Incidental gastric glomus tumor after laparoscopic sleeve gastrectomy

Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LS

Incidental gastric glomus tumor after laparoscopic sleeve gastrectomy

Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LS

Compliance of the patients to the ınstructions of colonic preparations undergoing elective colonoscopy; a survey study

Amaç: Kolorektal hastalıklarının tanı ve tedavisi için kolonoskopi işlemi öncesi barsak hazırlığının yeterli olması çok önemlidir. Biz bu çalışmada; kolonoskopi işlemi öncesinde oral ve lavman yoluyla sağlanan kolon temizliğinin etkinliğini ve hastaların uyumunu değerlendirilmeyi amaçladık. Yöntemler: Çalışmaya kolonoskopi planlanan ve 250 ml Sennozit A-B ve kalsiyum tuzunu içeren solüsyon ve 210 ml sodyum hidrojen fosfat içerikli lavman ile barsak hazırlığı yapılan 400 hasta çalışmaya alındı. Kolonoskopi öncesinde kolonoskopi işlemine hazırlık ve işlem esnasında yaşamış olabilecekleri soruları içeren anket uygulandı. Kolonoskopi işlemi öncesinde hastaların kendilerinden demografik, klinik ve barsak hazırlığına yönelik 14 sorudan oluşan anketin doldurulması istendi. Anketin sonuçları değerlendirildi. Bulgular: 213 erkek 187 bayan toplam 400 hastanın ortalama yaşı 48.6±12.3 (18-80) idi. Hastaların Boy, kilo ve Vücut Kitle İndeksleri sırasıyla; 158.6±27.5cm (142-197), 76.8±9.7kg (47-152), 27.9±4.2 kg/m² (22-41) olarak bulundu. Kolon Anketi soruları ve sonuçlarından hastaların oral, rektal temizliğe ve diyete uyumlulukları sırasıyla %93.2, %90.5, ve %88.0 olarak bulundu. İşlemden bir gün öncesinde günlük alınan sıvı miktarı ise büyük bir çoğunlukta 3litre ve üzeri olarak bulundu (%71.8). Hastaların kolon temizliği sırasında karşılaştıkları şikayet ve bulguların başında bulantı (%30.3), karın ağrısı ya da kramp (%15.5) ve şişkinlik (%12.8) gelmekteydi. Hastaların yaklaşık %45.5’i işlemin başarısız olması durumunda kolon temizliğinin zor olmasından ve de işlemin kendi zorluğu nedeniyle tekrar yaptırmayacağını bildirdi. Hastaların çoğunluğunun anestezi Skoru ASA I ve kolon temizliği iyi olarak değerlendirildi. Sonuç: Kolon temizliği için, Sennozit A-B ve kalsiyum tuzunu içeren oral solüsyon ve 210 ml sodyum dihidrojen fosfat ve disodyum hidrojen fosfat içerikli rektal lavman güvenle kullanılabilir.Objective: Enough bowel preparation prior to colonoscopy for the diagnosis and treatment of colorectal is very important. In this study; we aimed to assess the effectiveness of cleansing the colon provided through oral and enema prior to colonoscopy and the compliance of the patients. Material and Methods: 400 patients were enrolled to this study scheduled for a colonoscopy and bowel preparation made with 250 ml Sennozit A-B and calcium salt solution containing 210 ml of sodium hydrogen phosphate containing enema. A questionnaire containing questions will be administered during colonoscopy preparation and processing before the colonoscopy. Before the colonoscopy from patients themselves were asked to fill in the questionnaire consisting of 14 questions related to demographic, clinical data and bowel preparation. The results of the survey were evaluated. Results: A total of 400; 213 male and 187 female patients has a mean age of 48.6±12.3(18-80) years. Patients height, weight and body mass index were; 158.6±27.5cm(142- 197), 76.8±9.7kg(47-152), 27.9±4.2kg/m²(22-41), respectively. From questions from the survey patients compliance to oral, rectal cleansing and diet was found to be 93.2%, 90.5%, and 88.0%, respectively. The amount of fluid taken daily on the day before the procedure was found to be 3litre and over at a large majority (71.8%). Complaints of patients encountered while cleansing the colon were; nausea (30.3%), abdominal pain or cramps (15.5%) and distention (12.8%). Approximately 45.5% of the patients were in the process of colon cleansing in case of failure is also announced that it would not make the process again because of their difficulties. The majority of patients have Anesthesia score as ASA I and Cleansing Score was evaluated as well. Conclusion: For colon cleansing, oral solution containing the 210 ml Sennozit A-B and calcium salt rectal enema consisting of sodium dihydrogen phosphate and disodium hydrogen phosphate can be used safely

Compliance of the patients to the ınstructions of colonic preparations undergoing elective colonoscopy; a survey study

