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Treatment of severe obesity by means of surgical procedures upon the gastrointestinal tract


Author: Balan Sergiu
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2010
Scientific adviser: Gheorghe Ghidirim
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.27
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 24 November, 2010
Approved by NCAA on the 23 December, 2010

Abstract

Adobe PDF document0.74 Mb / in romanian

Keywords

severe obesity, bariatric surgery, metabolic syndrome

Summary

The thesis is stated on 135 pages and includes: the introduction, 5 chapters, conclusions, and practical recommendations, bibliography inspired from 150 sources, 35 tables, 50 figures.

Theses and support ideas of the study were related in 15 scientific papers.

Field of study. patients with severe obesity that were subjected to ethiopathogenetic surgical treatment. Work tasks. Improvement of early and late results in the surgical treatment of severe obesity by applying individually matched methods of bariatric treatment.

Novelty and scientific originality of the work study. Based on the clinical material studied it has been proved that the degree of lipid metabolism disorders is directly proportional to the degree of insulin resistance, and the installation of dyslipidemia is dependent of the hyperglycemia duration. For the first time in the Republic of Moldova the efficiency of the use of restrictive and mix bariatric procedures in the treatment of severe obesity and the clash of these methods upon the evolution of the metabolic syndrome and its components has been studied. Resolution of hyperglycemia has been noted as a result of adjustable gastric banding and the inefficiency of it at correcting dyslipidemia. On the other hand the gastric bypass has shown great results in weight loss, correction and/or resolving of dyslipidemia and type II diabetes.

Practical value of the work study. As a result of the clinical studies a new algorithm based on the metabolic disorders of the patient and the disease evolution has been applied into clinical practice, and namely in the election of the surgical procedure. Were established the criteria of patient selection for surgical treatment as a mean of improving treatment results and diminishing the surgical risk. The level of the intestinal anastomosis in dependence of the body mass index was established based on late postoperative results.

Implementation of the scientific results. The study results were implemented in the clinical practice of the 1st Department of Surgery „N. Anestiadi”.