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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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    Sleeve Gastrectomy Pathologies: A Single-Center Retrospective Analysis
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Pekşen, Ç.; Sumer, A.
    Sleeve Gastrectomy (SG) has emerged as a prominent surgical approach in the battle against obesity, gaining widespread recognition for its effectiveness in promoting significant weight loss and improving metabolic health. However, despite its increasing popularity, the impact of SG on the histological and pathological characteristics of the gastrointestinal tract remains a subject of intensive research. This retrospective study, conducted at Istinye University, aimed to investigate the pathological outcomes of 530 SG procedures performed between June 1, 2022, and 2023. The study included demographic information, comorbidities, operative details, and both endoscopic and pathological findings. Our analysis uncovered notable trends in post-SG endoscopic and pathological findings. Gastritis was observed in a significant portion of patients, where 65.4% exhibited endoscopic gastritis and 70.8% showed pathologi cal gastritis. H. pylori infection, a known factor in gastritis development, was detected in 27.9% endoscopically and 35.6% pathologically. Further investigation is warranted to explore the disparities between endoscopic and pathological detection rates an d assess diagnostic accuracy. The presence of comorbidities showed a significant association with gastritis (p < 0.05), underscoring the potential interplay between systemic health conditions and gastric pathologies following SG. No significant relationshi p was found between gender and pathological findings. This study offers valuable insights into the pathological outcomes of SG and emphasizes the importance of postoperative monitoring and the management of gastric health. Routine endoscopy remains a funda mental component of postoperative care for bariatric surgery patients, contributing significantly to their long-term well-being and optimizing surgical outcomes. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Technical details of laparoscopic sleeve gastrectomy
    (OAE Publishing Inc., 2020) Aktokmakyan, T.V.; Gungor, O.; Sumer, A.
    Obesity is an expanding threat globally. Several surgical procedures have been developed to achieve the best outcomes in obesity. One of them is laparoscopic sleeve gastrectomy that was first applied in 1999 to initiate weight loss in overweight patients. Laparoscopic sleeve gastrectomy is a restrictive bariatric technique consisting of subtotal partial vertical gastrectomy with the preservation of the pylorus, and a gastric tube is created as a continuation of the esophagus along the lesser curvature with the resection of the fundus, corpus, and antrum. Although this technique is routinely-applied all over the world, the technical details are still controversial. This review aims to define the tips and tricks for the sleeve gastrectomy technique and discuss the controversial subjects in this technique. © The Author(s) 2020.
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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.