Amaç: Kolorektal hastalıklarının tanı ve tedavisi için kolonoskopi işlemi öncesi barsak hazırlığının yeterli olması çok önemlidir. Biz bu çalışmada; kolonoskopi işlemi öncesinde oral ve lavman yoluyla sağlanan kolon temizliğinin etkinliğini ve hastaların uyumunu değerlendirilmeyi amaçladık. Yöntemler: Çalışmaya kolonoskopi planlanan ve 250 ml Sennozit A-B ve kalsiyum tuzunu içeren solüsyon ve 210 ml sodyum hidrojen fosfat içerikli lavman ile barsak hazırlığı yapılan 400 hasta çalışmaya alındı. Kolonoskopi öncesinde kolonoskopi işlemine hazırlık ve işlem esnasında yaşamış olabilecekleri soruları içeren anket uygulandı. Kolonoskopi işlemi öncesinde hastaların kendilerinden demografik, klinik ve barsak hazırlığına yönelik 14 sorudan oluşan anketin doldurulması istendi. Anketin sonuçları değerlendirildi. Bulgular: 213 erkek 187 bayan toplam 400 hastanın ortalama yaşı 48.6±12.3 (18-80) idi. Hastaların Boy, kilo ve Vücut Kitle İndeksleri sırasıyla; 158.6±27.5cm (142-197), 76.8±9.7kg (47-152), 27.9±4.2 kg/m² (22-41) olarak bulundu. Kolon Anketi soruları ve sonuçlarından hastaların oral, rektal temizliğe ve diyete uyumlulukları sırasıyla %93.2, %90.5, ve %88.0 olarak bulundu. İşlemden bir gün öncesinde günlük alınan sıvı miktarı ise büyük bir çoğunlukta 3litre ve üzeri olarak bulundu (%71.8). Hastaların kolon temizliği sırasında karşılaştıkları şikayet ve bulguların başında bulantı (%30.3), karın ağrısı ya da kramp (%15.5) ve şişkinlik (%12.8) gelmekteydi. Hastaların yaklaşık %45.5’i işlemin başarısız olması durumunda kolon temizliğinin zor olmasından ve de işlemin kendi zorluğu nedeniyle tekrar yaptırmayacağını bildirdi. Hastaların çoğunluğunun anestezi Skoru ASA I ve kolon temizliği iyi olarak değerlendirildi. Sonuç: Kolon temizliği için, Sennozit A-B ve kalsiyum tuzunu içeren oral solüsyon ve 210 ml sodyum dihidrojen fosfat ve disodyum hidrojen fosfat içerikli rektal lavman güvenle kullanılabilir.Objective: Enough bowel preparation prior to colonoscopy for the diagnosis and treatment of colorectal is very important. In this study; we aimed to assess the effectiveness of cleansing the colon provided through oral and enema prior to colonoscopy and the compliance of the patients. Material and Methods: 400 patients were enrolled to this study scheduled for a colonoscopy and bowel preparation made with 250 ml Sennozit A-B and calcium salt solution containing 210 ml of sodium hydrogen phosphate containing enema. A questionnaire containing questions will be administered during colonoscopy preparation and processing before the colonoscopy. Before the colonoscopy from patients themselves were asked to fill in the questionnaire consisting of 14 questions related to demographic, clinical data and bowel preparation. The results of the survey were evaluated. Results: A total of 400; 213 male and 187 female patients has a mean age of 48.6±12.3(18-80) years. Patients height, weight and body mass index were; 158.6±27.5cm(142- 197), 76.8±9.7kg(47-152), 27.9±4.2kg/m²(22-41), respectively. From questions from the survey patients compliance to oral, rectal cleansing and diet was found to be 93.2%, 90.5%, and 88.0%, respectively. The amount of fluid taken daily on the day before the procedure was found to be 3litre and over at a large majority (71.8%). Complaints of patients encountered while cleansing the colon were; nausea (30.3%), abdominal pain or cramps (15.5%) and distention (12.8%). Approximately 45.5% of the patients were in the process of colon cleansing in case of failure is also announced that it would not make the process again because of their difficulties. The majority of patients have Anesthesia score as ASA I and Cleansing Score was evaluated as well. Conclusion: For colon cleansing, oral solution containing the 210 ml Sennozit A-B and calcium salt rectal enema consisting of sodium dihydrogen phosphate and disodium hydrogen phosphate can be used safely

Early postoperative changes of sphingomyelins and ceramides after laparoscopic sleeve gastrectomy

Abstract Background This study aimed to determine early postoperative changes of serum sphingomyelin (SM) and ceramide (CER) species following laparoscopic sleeve gastrectomy (LSG). Methods Twenty obese patients [mean body mass index (BMI) 45,64 ± 6,10 kg/m2] underwent LSG and normal weight control patients (mean BMI 31,51 ± 6,21 kg/m2) underwent laparoscopic cholecystectomy. Fasting blood samples were collected prior to surgery, at day 1 and day 30 after surgery. Circulating levels of C16-C24 SMs, C16-C24 CERs and sphingosine-1-phosphate (S1P) were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Serum activity of neutral sphingomyelinase (N-SMase) was assayed by standard kit methods, and ceramide-1-phosphate (C1P) levels were determined by enzyme-linked immunosorbent assay (ELISA). Lipid profile, routine biochemical and hormone parameters were assayed by standard kit methods. Insulin sensitivity was evaluated using homeostatic model assessment for insulin resistance (HOMA IR). Results A significant decrease was observed in serum levels of very-long-chain C24 SM, very-long-chain C22-C24 CERs, HOMA-IR, N-SMase and C1P in LSG patients after postoperation day 1 and day 30 compared to preoperation levels. At 30 days postsurgery, BMI was reduced by 11%, fasting triglycerides were significantly decreased, and insulin sensitivity was increased compared to presurgery values. A significant positive correlation was found between HOMA-IR and serum levels of C22-C24 CERs in LSG patients. Conclusion We conclude that very long chain CERs may mediate improved insulin sensitivity after LSG