The authors present their own experience with surgery carried out in the out-patient department in 1985-1996. It is a modern, effective, reliable and above all economical therapeutic method, because it maintains the standard of surgery while saving the costs of hospitalisation. It is a very attractive method for patients who want to return to work as soon as possible. As many as 87% patients were satisfied with surgical treatment of the anus and rectum.

• MeSH
• ambulantní chirurgické výkony * statistika a číselné údaje   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• pooperační komplikace MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika MeSH

• MeSH
• ambulantní chirurgické výkony * škodlivé účinky   MeSH
• gynekologické chirurgické výkony * škodlivé účinky   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• ambulantní chirurgické výkony * MeSH
• gynekologické chirurgické výkony * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity-European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years. It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria. The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.

• MeSH
• bariatrická chirurgie * MeSH
• diabetes mellitus 2. typu etiologie   chirurgie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• morbidní obezita komplikace   chirurgie   MeSH
• společnosti lékařské MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Evropa MeSH

In 2012, an expert panel composed of presidents of each of the societies, the European Chapter of the International Federation for the Surgery of Obesity (IFSO-EC), and of the European Association for the Study of Obesity (EASO), as well as of the chair of EASO Obesity Management Task Force (EASO OMTF) and other key representatives from IFSO-EC and EASO, devoted the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery in advance of the 2013 European Congress on Obesity held in Liverpool. This meeting was prompted by the extraordinary advancement made in the field of metabolic and bariatric surgery during the past decade. It was agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced by focusing in particular on the evidence gathered in relation to the effects on diabetes and the changes in the recommendations of patient eligibility criteria. The expert panel allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.

• MeSH
• bariatrická chirurgie * metody   psychologie   normy   MeSH
• diabetes mellitus 2. typu chirurgie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• obezita komplikace   psychologie   chirurgie   MeSH
• pooperační péče MeSH
• předoperační péče MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Evropa MeSH

STUDY OBJECTIVE: Assess the relationship between the Enhanced Recovery After Surgery (ERAS®) pathway and routine care and 30-day postoperative outcomes. DESIGN: Prospective cohort study. SETTING: European centers (185 hospitals) across 21 countries. PATIENTS: A total of 2841 adult patients undergoing elective colorectal surgery. Each hospital had a 1-month recruitment period between October 2019 and September 2020. INTERVENTIONS: Routine perioperative care. MEASUREMENTS: Twenty-four components of the ERAS pathway were assessed in all patients regardless of whether they were treated in a formal ERAS pathway. A multivariable and multilevel logistic regression model was used to adjust for baseline risk factors, ERAS elements and country-based differences. RESULTS: A total of 1835 patients (65%) received perioperative care at a self-declared ERAS center, 474 (16.7%) developed moderate-to-severe postoperative complications, and 63 patients died (2.2%). There was no difference in the primary outcome between patients who were or were not treated in self-declared ERAS centers (17.1% vs. 16%; OR 1.00; 95%CI, 0.79-1.27; P = 0.986). Hospital stay was shorter among patients treated in self-declared ERAS centers (6 [5-9] vs. 8 [6-10] days; OR 0.82; 95%CI, 0.78-0.87; P < 0.001). Median adherence to 24 ERAS elements was 57% [48%-65%]. Adherence to ERAS-pathway quartiles (≥65% vs. <48%) suggested that patients with the highest adherence rates experienced a lower risk of moderate-to-severe complications (15.9% vs. 17.8%; OR 0.71; 95%CI, 0.53-0.96; P = 0.027), lower risk of death (0.3% vs. 2.9%; OR 0.10; 95%CI, 0.02-0.42; P = 0.002) and shorter hospital stay (6 [4-8] vs. 7 [5-10] days; OR 0.74; 95%CI, 0.69-0.79; P < 0.001). CONCLUSIONS: Treatment in a self-declared ERAS center does not improve outcome after colorectal surgery. Increased adherence to the ERAS pathway is associated with a significant reduction in overall postoperative complications, lower risk of moderate-to-severe complications, shorter length of hospital stay and lower 30-day mortality.

