We compared a new fascia transversalis based hernioplasty with mesh repair techniques which leave... more We compared a new fascia transversalis based hernioplasty with mesh repair techniques which leave the fascia transversalis intact. We prospectively randomized 180 consecutive patients with inguinal hernia to undergo one of the three hernia repair techniques. Hernias were repaired either by using the new fascia transversalis repair-Coskun's hernia repair (FTR), based on the plication of fascia using continuous sutures and followed by a second layer of interrupted or continuous sutures between inguinal ligament and conjoint tendon to distribute the tension, or one of the two mesh repair techniques: anterior (Lichtenstein) or posterior (preperitoneal) repair. Parameters such as age, sex, hernia cause, operation time, type of anesthesia, surgeon's seniority, complications, hospital stay and follow-up were evaluated. Recurrence rates were determined through clinical examination. Effect of prostatism, co-morbid disease, operation time, complications and Nyhus type of hernia on recurrences were also analysed. Most patients in each group were operated on under general anesthesia (78% vs. 80% vs. 85% for FTR, Lichtenstein, and preperitoneal repair, respectively) and by surgeons in training (average 78%). Patients were followed up for a median of 36 months. FTR had less complications and an acceptable time for operation whereas preperitoneal repairs needed more seniority, longer operation time, and caused more complications. There were only 3 (1.6%) recurrences, none in the FTR group and two the in Lichtenstein group during first postoperative year. There was no recurrence in preperitoneal repair group. All patients with recurrences had an operation time longer than 60 min and were operated on by surgeons in training. Two patients with recurrences had prostatism symptoms and chronic cough. We conclude that the new FTR is as effective as mesh repair (either anterior or posterior) with an acceptable rate of recurrences, fewer complications, and that it can be performed by the surgeons in training.
Surgery for Obesity and Related Diseases, Nov 1, 2015
in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB,... more in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB, while 5,033 (10%) underwent LSG. The two patient subgroups were of similar age, gender makeup and BMI (Table1). DVT rate was higher for LSG (0.48% vs. 0.26%, p o 0.05) while PE rates was lower (0.18% vs. 0.21%, p o 0.05). Risk factors for DVT include age, dyspnea at rest and CHF (Table 2). Risk factors for PE include age, COPD, CHF, ESRD, CVA, paraplegia, 4 10% unintentional weight loss in last 6 months and bleeding disorders (Table 3). Discussion: The LSG appears to confer a higher risk for DVT than LRYGB. The reasons for this are unclear. Continued vigilance in the post-operative period should be maintained. Further studies with a larger LSG population will help clarify this issue.
Annals of Laparoscopic and Endoscopic Surgery, Jul 1, 2020
After the introduction of biliopancreatic diversion (BPD), it is modified by adding duodenal swit... more After the introduction of biliopancreatic diversion (BPD), it is modified by adding duodenal switch (DS) to BPD-DS. Although its technical difficulty and high complication rates, it is accepted as one of the most effective procedure for the treatment of obesity. Many modifications have been developed in order to ease the technique and to overcome the complications. Present paper explains our modified technique of single anastomosis duodenal switch (SADS) and results in 2 years follow-up.
Surgery for Obesity and Related Diseases, Aug 1, 2016
thrombotic events.55 percent of the patients were discharged on POD1 in 2015, and 36 percent in 2... more thrombotic events.55 percent of the patients were discharged on POD1 in 2015, and 36 percent in 2014. Conclusion: An experienced team, exceptional technique and proper education demonstrate that excellent outcomes can be achieved without the use of adjunct buttress materials in performing VSG. Our results reflect a low bleeding rate and no increase in venous thrombosis events, without the administration of postop anticoagulation and with rapid postop patient ambulation. Technique may account for keeping readmission rates low, in addition to education and access to expert personnel.
