The effect of using a larger port on reducing the complications of laparoscopic cholecystectomy: A randomized trial

Aim: Laparoscopic cholecystectomy (LC) is the gold standard treatment method for cholelithiasis. There are many complications related to LC and many different microinvasive interventions have been performed to decrease the complication rate. In this study, we aimed to demonstrate the surgical results of the LC that was performed with a 15-mm port tool. Material and Method: Two-hundred patients who underwent LC in our clinic were included in this study. These cases were randomized as 10-mm port tool group (n-100) and 15-mm port tool group (n-100) according to the port-tool diameter that was used in LC. The gallbladder extraction time, port site complications, length of hospital stay, postoperative pain and cosmesis scores were compared between two groups.Results: The gallbladder extraction time was 135.3 sec in the 10-mm port tool group and 13.4 sec in the 15-mm port tool group (p<0.05). The complication rate was 53% (53cases) in the 10-mm port tool group and 13% (13cases) in the 15-mm port tool group (p<0.05). The duration of hospitalization was the same in both groups. The port site pain was 5.4 (2-9) in the 10-mm port tool group and 4.3 (1-7) in the 15-mm port tool group (p<0.05). None of the patients in either group had port site hernias or infections, and there was no significant difference between the two groups with regard to the port site incision scarring. Discussion: It was thought that it can reduce the operation time, the need for fascial expansion, gallbladder perforations during removal, and postoperative port site pain. Moreover, it does not increase the risk of a port site infection or a hernia and is not different from wound scarring

Evaluation of preoperative and postoperative total serum sialic acid levels in patients with colon cancer

AIM: The aim of this study was to compare the preoperative and postoperative (48th hour) total serum sialic acid levels of the patients with colon cancer and to investigate if the total serum sialic acid levels can be used as a tumor marker in colon cancer

Unveiling the Safety and Efficacy of Bariatric Surgery in Geriatric Patients: A Comprehensive Analysis of Three Years' Experience

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

Bridged one-anastomosis gastric bypass: technique and preliminary results

Purpose One-anastomosis gastric bypass (OAGB) is an established bariatric procedure performed worldwide. We developed a modification of OAGB leaving a bridge at the cranial 2 cm of the fundus as a gastro-gastric fistula to allow for endoscopic access to the bypassed stomach. We present the preliminary results of 44 patients who underwent this technique in our hospital. Methods We analyzed, retrospectively, data collected prospectively on 44 patients who underwent our bridged one-anastomosis gastric bypass (BOAGB) procedure between September, 2018 and November, 2020. Results The mean age of the patients was 45.2 +/- 9.3 years (range 20-66 years). The mean preoperative body mass index (BMI), weight, and HbA1c values were 41.5 +/- 6.4 kg/m(2) (range 35-59), 116 +/- 22.7 kg, and 8.2 +/- 2.1%, respectively. After a median follow-up period of 18 months (11-26 months), the mean postoperative BMI was 28.4 +/- 3.2 kg/m(2) (range 21-38), the mean total weight loss was 35.8 +/- 13.5 kg (range 20-80 kg), and the mean percentage of excess weight loss (%EWL) and the percentage of total weight loss (%TWL) were 79.8 +/- 16.1% (range 47-109) and 30.6 +/- 6.9% (range 19-48), respectively. The mean postoperative HbA1c level was 6.3 +/- 0.9%. There were two early complications (stenosis and bleeding) and one late complication (marginal ulcer). Conclusion Patients who underwent BOAGB lost weight similarly to those who underwent OABG as reported in the literature, without an apparent increase in complications related to the technique. Randomized studies with longer term follow-up are needed

A new approach in bariatric operations: bridged mini gastric by-pass. Is rabbit model suitable for an experimental study?

Objective: Obesity is a global health epidemic with considerable co-morbidities. The increasing demand for bariatric surgery has led to the emergence of new techniques. We modified previously described Mini Gastric By-pass(MGB) technique via leaving a bridge at the most cranial 2 cm of the fundus of the human stomach to the follow-up and treatment of the remnant stomach and duodenum. We would like to entitle this new technique as Bridged MGB and aimed to apply on rabbits as an experimental study

Comparison of Magenstrasse and Mill gastroplasty and sleeve gastrectomy techniques as an experimental study on rabbits

AIM: Bariatric surgery is an important option when lift-style modification, diet, and medical treatment are inadequate in lose weight. Bariatric surgical methods have gained popularity in recent years. In this paper, we compared the Magenstrasse and Mill(M&M) technique, with performing a simpler and more physiological type of gastroplasty without implanted foreign material such as band and reservoir, to the Sleeve Gastrectomy (SG) technique. This study aimed to determine the effects of the M&M for obesity on the rabbits in comparison with the SG, which is accepted as a standard bariatric technique with creating a gastric tube

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n&nbsp;=&nbsp;122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7&nbsp;± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n&nbsp;=&nbsp;146; 85.9%), only 42.4% (n&nbsp;=&nbsp;72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n&nbsp;=&nbsp;9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries

Abstract Background There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. Methods We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. Results Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. Conclusions BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak. </jats:sec