Paweł Lech

Dr. Paweł Lech

Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, Niepodległosci 44 St., 10-045 Olsztyn, Poland

Research Focus & Metrics

Academic Career Length

6Years (2021-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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15 April 2023 in Medicina
Verified
Journal Article
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Jan Maciej KapałaJan Maciej Kapała
Jan Maciej Kapała
TMTomasz Maroszczuk
Tomasz Maroszczuk
JLJulia Alicja Lewandowska
Julia Alicja Lewandowska
PLPaweł Lech
Paweł Lech
NDNatalia Dowgiałło-Gornowicz
Natalia Dowgiałło-Gornowicz
Background and Objectives: Sleeve gastrectomy (SG) is an effective surgical procedure in the treatment of obesity. However, a significant percentage of patients suffer from weight regain over long-term follow-up. The mechanisms responsible for this process are still poorly understood. The aim of the study is to evaluate the predictive effect of weight regain in the second year after SG on long-term bariatric surgery effectiveness. Methods: A retrospective cohort study was performed using the database of routinely collected information about patients undergoing SG in the Department of General, Minimally Invasive and Elderly Surgery in Olsztyn. Patients were divided into two groups according to the change in body weight between the first and second years after the surgery: weight gainers (WG) and weight maintainers (WM). Results: A study group consisting of 206 patients, with follow-up over 5 years, was included in the study. The WG group consisted of 69 patients while the WM group had 137 patients. There were no significant differences between the patient characteristics (p > 0.05). The WM group had a mean %EWL of 7.45% (SD, 15.83%) and %TWL of 3.74 (SD, 8.43). The WG group had a mean %EWL of 22.78% (SD, 17.11%) and %TWL of 11.29% (SD, 8.68). The difference between the groups was statistically significant (p < 0.05). The study showed significantly better results in WM compared to WG (p < 0.05). Conclusion: Weight regain in the second year after SG may be a good factor for long-term bariatric surgery effectiveness prognosis.

14 November 2021 in Medicina
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Journal Article
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NDNatalia Dowgiałło-Gornowicz
Natalia Dowgiałło-Gornowicz
KSKlaudia Sztaba
Klaudia Sztaba
PLPaweł Lech
Paweł Lech
.B. Botulinska
. Botulinska
MMMaciej Michalik
Maciej Michalik
Background and Objectives: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms located mainly in the fundus (60–70%). The incidence of GIST is approximately 10 per million population per year in Europe, with a peak incidence at the age of 63. Recent studies suggest that morbidly obese patients have a higher incidence of GIST than the general population. The aim of this study was to analyze the incidence of GIST in patients undergoing laparoscopic sleeve gastrectomy (LSG) in our department. Materials and Methods: this paper present the retrospective study of prospectively collected data of 1564 patients who underwent LSG in a single large bariatric center from October 2013 to September 2021. After surgery, each sample of the resected stomach was sent for histopathological examination. For the analysis, we included patients diagnosed with GIST intraoperatively or postoperatively. Results: GISTs were found in five patients (0.31%). There were three men and two women. The mean age was 50.2 (range 32–63 ± 11.8) and the mean preoperative body mass index was 43.3 kg/m2 (40–49.4 ± 3.2). In four cases, GISTs were found in the fundus (80%), and in one in the pylorus (20%). None of the tumors were larger than 7 mm in diameter and all were diagnosed as a very low-risk category. No adjuvant treatment was required. All patients achieved good or satisfactory bariatric and metabolic results. Conclusions: The incidence of GIST in our study was estimated at 0.31%. All patients had a very low-risk GIST and no recurrence until follow-up. Recent literature suggests that the risk of GIST is higher in the obese population, and therefore surgeons should be aware of the risk of incidental GIST during LSG.

17 December 2021 in Journal of Clinical Medicine
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Journal Article
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NDNatalia Dowgiałło-Gornowicz
Natalia Dowgiałło-Gornowicz
JKJustyna Kacperczyk
Justyna Kacperczyk
AMAnna Masiewicz
Anna Masiewicz
PLPaweł Lech
Paweł Lech
SSSławomir Saluk
Sławomir Saluk
MMMaciej Michalik
Maciej Michalik
Up to 33% of the population suffers from gastroesophageal reflux disease (GERD). Given its high prevalence, the negative impact on quality of life, and the possible progression to esophageal cancer, the definitive treatment of GERD should be used more frequently. This study aims to assess long-term patient satisfaction after laparoscopic Nissen fundoplication (LNF). We reviewed the prospectively collected data of patients who underwent LNF for GERD in our department in 2014–2018. Each patient completed a preoperative questionnaire according to GERD Impact Scale (GERD-IS). Postoperative survey consisted of GERD-IS, the need for PPIs, and two “yes or no” questions to assess satisfaction with the outcome. The mean follow-up time was 50 months (21.2–76.3 ± 16.6 months). There was a statistically significant improvement in each GERD-IS question (p < 0.001). A total of 87 patients (78.4%) would recommend the surgery to their relatives. Patients without symptom recurrence and without the need for chronic PPI use after surgery were significantly more likely to recommend surgery and to undergo the procedure again (p < 001). The age of patients did not influence patients’ recommendations (p = 0.75). A total of 17 patients (15.3%) would not undergo LNF again. There was no significant correlation between the answer and patient’s complications or age (p > 0.05). LNF is a good treatment for GERD with a satisfaction rate of 78.4%.