Surgery for Obesity and Related Diseases, Nov 1, 2015
in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB,... more in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB, while 5,033 (10%) underwent LSG. The two patient subgroups were of similar age, gender makeup and BMI (Table1). DVT rate was higher for LSG (0.48% vs. 0.26%, p o 0.05) while PE rates was lower (0.18% vs. 0.21%, p o 0.05). Risk factors for DVT include age, dyspnea at rest and CHF (Table 2). Risk factors for PE include age, COPD, CHF, ESRD, CVA, paraplegia, 4 10% unintentional weight loss in last 6 months and bleeding disorders (Table 3). Discussion: The LSG appears to confer a higher risk for DVT than LRYGB. The reasons for this are unclear. Continued vigilance in the post-operative period should be maintained. Further studies with a larger LSG population will help clarify this issue.
Surgery for Obesity and Related Diseases, Aug 1, 2016
points, suggesting that patients who become pregnant within 2 years after surgery may have greate... more points, suggesting that patients who become pregnant within 2 years after surgery may have greater long term weight loss.
European journal of endoscopic laparoscopic surgery, Dec 4, 2014
Pancreatic cancer is one of the leading causes of cancer deaths worldwide. Curative resection is ... more Pancreatic cancer is one of the leading causes of cancer deaths worldwide. Curative resection is the only chance of cure. Laparoscopy is a method proving itself in the oncologic surgery fi eld. Currently, laparoscopic resection is the treatment of choice for benign lesions and borderline tumors. Still, more work need to be done for malignancies; however, current advantages of laparoscopy make it an attractive candidate for future pancreatic oncologic surgery.
BACKGROUND AND AIMS The immune cells in tumor microenvironment release chemokines and cytokines w... more BACKGROUND AND AIMS The immune cells in tumor microenvironment release chemokines and cytokines which determine the immune phenotype of the tumor and play an important role in the prognosis. Present study evaluates the gene expression levels of IL-21 and IL-32 and their relations to clinicopathologic parameters in colorectal cancer. PATIENTS AND METHODS 31(17F) patients with colorectal cancer were included. Samples were obtained from normal and tumor tissues. After RNA isolation, IL-21 and IL-32 gene expression levels were measured. Immunohistochemistry was also carried out for CD4+, CD8+ and NKcells to measure cell density. The relations between expression levels, immune cell density and differentiation, stage, presence of vascular, perineural invasion and lymph node metastasis(MLN) were investigated. RESULTS IL-32 gene expression levels were increased in tumor tissues. IL-21 levels were found to be decreased in 50% of the patients. IL-32 levels were also increased with the stage h...
Poster: "ECR 2016 / C-1264 / Imaging Following Mini-Gastric Bypass and Sleeve Gastrectomy: w... more Poster: "ECR 2016 / C-1264 / Imaging Following Mini-Gastric Bypass and Sleeve Gastrectomy: what every radiologists need to know " by: " C. Yazgan , S. Balci, T. Sahin, M. Ozmen; Ankara/TR"
International Journal of Multidisciplinary Research and Development, 2015
Aim: Acute appendicitis is the most common acute condition of the abdomen requiring surgery. To d... more Aim: Acute appendicitis is the most common acute condition of the abdomen requiring surgery. To date, several inflammatory markers have been used for the diagnosis of acute appendicitis. The aim of this study was to evaluate the diagnostic utility of CA-125 (cancer antigen 125) in acute appendicitis. Methods: We prospectively enrolled 52 consecutive male patients and 20 healthy control subjects. Results: Overall, 48/52 patients had acute appendicitis. Of these, 17 had complicated appendicitis (35%). The CA-125 concentration was significantly greater in patients with acute appendicitis than in healthy subjects (26.3 vs. 9.6 U/mL, P .017). Receiver operating characteristic curve analysis suggested that the optimal cutoff CA-125 concentration for acute appendicitis diagnosis was 11.78 U/mL. The positive predictive value and the negative predictive values were 91.0% (95% confidence interval 78.14%–97.52%) and 66.6% (95% confidence interval 44.62%–84.33%), respectively. Conclusions: We c...