• Klíčová slova
• Colorectal surgery, ERAS, Enhanced recovery, Optimization, Perioperative management, Postoperative complications,
• MeSH
• délka pobytu MeSH
• dospělí MeSH
• elektivní chirurgické výkony škodlivé účinky   MeSH
• kolorektální chirurgie * škodlivé účinky   MeSH
• lidé MeSH
• perioperační péče metody   MeSH
• pooperační komplikace epidemiologie   etiologie   MeSH
• pozorovací studie jako téma MeSH
• prospektivní studie MeSH
• urychlená pooperační rehabilitace * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Enhanced recovery after surgery (ERAS) protocols in colorectal surgery leads to improved quality of care and more efficient resource utilization. Despite these positive outcomes, the penetration of ERAS protocols in the Czech Republic is low. The aim of this study is to present a general methodology for implementing an ERAS protocol in colorectal surgery. METHODS: The methodology is based on the authors' extensive experience in implementing clinical protocols at various institutions in the Czech Republic, as well as published international experiences. This methodology is described in detail and supplemented with data obtained during implementation of an ERAS program at the author's institution. RESULTS: The preparatory phase includes in-depth quality of care audits and preparation of an ERAS protocol. The purpose of the audits is to identify areas of care where standardization or targeted changes in clinical practice are desirable. The implementation phase involves staff training, technical implementation support, protocol dissemination, adherence monitoring, and evaluation of a pilot phase with subsequent protocol adjustments. The evaluation phase involves data collection, maintaining a prospective database, and regular assessments. CONCLUSION: The presented methodology describes the individual steps in the process of implementing a clinical protocol into practice. This text can serve as a manual for implementing an ERAS protocol in colorectal surgery at any institution.

• Klíčová slova
• ERAS, clinical protocol, colorectal surgery, implementation, methodology,
• MeSH
• chirurgie trávicího traktu * MeSH
• délka pobytu MeSH
• klinické protokoly MeSH
• kolorektální chirurgie * MeSH
• lidé MeSH
• pooperační komplikace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Surgical treatment of obesity is complex solution and include several basic tasks, without which treatment would not be successful. The medical care depends on the level of obesity, surgical treatment is indicated for patients with BMI over 35 with complications, otherwise over 40. Postbariatric plastic surgery includes set of pre-operative planning and operating procedures that remove skin excess and reduce the health complications associated with it, mainly return the patient to his normal body and return his lost self-confidence and enables its integration into society. Considerable variability of the condition and the local finding of patients after weight reduction make this part of plastic or general surgery a very heterogeneous area - with spectrum and range of outputs and adaptations after successful treatment of obesity. Keywords: obesity, bariatric surgery, body contouring, lower body lifting, armlift, thightlift, gluteoplasty.

• Klíčová slova
• armlift, bariatric surgery, body contouring, gluteoplasty, lower body lifting, obesity, thightlift,
• MeSH
• bariatrická chirurgie * MeSH
• hmotnostní úbytek MeSH
• lidé MeSH
• obezita MeSH
• plastická chirurgie * MeSH
• zákroky plastické chirurgie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• SURGERY *,
• MeSH
• chirurgie * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Currently, bariatric surgery is the most effective treatment for the morbid obesity. It provides sustained weight loss as well as demonstrated positive effects on obesity-related comorbidities. The number of procedures performed worldwide has seen a sharp increase in the past twenty years. Therefore, an effort has been developed to establish a consensus in perioperative care based on best evidence. METHODS: The working group of the Joint Bariatric and Metabolic Surgery Section of the Czech Surgery Society and Czech Society of Obesitology prepared clinical practice guidelines for the ERAS (enhanced recovery after surgery) concept in perioperative care in bariatric surgery. The working group based its guidelines on ERAS guidelines published in 2021. The working group adopted the original text and then adapted the text and added its comments to specific items as appropriate. Electronic voting of all members of the working group was the final phase, by which the strength of consensus was expressed with respect to individual elements of the guidelines. RESULTS: The Czech working group reached a consensus with ERABS (enhanced recovery after bariatric surgery) guidelines for most elements. The quality of evidence is low for some interventions of the ERAS protocol for bariatric surgery. Therefore, extrapolation from other surgeries and fields is needed for evidence-based practice. CONCLUSION: The guidelines are intended for clinical practice in bariatric surgery with the ERAS protocol based on updated evidence and guidelines. It is based on recent and comprehensive ERAS guidelines adopted and adapted by the Czech working group of the Joint Bariatric and Metabolic Surgery Section of the Czech Surgery Society and Czech Society of Obesitology. Some supplementations and specifications are reflected in comments added to the Czech version.

• Klíčová slova
• Enhanced Recovery After Surgery, bariatric and metabolic surgery, guidelines for clinical practice,
• MeSH
• bariatrická chirurgie * metody   MeSH
• hlasování MeSH
• lidé MeSH
• morbidní obezita * chirurgie   MeSH
• perioperační péče metody   MeSH
• urychlená pooperační rehabilitace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Geografické názvy
• Česká republika MeSH