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Öğe Benefits of suture reinforcement in laparoscopic sleeve gastrectomy(Lippincott Williams & Wilkins, 2019) Batman, Burçin; Altun, HasanObesity is an increasing problem worldwide. Laparoscopic sleeve gastrectomy is gaining popularity. Although it has unique complications such as leakage, bleeding, and stenosis, it is a reliable procedure. A total of 1200 consecutive patients who underwent sleeve gastrectomy and omentopexy between March 2013 and December 2018 were enrolled in this retrospective study. Body mass index, age, sex, and postoperative complications were recorded in all patients. Of 1200 patients, 864 (72%) were female and 336 (28%) were male. The median age was 38 years (13 to 69 y). Preoperative median body mass index was found as 40.87 kg/m(2) (30 to 88 kg/m(2)). Operative complications included strictures which occurred in 16 (1.33%) patients, bleeding in 7 (0.58%), stapler line leaks in 3 (0.25%), wound infection in 1 (0.08%), fat necrosis in 1 (0.08%), splenic arterial injury in 1 (0.08%), and intra-abdominal abscess in 1 (0.08%) patient. There was no mortality. Sleeve gastrectomy and omentopexy is a safe procedure with low complication rates.Öğe The effect of laparoscopic sleeve gastrectomy on nonalcoholic fatty liver disease(Lippincott Williams & Wilkins, 2019) Batman, Burçin; Altun, Hasan; Pınarbaşı Şimşek, Binnur; Aslan, Ekrem; Koç, Şule NamlıObesity is associated with nonalcoholic fatty liver disease which is one of the most common causes of chronic liver disease. FibroScan is a noninvasive tool for liver stiffness measurement and controlled attenuation parameter to evaluate liver steatosis and fibrosis. We aimed to demonstrate the effect of laparoscopic sleeve gastrectomy on liver steatosis and fibrosis. Of the 120 consecutive patients screened, 72 were enrolled in this study. FibroScan M probe and XL probe were used for the evaluation of liver steatosis and fibrosis. Fifty-two patients (72.2%) were female individuals and 20 (27.8%) were male individuals; the mean age was 37.9 +/- 10.4 years. Percentage of excess weight loss was significant at the third and sixth months: 57.2 +/- 18.3 (P<0.05) and 81.4 +/- 24.6 (P<0.05), respectively. Mean preoperative controlled attenuation parameter and liver stiffness measurement values were 309.2 +/- 68.7 dB/m and 7.5 +/- 5.0 kPa, respectively, and significantly declined to 217.4 +/- 56.4 dB/m and 5.6 +/- 2.5 kPa, respectively, at sixth postoperative month (P<0.001 and <0.01, respectively). These results suggest that laparoscopic sleeve gastrectomy is associated with significant improvement in liver steatosis and fibrosis. Bariatric surgery has a beneficial effect on nonalcoholic fatty liver disease in morbidly obese patients.Öğe The effect of laparoscopic sleeve gastrectomy on nonalcoholic fatty liver disease [letter](Lippincott Williams & Wilkins, 2019) Batman, Burçin; Altun, Hasan; Pınarbaşı Şimşek, Binnur; Aslan, Ekrem; Koç, Şule NamlıamlıIn this study, our aim was to determine the changes in values of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) after bariatric surgery. Our aim was not to make a diagnosis of liver disease. Because of this, we did not detect any cut-off point in this study. Also, cut-off levels for specific stages of hepatic fibrosis vary according to the etiology of the chronic liver diseases.Öğe The effects of laparoscopic sleeve gastrectomy on glucose metabolism in patients with a body mass index below 35 kg/m(2)(Kare Publ, 2020) Batman, Burçin; Altun, HasanObjectives: The prevalence of obesity and its associated comorbidities are increasing all over the world. Laparoscopic sleeve gastrectomy has become the most common bariatric surgery in the world today, especially in the treatment of Type 2 diabetes mellitus, which is one of the effective surgical methods. The present study aims to investigate the effects on glucose metabolism in patients following laparoscopic sleeve gastrectomy. Methods: In this study, the files of 174 patients who had laparoscopic sleeve gastrectomy with a body mass index between 30-35kg/m2 between March 2013 and September 2019 were analyzed retrospectively. Patients were evaluated by a multidisciplinary team in the preoperative period. Patients who met the criteria for laparoscopic sleeve gastrectomy were operated according to American Metabolic and Bariatric Surgeons criteria. Demographic data, body mass index, insulin, glycosylated hemoglobin (HbA1c), glucose, homeostasis model insulin resistance (HOMA-IR) values were recorded. The patients were followed up with visits to the outpatient clinic scheduled for 1-3-6 and 12 months postoperatively. Results: The mean age of the 174 patients who underwent laparoscopic sleeve gastrectomy was 39.57 +/- 9.40, and the mean body mass index was 32.70 +/- 2.65. 