Intest nal dupl cat ons are rare developmental anomal es that can occur anywhere along the gastro... more Intest nal dupl cat ons are rare developmental anomal es that can occur anywhere along the gastro ntest nal tract. Gastr c dupl cat on cysts are uncommon congen tal anomal es and are rarely d agnosed n adults. However, d agnos s of the cond t on n an adult can be d ff cult, as t s usually asymptomat c, or the symptoms are nonspec f c. Here we report a rare case of symptomat c Gastr c dupl cat on cysts n an adult who was treated successfully w th surg cal resect on.
The virus COVID-19, which emerged in China in December 2019, was announced by the World Health Or... more The virus COVID-19, which emerged in China in December 2019, was announced by the World Health Organization as a pandemic in January 2020. It is known that infection is not severe and may even progress without symptoms in patients who have come into contact with COVID-19. Although various organizations have been informed about how to take measures to protect the patient and the surgeon in case of diseases requiring urgent or elective surgery in people infected with COVID-19 or in cases with high suspicion, there is still no definite judgment between patients, physicians and health authorities. In this study, which was prepared with the initiative of the Turkish Surgical Association, we tried to shed light on what should be done and how surgeons should act in patients whose operation is mandatory in light of the available data.
Hernie de Petersen après mini-bypass gastrique ଝ Petersen's hernia after mini (one anastomosis) g... more Hernie de Petersen après mini-bypass gastrique ଝ Petersen's hernia after mini (one anastomosis) gastric bypass Mots clés Mini-bypass gastrique ; Une anastomose bypass gastrique ; Simple anastomose bypass gastrique ; Oméga boucle gastric bypass ; Hernie interne ; Hernie
We read with interest this report [1] of Petersen's hernia (PH) after mini (one anastomosis) gast... more We read with interest this report [1] of Petersen's hernia (PH) after mini (one anastomosis) gastric bypass (MGB/OAGB) published recently in your esteemed journal. Authors of this article suggested that surgeons reconsider whether this case report should lead to a recommendation of routine closure of Petersen's space with MGB/OAGB. This issue was hence debated at length within the community of surgeons routinely performing this operation and we feel obliged to share some of the discussion with your readers, who would have also read this case report. First of all, we would like to thank the authors for bringing this problem to our attention. It is indeed a serious issue that merits careful consideration. To the best of our knowledge there is only one other case report of PH after MGB/OAGB [2]. This is significant as there are now several thousand published cases [3,4] of this procedure. Moreover signatories of this letter are now aware of 4 more unpublished cases of PH after MGB/OAGB. Since we believe globally more than 30,000 of this procedure have been carried out till date, this translates into a rough incidence of 2/10,000 published cases and 6/30,000 published as well as unpublished cases. It would hence appear that the incidence of PH is approximately 1:5000. This relatively low incidence might explain why none of the large series till date have reported any PH with MGB/OAGB [3,4]. Authors believe that a long pouch and large Petersen's space with MGB/OAGB helps reduce the incidence of PH with MGB/OAGB. Because it is such a rare condition, we do not believe routine closure of Petersen's space with MGB/OAGB can be recommended at this stage. Moreover the closure may have problems of its own. When surgeons close Petersen's space with Roux-en-Y gastric bypass (RYGB), typically they close the lower part of the space and the space between the Roux limb and the bypassed stomach is left open. Such a closure may actually enhance the incidence of PH with MGB/OAGB by making the space smaller. This might even lead to massive gut infarctions that has not yet been reported after MGB/OAGB but is not unknown after RYGB. In addition, the closure may also predispose to kinks and even leaks;