15 October 2024 in Nutrients
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NDNatalia Dowgiałło-Gornowicz
Natalia Dowgiałło-Gornowicz
DMDominika Mysiorska
Dominika Mysiorska
ESEwelina Sosnowska-Turek
Ewelina Sosnowska-Turek
.B. Botulinska
. Botulinska
PLPaweł Lech
Paweł Lech
Background: Sleeve gastrectomy (SG) has become the predominant bariatric surgery, leading to significant weight loss and reductions in obesity-related complications. However, postoperative gastrointestinal symptoms such as constipation and bloating are common. This study aims to evaluate the impact of probiotic supplementation on postoperative gastrointestinal symptoms in patients undergoing SG. The secondary aim is to analyze laboratory and stool test results. Materials and methods: This prospective, placebo-controlled study included patients undergoing SG at a single center. Participants were adults without specific gastrointestinal diseases. They were randomly assigned to either the Probiotics or Controls group. Gastrointestinal symptoms and laboratory and stool tests were assessed before surgery and one month after. Results: Thirty-one patients participated, with 15 in the Probiotics group and 16 in the Controls group. Probiotic supplementation significantly increased the number of stools per week (p = 0.027) and reduced constipation incidence (p = 0.002). Patients in the Probiotics group reported easier defecation and greater bowel movement completeness (p = 0.015, p = 0.004). No significant differences in weight loss or laboratory tests were observed between the groups. Stool microbiota analysis showed a return to normal levels of Enterococcus faecalis, Enterococcus faecium, and Clostridium perfringens in the Probiotics group and an increase in the Controls group. Conclusions: Probiotic supplementation after SG significantly reduces constipation without adverse effects. These findings suggest that incorporating probiotics into postoperative care protocols can enhance patient comfort and recovery.

28 December 2021 in Medicina
Verified
Journal Article
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NDNatalia Dowgiałło-Gornowicz
Natalia Dowgiałło-Gornowicz
AMAnna Masiewicz
Anna Masiewicz
JKJustyna Kacperczyk
Justyna Kacperczyk
PLPaweł Lech
Paweł Lech
SSSławomir Saluk
Sławomir Saluk
MMMaciej Michalik
Maciej Michalik
Background and Objectives: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases. It affects 20% of the adult population and is the third most common cause of chronic cough in adults. This study describes the results of LNF for the relief of GERD-related cough. Materials and Methods: The prospectively collected data on 135 laparoscopic LNF in our department from 2014 to 2018 were reviewed. During consultations, patients were asked about the frequency of symptoms using the GERD Impact Scale (GERD-IS), their satisfaction and recommendation to others, and their general condition after the procedure. Results: We analyzed 23 of 111 patients (20.7%) reporting chronic cough. The mean age was 47 years (range 27–76 years, ±13.9 years) and the mean follow-up time was 48.3 months (range 22.6–76.3 ± 18.05 months). Most patients reported relief from cough after the surgery (78.3%, p < 0.001). Five patients (22%) reported the recurrence of symptoms after a mean of 10.8 months (6–18 months). Seventeen patients (74%) would undergo the surgery again and 18 patients (78%) would recommend the surgery to their relatives. There was a statistically significant improvement in all symptoms from the GERD-IS (p < 0.05). Conclusions: LNF may play an important role in the management of GERD patients with extraesophageal symptoms. After LNF, most of the operated patients reported complete resolution of chronic cough and would recommend the procedure to their relatives.

30 May 2025 in Obesity Surgery
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NDNatalia Dowgiałło-Gornowicz
Natalia Dowgiałło-Gornowicz
Mateusz WitykMateusz Wityk
Mateusz Wityk
PLPaweł Lech
Paweł Lech
Background Sleeve gastrectomy (SG) is currently the most frequently performed bariatric procedure worldwide. While its popularity continues to grow due to favorable surgical outcomes and acceptable complication rates, maintaining long-term postoperative follow-up remains a major challenge. This study aimed to identify factors influencing adherence to 10-year follow-up in patients who underwent SG and to evaluate their long-term clinical outcomes. Methods A retrospective analysis was conducted on 150 patients who underwent SG between 2013 and 2014 at a single center in Poland. Data included demographics, obesity-related diseases, surgical details, and follow-up adherence. Logistic regression was used to identify predictors of long-term follow-up. Outcomes such as weight loss, obesity-related diseases remission, and surgical complications were assessed in accordance with ASMBS guidelines. Results Of 150 patients, 101 (67.3%) completed the 10-year follow-up. Age was the only independent predictor of long-term follow-up adherence (OR = 1.03, CI = 1.00–1.07, p = 0.048). Neither distance from the hospital nor size of the city of residence significantly impacted follow-up rates. Among the patients with follow-up, the median total weight loss (%TWL) was 21.5%, and remission of type 2 diabetes and hypertension occurred in 55.6% and 36.8% of patients, respectively. Additional surgery was performed in 16 patients, mainly due to recurrent weight gain and gastroesophageal reflux disease. Complication rate was 4.0%, with no mortality reported. Conclusions Older patients had slightly higher follow-up adherence after SG. Despite multiple measures to maintain contact, a substantial proportion of patients were lost to follow-up.