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Biomedical subjects

R Góral

Publications and source records attributed to R Góral.

At least 19 recordsLinked to original sources
PubMed1985

Long-term results of jejunoileostomy for extreme obesity.

The results of jejunoileostomy performed on 130 extremely obese patients in 1972-1982 are presented. The mean preoperative body weight was 130.9 kg. The postoperative observation period was 2-10 years and in 85 cases it was more than 5 years. The Salmon-Scott technique of jejunoileostomy was used in 6 cases and the Payne-De Wind method in 124. Overweight was reduced from 118% to 30.4% of normal body weight (Broca Index). Weight reduction was classified as very good or good in 82% of the patients. It was accompanied by increased psychosocial activity and improved working capacity. Disturbed carbohydrate and lipid balances normalized and liver steatosis disappeared. The direct postoperative mortality was 3.8%, and another patient died from long-term metabolic complications. Clinical symptoms of hepatic insufficiency appeared in one patient and were successfully managed with conservative treatment. Most other metabolic disturbances were transient and without clinical manifestations. They gradually subsided as adaptation progressed in the active intestinal remnant. Follow-up studies 5 to 10 years after jejunoileostomy showed that its therapeutic effects were lasting and the patients were free from persistent metabolic disturbance. In the authors' opinion, jejunoileostomy is an effective therapeutic method, though associated with certain risks.

Female↗
PubMed1984

[Morphological assessment of the adaptation process in the small intestine after jejunoileostomy for extreme obesity].

The paper presents the author's experiments performed for examining the morphological adaptation in the intestinal loop, preserved for the food passage after jejunoileostomy for extreme obesity. Macro-, micro-, and ultramicroscopic examinations were carried out in 20 patients. A characteristic elongation and hypertrophy of the active intestinal loop, thickening of its wall (especially mucosa), hypertrophy and elongation of the intestinal villi as well as reduction of the mucous cells could be observed. The enzymatic activity of the mucous membrane could be found to be increased in the active part of the jejunum too. In the author's opinion the observed changes clearly demonstrate the transient character of those metabolic disturbances which develop after producing the artificial short gut syndrome.

Adaptation, Physiological↗
PubMed1978

Function and morphological picture of the liver in obese patients before and after jejunoileostomy.

In 40 obese patients, the liver function and the morphological picture were examined before and after jejuno-ileostomy. In 94% of the patients, distinct fatty liver was observed already before the small bowel exclusion, and the function tests showed an impaired function of this organ in 25% of the subjects before the operation. No clinical symptoms of liver insufficiency were recorded during the postoperative period. During one to three months after surgery, an increased impairment of the liver function was ascertained but, later on, a gradual improvement. More than one year after jejuno-ileostomy, the function test results were considerably better than before the operation. The degree of steatosis increased in the majority of the patients within 6 months after surgery, and some time later a considerable decrease in fatty liver was observed. Within 18 to 24 months after the jejunoileostomy, the morphological picture of the liver did not differe from the normal. The impaired function and the increased degree of steatosis were noted during diarrhea and rapid loss of body weight. The reson for this is most probably the protein malnutrition caused by the radical reduction in the absorption surface of the small bowel. The improved function and morphological picture of the liver are related to the progress of adaptation changes of the active part of small bowel. The results of the author's research do not confirm the hypothesis of permanent, harmful effect of jejuno-ileostomy on the state of the liver. The symptoms observed are definitely of a periodical and transient character, and are therefore not contra-indicated in the application of this operation in morbid extreme obesity treatment.

Adult↗
PubMed1977

[Surgical treatment of obesity by jejuno-ileal bypass (author's transl)].

50 patients were operated on; 42 women and 8 men at the age of 17 to 57. The weight of the patients was 100 to 184 kg. and the overweight amounted in most cases to 70 to 188%. Long lasting conservative treatment proved to be inefficient. The endocrynological basis of the obesity was excluded. 6 patients were operated upon according to the Salmon-method and 44 according to the Payne-De Wind-method. 3 patients died. 47 patients recovered without complications. For two years after the operation the loss of weight was 28 to 50% compared with the initial weight. Diarrhoe stopped six months after the operation. During this time a decrease in the concentration of potassium and calcium in the blood serum was observed. Judging from the positive changes the decrease of the cholesterol concentration in the blood was observed as well as the general improvement of the patients health. All patients are in good health and have taken up their jobs again.

Adolescent↗