Obesity is a multifactorial disease in which environmental and genetic factors play an integrated... more Obesity is a multifactorial disease in which environmental and genetic factors play an integrated role. Determining such target genes will help to elucidate the mechanisms underlying complex diseases such as obesity and diabetes which are usually seen together. Present study investigates the expression levels of STEAP4 and HIF-1α in visceral and subcutaneous adipose tissue. 30(6M) morbidly obese patients undergoing bariatric surgery were included in the study. The patients were grouped according to the BMI as Group I (BMI <50kg/m(2)) and Group II (BMI ≥50kg/m(2)). Samples from visceral (omentum) and subcutaneous adipose tissues were obtained from each patient and real-time PCR (qPCR) was carried out for STEAP4 and HIF-1α gene expressions. Correlations between expression levels and clinical parameters were analyzed. Mean age of the patients recruited to the study was 37.4 (18-64) years. Mean BMI was 46 (36-60) kg/m(2). STEAP4 expression in visceral adipose tissue was significantly higher than subcutaneous tissue. Visceral STEAP4 expression was also found to be reduced with increased BMI. It was also lower in patients with HbA1C over 6. Furthermore, expression of subcutaneous and visceral HIF-1α was significantly higher in Group II. There was a significant correlation between BMI, glycosylated hemoglobin, STEAP4 and HIF-1α gene expression. Obesity and related disease are linked with the fact that there is a low grade inflammation in the adipose tissue of the obese individuals. Counter-regulatory processes such as STEAP4 protein family are overwhelmed by the proinflammatory stimuli. HIF-1α expression is increased due to tissue hypoxia and pro-inflammatory stimuli in the obese individuals, which results in increased visceral STEAP4 expressions.
in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB,... more in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB, while 5,033 (10%) underwent LSG. The two patient subgroups were of similar age, gender makeup and BMI (Table1). DVT rate was higher for LSG (0.48% vs. 0.26%, p o 0.05) while PE rates was lower (0.18% vs. 0.21%, p o 0.05). Risk factors for DVT include age, dyspnea at rest and CHF (Table 2). Risk factors for PE include age, COPD, CHF, ESRD, CVA, paraplegia, 4 10% unintentional weight loss in last 6 months and bleeding disorders (Table 3). Discussion: The LSG appears to confer a higher risk for DVT than LRYGB. The reasons for this are unclear. Continued vigilance in the post-operative period should be maintained. Further studies with a larger LSG population will help clarify this issue.
We compared a new fascia transversalis based hernioplasty with mesh repair techniques which leave... more We compared a new fascia transversalis based hernioplasty with mesh repair techniques which leave the fascia transversalis intact. We prospectively randomized 180 consecutive patients with inguinal hernia to undergo one of the three hernia repair techniques. Hernias were repaired either by using the new fascia transversalis repair-Coskun's hernia repair (FTR), based on the plication of fascia using continuous sutures and followed by a second layer of interrupted or continuous sutures between inguinal ligament and conjoint tendon to distribute the tension, or one of the two mesh repair techniques: anterior (Lichtenstein) or posterior (preperitoneal) repair. Parameters such as age, sex, hernia cause, operation time, type of anesthesia, surgeon's seniority, complications, hospital stay and follow-up were evaluated. Recurrence rates were determined through clinical examination. Effect of prostatism, co-morbid disease, operation time, complications and Nyhus type of hernia on recurrences were also analysed. Most patients in each group were operated on under general anesthesia (78% vs. 80% vs. 85% for FTR, Lichtenstein, and preperitoneal repair, respectively) and by surgeons in training (average 78%). Patients were followed up for a median of 36 months. FTR had less complications and an acceptable time for operation whereas preperitoneal repairs needed more seniority, longer operation time, and caused more complications. There were only 3 (1.6%) recurrences, none in the FTR group and two the in Lichtenstein group during first postoperative year. There was no recurrence in preperitoneal repair group. All patients with recurrences had an operation time longer than 60 min and were operated on by surgeons in training. Two patients with recurrences had prostatism symptoms and chronic cough. We conclude that the new FTR is as effective as mesh repair (either anterior or posterior) with an acceptable rate of recurrences, fewer complications, and that it can be performed by the surgeons in training.
