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Borycka-Kiciak K.,Oncological and Gastrointestinal Surgery
Journal of physiology and pharmacology : an official journal of the Polish Physiological Society | Year: 2013

It is said that leaving intact the functional motor unit of the pylorus leads to better gastric emptying and reduces postoperative upper gut motility disturbances. However, despite obvious different surgical approach, both major pancreatoduodenectomies lead to substantial myoelectrical dysfunctions. The latter are not efficiently recognized. We compared Whipple and Longmire-Traverso procedures in terms of electromyography patterns of the upper jejunum musculature and the density of Cajal cells network. Twelve male weaned pigs underwent surgery first to implant bipolar electrodes and telemetry transmitters for continuous electromyography recordings and then, after 1 week recovery, to create Whipple (n=6) and Longmire-Traverso (n=6) pancreatoduodenectomies. The first myoelectric activity was already registered 1-2 hours after both operations. Time to first regular patterns of migrating myoelectrical complex activity was significantly longer in the Whipple than in the Longmire-Traverso group (68.2±12.9 versus 27.8±51 hours, p=0.002). However, the restored patterns were substantially disturbed in both groups. Namely, after Longmire-Traverso operation, migrating myoelectrical complex cycles were very often and significantly shorter versus control ones, with reverse migration in the area of anastomosis while after Whipple procedure migrating myoelectrical complex cycles were less frequent and of short duration, significantly shorter in comparison even with Longmire-Traverso group. Cajal cells network in the vicinity of anastomosis, and distally from it, presented greater destruction after the Whipple operation. In conclusion, the advantage of one of two major pancreatoduodenectomies in terms of myoelectrical activity correctness in upper gut has not been proved in the study. Source


Borycka-Kiciak K.,Oncological and Gastrointestinal Surgery | Kiciak A.,Oncological and Gastrointestinal Surgery | Zabielski R.,Warsaw University of Life Sciences | Romanowicz-Barcikowska K.,Polish Academy of Sciences | And 2 more authors.
Journal of Physiology and Pharmacology | Year: 2013

It is said that leaving intact the functional motor unit of the pylorus leads to better gastric emptying and reduces postoperative upper gut motility disturbances. However, despite obvious different surgical approach, both major pancreatoduodenectomies lead to substantial myoelectrical dysfunctions. The latter are not efficiently recognized. We compared Whipple and Longmire-Traverso procedures in terms of electromyography patterns of the upper jejunum musculature and the density of Cajal cells network. Twelve male weaned pigs underwent surgery first to implant bipolar electrodes and telemetry transmitters for continuous electromyography recordings and then, after 1 week recovery, to create Whipple (n=6) and Longmire-Traverso (n=6) pancreatoduodenectomies. The first myoelectric activity was already registered 1-2 hours after both operations. Time to first regular patterns of migrating myoelectrical complex activity was significantly longer in the Whipple than in the Longmire-Traverso group (68.2±12.9 versus 27.8±51 hours, p=0.002). However, the restored patterns were substantially disturbed in both groups. Namely, after Longmire-Traverso operation, migrating myoelectrical complex cycles were very often and significantly shorter versus control ones, with reverse migration in the area of anastomosis while after Whipple procedure migrating myoelectrical complex cycles were less frequent and of short duration, significantly shorter in comparison even with Longmire-Traverso group. Cajal cells network in the vicinity of anastomosis, and distally from it, presented greater destruction after the Whipple operation. In conclusion, the advantage of one of two major pancreatoduodenectomies in terms of myoelectrical activity correctness in upper gut has not been proved in the study. Source


Dib N.,Oncological and Gastrointestinal Surgery | Kiciak A.,Oncological and Gastrointestinal Surgery | Pietrzak P.,Warsaw University of Life Sciences | Ferenc K.,Warsaw University of Life Sciences | And 4 more authors.
Journal of Physiology and Pharmacology | Year: 2013

Bariatric surgery consists in duodenal exclusion from the food passage in obese patients with coexistent type 2 diabetes. Nowadays bariatric surgery is considered the most effective method of glycemic index normalization and insulin resistance reduction. Recent results on obese and non-obese rats showed remission of type 2 diabetes symptoms within few days after the surgery. The aim of the present work was to analyze the mechanisms of neuro-hormonal regulation responsible for early normalization of metabolic syndrome after bariatric surgery. In present study the concentration of selected intestinal hormones and adipokines in blood plasma and gastrointestinal tissues were analyzed. Study was conducted on Wistar rats. Animals were divided into three groups (each n=6): control (SH) shame-operated rats; animals in which visceral fat tissue was extracted (LP); and rats in which Scopinaro bariatric surgery was performed (BPD). Immunochemistry analysis of blood plasma showed decrease of insulin concentration in BPD and LP and increase of polypeptide YY (PYY) in BPD group as compared to the control. In duodenal mucosa homogenates the tendency to reduce insulin in LP and BPD group, and increase PYY and visfatin in BPD group was observed. Histometry analysis showed reduction of mucosa thickness in excluded segments of gastrointestinal tract in BPD group as compared to the SH and L P. Concluding, model studies on rats allowed better understanding of mechanisms important for early normalization of glycemic index and insulin resistance reduction in rats. Source


Borycka-Kiciak K.,Oncological and Gastrointestinal Surgery | Dib N.,Oncological and Gastrointestinal Surgery | Janaszek L.,Oncological and Gastrointestinal Surgery | Soltysiak L.,Oncological and Gastrointestinal Surgery | And 2 more authors.
Polski Przeglad Chirurgiczny/ Polish Journal of Surgery | Year: 2013

Despite increasing number of reports indicating good treatment outcomes, laparoscopic treatment of Crohn's disease remains controversial. The aim of the study was to compare outcomes of laparoscopically assisted and open ileo-colonic resection in patients with active Crohn's disease. Material and methods. 82 patients who underwent surgical treatment (44 laparoscopic and 38 open procedures) at the Department of General, Oncological and Gastrointestinal Surgery in Warsaw were enrolled to the study. The following perioperative parameters were compared in both these groups: Duration of hospitalization and presence of postoperative complications in at least 12 months of follow-up. Results. The conversion rate in the laparoscopy group was 29.5%. There were no statistically significant differences between the study groups with regard to duration of the surgical procedure, requirement for perioperative transfusions and total number of postoperative complications (19.3% in the laparoscopy group versus 28.9% in the open surgery group). However, amount of analgesic drugs required in the postoperative period was significantly lower (25±6 vs 43±9, p>0.01) and duration of hospitalization was significantly shorter (9.0 vs 11.3 days, p=0.021) after laparoscopic versus open procedures procedures. Most of the patients with complicated Crohn's disease who were qualified to laparoscopic treatment, underwent successful treatment using this method. Patients in whom conversion was done, were more likely to be on long term preoperative immunosuppressive therapy versus other patients. Conclusions. Laparoscopy is a demanding procedure from the technical point of view, but provides valuable benefits to patients with Crohn's disease, including those with a complicated disease. However, this method requires ongoing improvement of technical aspects and thorough analysis of failures to identify factors that could accurately select patients with indications and contraindications to this procedure. Source

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