149 patients (85.6%) were female. The mean hospital stay was 3.1 +/- 0.7 days. When glucose, HbA1c, HOMAR-IR and insulin values of the patients were examined, it was observed that the decrease was statistically significant at 12 months follow-up. There was a significant decrease in body mass index compared to the preoperative period. Conclusion: Laparoscopic sleeve gastrectomy is an effective surgery on glucose metabolism in patients with a body mass index of 30-35kg/m(2).Öğe Mid-term effects of laparoscopic sleeve gastrectomy on metabolic syndrome(Mary Ann Liebert, Inc, 2020) Batman, Burçin; Altun, HasanBackground: Obesity is associated with lower life expectancy and many comorbid diseases, including arterial hypertension, hyperlipidemia, and type 2 diabetes mellitus (T2DM), which is defined as metabolic syndrome (MetS). The aim of this study was to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on parameters of MetS in obese patients 2 years after surgery. Methods: Between March 2013 and June 2019 1333 patients, who underwent LSG, were enrolled in this study; patients fulfilling the following conditions were considered eligible for LSG: body mass index (BMI) >= 40kg/m(2) or BMI >35kg/m(2) with comorbidities or BMI between 30 and 35kg/m(2) with T2DM or MetS. The patients were followed up by outpatient visits that were scheduled at 1st, 3rd, 6th, and 12th months postoperatively and annually thereafter. Results: One thousand three hundred and thirty-three patients underwent LSG. The mean age was 40.9310.86; 954 (71.5%) patients were female. After 2 years of surgery there was a significant improvement in glucose, glycosylated hemoglobin (HbA1c), insulin, the homeostasis model assessment insulin resistance, triglycerides, and high-density lipoprotein cholesterol (p<0.0001) with no significant reduction in serum total cholesterol (p=0.392) and low-density lipoprotein cholesterol (p=0.692) levels. Conclusions: LSG is an effective treatment for MetS and obesity related comorbidities.Öğe Unexpected histopathological findings after laparoscopic sleeve gastrectomy(Istanbul Training & Research Hospital, 2020) Batman, Burçin; Altun, HasanIntroduction: The prevalence of obesity is increasing all over the world. Laparoscopic sleeve gastrectomy (LSG) has become the most common bariatric surgery in the world today. Unlike other bariatric surgeries, laparoscopic sleeve gastrectomy yields a pathological examination. The aim of this study was to describe unexpected histopathological findings following LSG. Methods: In this study, the pathologies of 1364 patients who underwent LSG between March 2013 and September 2019 were analyzed retrospectively. Patients were evaluated by a multidisciplinary team in the preoperative period. Patients who met the criteria for LSG were operated. These criteria were; Body Mass index (BMI) >= 40 kg/m(2) or BMI >35 kg/m(2) and comorbidities or BMI between 30 and 35 kg/m2 with accompanying Type 2 diabetes Mellitus or Metabolic syndrome. Two hundred four of the patients underwent gastroscopy preoperatively. Results: One thousand three hundred sixty four patients underwent LSG. The mean age was 40.93 +/- 10.86 years; 974 patients (71.48%) were female. The mean BMI was 42.23 +/- 7.28. The most common findings in the pathologies were normal gastric specimen (50%), gastritis (30%) and changes due to proton pump inhibitor use (23%) respectively. Conclusion: Gastroscopy should be added to the preoperative preparation process in cases where there is no gastric specimen after the operation. Preoperative gastroscopy is not a necessity for laparoscopic sleeve gastrectomy. It can be performed in selected cases.