Surgery for Obesity and Related Diseases, Nov 1, 2015
in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB,... more in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB, while 5,033 (10%) underwent LSG. The two patient subgroups were of similar age, gender makeup and BMI (Table1). DVT rate was higher for LSG (0.48% vs. 0.26%, p o 0.05) while PE rates was lower (0.18% vs. 0.21%, p o 0.05). Risk factors for DVT include age, dyspnea at rest and CHF (Table 2). Risk factors for PE include age, COPD, CHF, ESRD, CVA, paraplegia, 4 10% unintentional weight loss in last 6 months and bleeding disorders (Table 3). Discussion: The LSG appears to confer a higher risk for DVT than LRYGB. The reasons for this are unclear. Continued vigilance in the post-operative period should be maintained. Further studies with a larger LSG population will help clarify this issue.
Annals of Laparoscopic and Endoscopic Surgery, Jul 1, 2020
After the introduction of biliopancreatic diversion (BPD), it is modified by adding duodenal swit... more After the introduction of biliopancreatic diversion (BPD), it is modified by adding duodenal switch (DS) to BPD-DS. Although its technical difficulty and high complication rates, it is accepted as one of the most effective procedure for the treatment of obesity. Many modifications have been developed in order to ease the technique and to overcome the complications. Present paper explains our modified technique of single anastomosis duodenal switch (SADS) and results in 2 years follow-up.
Surgery for Obesity and Related Diseases, Aug 1, 2016
thrombotic events.55 percent of the patients were discharged on POD1 in 2015, and 36 percent in 2... more thrombotic events.55 percent of the patients were discharged on POD1 in 2015, and 36 percent in 2014. Conclusion: An experienced team, exceptional technique and proper education demonstrate that excellent outcomes can be achieved without the use of adjunct buttress materials in performing VSG. Our results reflect a low bleeding rate and no increase in venous thrombosis events, without the administration of postop anticoagulation and with rapid postop patient ambulation. Technique may account for keeping readmission rates low, in addition to education and access to expert personnel.
Surgery for Obesity and Related Diseases, Nov 1, 2015
in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB,... more in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB, while 5,033 (10%) underwent LSG. The two patient subgroups were of similar age, gender makeup and BMI (Table1). DVT rate was higher for LSG (0.48% vs. 0.26%, p o 0.05) while PE rates was lower (0.18% vs. 0.21%, p o 0.05). Risk factors for DVT include age, dyspnea at rest and CHF (Table 2). Risk factors for PE include age, COPD, CHF, ESRD, CVA, paraplegia, 4 10% unintentional weight loss in last 6 months and bleeding disorders (Table 3). Discussion: The LSG appears to confer a higher risk for DVT than LRYGB. The reasons for this are unclear. Continued vigilance in the post-operative period should be maintained. Further studies with a larger LSG population will help clarify this issue.
Surgery for Obesity and Related Diseases, Aug 1, 2016
points, suggesting that patients who become pregnant within 2 years after surgery may have greate... more points, suggesting that patients who become pregnant within 2 years after surgery may have greater long term weight loss.
European journal of endoscopic laparoscopic surgery, Dec 4, 2014
Pancreatic cancer is one of the leading causes of cancer deaths worldwide. Curative resection is ... more Pancreatic cancer is one of the leading causes of cancer deaths worldwide. Curative resection is the only chance of cure. Laparoscopy is a method proving itself in the oncologic surgery fi eld. Currently, laparoscopic resection is the treatment of choice for benign lesions and borderline tumors. Still, more work need to be done for malignancies; however, current advantages of laparoscopy make it an attractive candidate for future pancreatic oncologic surgery.
BACKGROUND AND AIMS The immune cells in tumor microenvironment release chemokines and cytokines w... more BACKGROUND AND AIMS The immune cells in tumor microenvironment release chemokines and cytokines which determine the immune phenotype of the tumor and play an important role in the prognosis. Present study evaluates the gene expression levels of IL-21 and IL-32 and their relations to clinicopathologic parameters in colorectal cancer. PATIENTS AND METHODS 31(17F) patients with colorectal cancer were included. Samples were obtained from normal and tumor tissues. After RNA isolation, IL-21 and IL-32 gene expression levels were measured. Immunohistochemistry was also carried out for CD4+, CD8+ and NKcells to measure cell density. The relations between expression levels, immune cell density and differentiation, stage, presence of vascular, perineural invasion and lymph node metastasis(MLN) were investigated. RESULTS IL-32 gene expression levels were increased in tumor tissues. IL-21 levels were found to be decreased in 50% of the patients. IL-32 levels were also increased with the stage h...
