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    Comparison of Bipolar vascular sealing and conventional back-table dissection in terms of post-renal transplant drainage and back-table preparation times
    (Verduci Publisher, 2023) Eren, E.; Tokac, M.; Ozcelik, U.; Sahin, T.; Tellioglu, G.; Peksen, C.; Dinckan, A.
    - OBJECTIVE: The usage of ves-sel sealing devices has been gaining popularity in all surgical specialties. Post-renal transplant drain placement is a common practice among transplant surgeons. However, prolonged drain-age accompanied by surgical wound complica-tions and perirenal fluid collections is a frequent complication experienced by the recipients. This study aimed to compare Bipolar vascular seal-ing with conventional back-table dissection in terms of post-renal transplant drainage dura-tion, amount, surgical wound complication, and back-table preparation time. PATIENTS AND METHODS: A double-blind clinical study randomizes recipients into 2 groups, using Bipolar vascular sealing (Group 1) and conventional ligation (Group 2) back -ta-ble dissection. Variables such as recipient age, gender, body mass index (BMI), cause of end -stage renal disease, amount and duration of sur-gical drainage, back-table time, and cold isch-emia time (CIT) were collected prospectively. RESULTS: Ninety-eight consecutive living do-nor (M/F: 69/29) renal transplant recipients were enrolled in this prospective randomized clini-cal trial. There were 49 patients in each group. The mean BMI was 26.76 & PLUSMN;4.57. There was no difference among the groups regarding recipi-ent age, BMI, total drainage, and surgical drain-age duration. The surgical site infection rate was not different between the two groups. Group 1 had significantly shorter back-table time, with mean back-table time being 15.26 & PLUSMN;2.51 minutes in Group 1 and 28.83 & PLUSMN;6.27 minutes in Group 2 (p<0.001). The CIT was also significantly differ-ent between the 2 groups (p<0.001). In Group 1, the recorded CIT was 43.3 & PLUSMN;11.4, and in Group 2, 57.1 & PLUSMN;13.3 minutes. CONCLUSIONS: The use of Bipolar vascular sealing to seal lymphatic vessels at the back -ta-ble is feasible, safe, and easy to perform. It also expedites the dissection and shortens the time required for back-table graft preparation.
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    Comparison of laparoscopic evaluation of hepatosteatosis with ultrasound findings
    (Verduci Publisher, 2023) Peksen, C.; Aktokmakyan, T. V.; Savas, O. A.; Ediz, B.; Sumer, A.
    OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is a condition characterized by abnormal liver function because of lipid accumulation. NAFLD can range from simple fatty liver, which is usually harmless, to a more severe condition called non-alcoholic steatohepatitis (NASH), which involves inflammation, liver cell damage, cirrhosis, and liver cancer. Liver biopsy is considered the gold standard for diagnosing and staging hepatosteatosis, but it is an invasive and expensive procedure. Non-invasive methods, such as ultrasound, and magnetic resonance imaging (MRI), can provide useful information without the need for an invasive procedure. This study aimed to compare laparoscopic findings of hepatosteatosis with ultrasound da-ta to create a classification that can identify indi-viduals with NASH in operated patients.PATIENTS AND METHODS: 120 patients who applied to the General Surgery Department of Istinye University Faculty of Medicine between 06/2022 and 12/2022 were included in the study. They were evaluated for hepatosteatosis with preoperative ultrasound. Demographic, physical examination (BMI), laboratory, and radiological findings of the patients were recorded retrospectively. In addition, laparoscopy video recordings were reviewed retrospectively, and the findings were evaluated. Statistical analysis of the findings was made. The p-value was calcu-lated using the Chi-square test; p-value <0.05 was considered statistically significant.RESULTS: The mean age of 120 patients was 39.04 years, the mean BMI was 34.9 kg/m(2), and 63.3% of them were female patients. Cholecystectomy was performed in 60 of 120 patients, and sleeve gastrectomy in 60 of them. It has been observed that there is a high correlation between the ultrasound grade and the laparoscopic stage of hepatosteatosis (r=0.849) (p<0.05).CONCLUSIONS: Laparoscopy results to be an effective method in the diagnosis and classification of NASH.
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    Unveiling the Safety and Efficacy of Bariatric Surgery in Geriatric Patients: A Comprehensive Analysis of Three Years' Experience
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Aktokmakyan, T.V.; Peksen, C.; Savaş, O.A.; Sumer, A.
    Bariatric surgery has gained popularity as an effective method for achieving and maintaining weight loss. Despite higher mortality/morbidity risks and uncertain long-term outcomes due to age-related factors, bariatric surgery can also be beneficial for geriatric obese patients. In this study, we aimed to examine the outcomes of bariatric surgery performed on geriatric patients in our clinic. A retrospective analysis was conducted on 14 patients aged 65 and above who underwent bariatric surgery between March 2019 and 2021. Patients were evaluated preoperatively through a multidisciplinary approach. Among the 14 patients included in the study (11 females, 3 males), the mean a ge was 67 [65-74]. The mean Body Mass Index (BMI) was 42 kg/m² [40-60.4]. Comorbidities included hypertension (HT) in 11 patients, diabetes mellitus (DM) in 8 patients, and hyperlipidemia in 11 patients. A total of 9 patients had a history of antiplatelet use due to Chronic Arterial Disease (CAD). Among the patients, ten underwent Laparoscopic Sleeve Gastrectomy, while four opted four Mini Gastric Bypass. The mean hospital stay was 3 days, and all patients were discharged smoothly after this period (100%). No patient required postoperative intensive care (0%), and there were no observed mortalities (0%). At the 6th postoperative month, the mean BMI was 31.6 kg/m². Our study suggests that bariatric surgery can be effective and safe for well-selected geriatric obese patients. It is crucial to carefully consider patient selection and manage comorbidities to achieve positive outcomes. In well-selected geriatric obese patients, bariatric surgery can be an effective and safe method. Further research with larger sam ples is warranted to validate our findings and improve patient care in this population. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.