Faculty of Medicine

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    Item type:Publication,
    Long-term effectiveness, outcomes and complications of bariatric surgery
    (Baishideng Publishing Group Inc., 2023-07-06)
    Gulinac, Milena
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    Miteva, Dimitrina Georgieva
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    Peshevska Sekulovska, Monika
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    Novakov, Ivan P
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    Dietary imbalance and overeating can lead to an increasingly widespread disease - obesity. Aesthetic considerations aside, obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases, including diabetes; hypertension; atherosclerosis; coronary artery disease and stroke; obstructive sleep apnea; depression; weight-related arthropathies and endometrial and breast cancer. A body weight 20% above ideal for age, gender and height is a severe health risk. Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet, increased physical activity, behavioral changes and drugs have failed. The two most common procedures currently used are sleeve gastrectomy and gastric bypass. This procedure has gained popularity recently and is generally considered safe and effective. Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved, more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures. This review aims to synthesize and summarize the growing evidence on the long-term effectiveness, outcomes and complications of bariatric surgery.
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    Item type:Publication,
    PERFORATED ANASTOMOTIC MARGINAL ULCER POST ROUX-EN-Y GASTRIC BYPASS SURGERY: A CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2022)
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    Panikj, Katarina
    Among the techniques available for bariatric surgery, Roux-en-Y gastric bypass is safe and effective option. However, it may present with some complications such as marginal anasomotic ulcers, which can perforate and become serious surgical emergency. We present a case of 28-year-old female patient, with abdominal pain and vomiting with clinical presentation of diffuse peritonitis, radiological presentation of pneumoperitoneum and medical history of RYGB 3 years before, with suspected perforation after initial medical assessment and examination. Upper medial laparotomy was performed with large amount of fibrinopurulent content presented in abdominal cavity and perforated MU at medial anastomotic site. It was closed with omental patch, after thorough abdominal irrigation. The patient was discharged on the 10th day after surgery. One of the most common long-term complications after RYGB is the occurence of peptic ulcers and anastomotic stenosis. The main manifestation of untreated MU is perforation, which is urgent surgical and life-threatening condition. The perforated marginal ulcer is a complication of the RYGB procedure in bariatric surgery and is an acute surgical condition. Thorough irrigation of abdominal cavity and omentoplasty of the ulcer lesion is a safe and effective treatment of choice and it gives a good postoperative outcome.