Poster: "ECR 2016 / C-1264 / Imaging Following Mini-Gastric Bypass and Sleeve Gastrectomy: w... more Poster: "ECR 2016 / C-1264 / Imaging Following Mini-Gastric Bypass and Sleeve Gastrectomy: what every radiologists need to know " by: " C. Yazgan , S. Balci, T. Sahin, M. Ozmen; Ankara/TR"
International Journal of Multidisciplinary Research and Development, 2015
Aim: Acute appendicitis is the most common acute condition of the abdomen requiring surgery. To d... more Aim: Acute appendicitis is the most common acute condition of the abdomen requiring surgery. To date, several inflammatory markers have been used for the diagnosis of acute appendicitis. The aim of this study was to evaluate the diagnostic utility of CA-125 (cancer antigen 125) in acute appendicitis. Methods: We prospectively enrolled 52 consecutive male patients and 20 healthy control subjects. Results: Overall, 48/52 patients had acute appendicitis. Of these, 17 had complicated appendicitis (35%). The CA-125 concentration was significantly greater in patients with acute appendicitis than in healthy subjects (26.3 vs. 9.6 U/mL, P .017). Receiver operating characteristic curve analysis suggested that the optimal cutoff CA-125 concentration for acute appendicitis diagnosis was 11.78 U/mL. The positive predictive value and the negative predictive values were 91.0% (95% confidence interval 78.14%–97.52%) and 66.6% (95% confidence interval 44.62%–84.33%), respectively. Conclusions: We c...
Intest nal dupl cat ons are rare developmental anomal es that can occur anywhere along the gastro... more Intest nal dupl cat ons are rare developmental anomal es that can occur anywhere along the gastro ntest nal tract. Gastr c dupl cat on cysts are uncommon congen tal anomal es and are rarely d agnosed n adults. However, d agnos s of the cond t on n an adult can be d ff cult, as t s usually asymptomat c, or the symptoms are nonspec f c. Here we report a rare case of symptomat c Gastr c dupl cat on cysts n an adult who was treated successfully w th surg cal resect on.
The virus COVID-19, which emerged in China in December 2019, was announced by the World Health Or... more The virus COVID-19, which emerged in China in December 2019, was announced by the World Health Organization as a pandemic in January 2020. It is known that infection is not severe and may even progress without symptoms in patients who have come into contact with COVID-19. Although various organizations have been informed about how to take measures to protect the patient and the surgeon in case of diseases requiring urgent or elective surgery in people infected with COVID-19 or in cases with high suspicion, there is still no definite judgment between patients, physicians and health authorities. In this study, which was prepared with the initiative of the Turkish Surgical Association, we tried to shed light on what should be done and how surgeons should act in patients whose operation is mandatory in light of the available data.
