laparoscopic adrenalectomy is considered relatively safe, the results of treatment vary depending on the profile of the hospital. We would like to present our experience with laparoscopic surgery of the adrenals.

Methods: We conducted a retrospective cohort study of consecutive patients operated for adrenal tumours in the years 2003-2014.

Enhanced recovery after colorectal surgery in elderly patients.

Introduction: The elderly will soon constitute 20% of the population. Their number is constantly rising, particularly in developed countries. It was found that they particularly benefit from the use of minimally invasive surgery.