Hernie de Petersen après mini-bypass gastrique ଝ Petersen's hernia after mini (one anastomosis) g... more Hernie de Petersen après mini-bypass gastrique ଝ Petersen's hernia after mini (one anastomosis) gastric bypass Mots clés Mini-bypass gastrique ; Une anastomose bypass gastrique ; Simple anastomose bypass gastrique ; Oméga boucle gastric bypass ; Hernie interne ; Hernie
We read with interest this report [1] of Petersen's hernia (PH) after mini (one anastomosis) gast... more We read with interest this report [1] of Petersen's hernia (PH) after mini (one anastomosis) gastric bypass (MGB/OAGB) published recently in your esteemed journal. Authors of this article suggested that surgeons reconsider whether this case report should lead to a recommendation of routine closure of Petersen's space with MGB/OAGB. This issue was hence debated at length within the community of surgeons routinely performing this operation and we feel obliged to share some of the discussion with your readers, who would have also read this case report. First of all, we would like to thank the authors for bringing this problem to our attention. It is indeed a serious issue that merits careful consideration. To the best of our knowledge there is only one other case report of PH after MGB/OAGB [2]. This is significant as there are now several thousand published cases [3,4] of this procedure. Moreover signatories of this letter are now aware of 4 more unpublished cases of PH after MGB/OAGB. Since we believe globally more than 30,000 of this procedure have been carried out till date, this translates into a rough incidence of 2/10,000 published cases and 6/30,000 published as well as unpublished cases. It would hence appear that the incidence of PH is approximately 1:5000. This relatively low incidence might explain why none of the large series till date have reported any PH with MGB/OAGB [3,4]. Authors believe that a long pouch and large Petersen's space with MGB/OAGB helps reduce the incidence of PH with MGB/OAGB. Because it is such a rare condition, we do not believe routine closure of Petersen's space with MGB/OAGB can be recommended at this stage. Moreover the closure may have problems of its own. When surgeons close Petersen's space with Roux-en-Y gastric bypass (RYGB), typically they close the lower part of the space and the space between the Roux limb and the bypassed stomach is left open. Such a closure may actually enhance the incidence of PH with MGB/OAGB by making the space smaller. This might even lead to massive gut infarctions that has not yet been reported after MGB/OAGB but is not unknown after RYGB. In addition, the closure may also predispose to kinks and even leaks;
Obesity is a multifactorial disease in which environmental and genetic factors play an integrated... more Obesity is a multifactorial disease in which environmental and genetic factors play an integrated role. Determining such target genes will help to elucidate the mechanisms underlying complex diseases such as obesity and diabetes which are usually seen together. Present study investigates the expression levels of STEAP4 and HIF-1α in visceral and subcutaneous adipose tissue. 30(6M) morbidly obese patients undergoing bariatric surgery were included in the study. The patients were grouped according to the BMI as Group I (BMI <50kg/m(2)) and Group II (BMI ≥50kg/m(2)). Samples from visceral (omentum) and subcutaneous adipose tissues were obtained from each patient and real-time PCR (qPCR) was carried out for STEAP4 and HIF-1α gene expressions. Correlations between expression levels and clinical parameters were analyzed. Mean age of the patients recruited to the study was 37.4 (18-64) years. Mean BMI was 46 (36-60) kg/m(2). STEAP4 expression in visceral adipose tissue was significantly higher than subcutaneous tissue. Visceral STEAP4 expression was also found to be reduced with increased BMI. It was also lower in patients with HbA1C over 6. Furthermore, expression of subcutaneous and visceral HIF-1α was significantly higher in Group II. There was a significant correlation between BMI, glycosylated hemoglobin, STEAP4 and HIF-1α gene expression. Obesity and related disease are linked with the fact that there is a low grade inflammation in the adipose tissue of the obese individuals. Counter-regulatory processes such as STEAP4 protein family are overwhelmed by the proinflammatory stimuli. HIF-1α expression is increased due to tissue hypoxia and pro-inflammatory stimuli in the obese individuals, which results in increased visceral STEAP4 expressions.
in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB,... more in these patients. Results: We identified 52,389 patients, of which 47,356 (90%) underwent LRYGB, while 5,033 (10%) underwent LSG. The two patient subgroups were of similar age, gender makeup and BMI (Table1). DVT rate was higher for LSG (0.48% vs. 0.26%, p o 0.05) while PE rates was lower (0.18% vs. 0.21%, p o 0.05). Risk factors for DVT include age, dyspnea at rest and CHF (Table 2). Risk factors for PE include age, COPD, CHF, ESRD, CVA, paraplegia, 4 10% unintentional weight loss in last 6 months and bleeding disorders (Table 3). Discussion: The LSG appears to confer a higher risk for DVT than LRYGB. The reasons for this are unclear. Continued vigilance in the post-operative period should be maintained. Further studies with a larger LSG population will help clarify this issue.
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