Upper Gastrointestinal Endoscopy performed before sleeve gastrectomy in patients with morbid obesity: retrospective analysis of 460 patients

Objective: We aim to retrospectively evaluate results of preoperative upper gastrointestinal endoscopy[UGE] performed in our endoscopy unit on morbid obese patients who underwent Laparoscopic Sleeve Gastrectomy [LSG].

Material and Method: The study was carried out on 460 morbid obese patients who underwent UGE before LSG at the General Surgery Endoscopy Unit of Keçi?ren Training and Research Hospital and their age, body mass index, additional diseases and endoscopy findings were evaluated..From endoscopy findings, antral gastritis, LES laxity, pyloric dysfunction, esophagitis, hiatal hernia, pancreatitis, body mass index were evaluated with univariate analysis and comparative logistic method

Findings: UGE was performed in 460 patients who were scheduled for LSG. Patients had antral gastritis, 46 [10 percent] patients had pangastritis, 30 [6.6 percent] patients had esophagitis, 163 [35.6] patients had LES laxity, 58 [12.7 percent] patients had Hiatal Hernia, 25 [5.5 percent] patients had pylor dysfunction and additional comorbidities were detected in 18 [3.9; percent] patients.Patients with antral gastritis had statistical significance with LES laxity and age [p 0,002, p 0,003], patients with pancreatitis had statistical significance with Hiatal Hernia, pyloric dysfunction and LES laxity[p 0.007, p 0.004, p 0.002]. There is also significant statistical relationship between esophagitis and hiatal hernia [p 0.001].In multivariant analysis; Hiatal Hernia increased the risk of pancreatitis by 2.5 times, while LES laxity increased risk of pangastritis by 0.42 times. Pyloric dysfunction has been shown to increase pangastritis risk by 5.6 fold.Age increased risk of antral gastritis by 1.04 fold, and LES laxity increased risk of antral gastritis by 2.07 fold

Discussion and Conclusion: We believe that an upper GIS endoscopy that will be performed before obesity surgery will play a very important role in surgical method selection

rare cause of ileus: napkin

Foreign bodies are one of the rare cause of mechanical intestinal obstructions. 75 years old female patient presented to emergency department complaining about abdominal pain, nausea and vomiting. Patient underwent to surgery for mechanical intestinal obstruction. Obstruction due to necrosis in 30 centimeters of terminal ileum detected. Resection and end to end anastomosis performed. A napkin seen inside of the specimen. We are presenting a patient with mechanical intestinal obstruction due to a napkin

Outcomes of laparoscopic versus open splenectomy / 대한외과학회지

PURPOSE: Laparoscopic techniques have gained wide clinical acceptance in surgical practice today. The laparoscopic approach has been established as the technique of choice for elective splenectomies performed on normal sized spleens. The purpose of this study was to evaluate the outcome of patients undergoing laparoscopic splenectomy (LS) at the TOBB University of Economics and Technology (ETU) Hospital and Kecioren Training and Research Hospital. METHODS: One hundred and thirty-five patients underwent splenectomy between January 2000 and July 2010. For comparison, the records of 130 patients undergoing splenectomy were evaluated for age, gender, hospital stay, time to start of diet, conversion rate, operation time and wound infection. RESULTS: Mean operation time means the time interval between surgeon commencing operation to end of operation. Mean operation time in patients treated by LS was 132 minutes and 121 minutes in open splenectomy (OS). Mean hospital stay was 5.65 days in patients undergoing LS and starting of diet was 1.21 days. In patients treated by OS, mean hospital stay was 9.17 days, starting of diet was 2.37 days. Four patients were converted to open surgery. Conversion rate was 6.4 percent. In the early post operative period (within 10 days of surgery) 9.2%, LS group had lower incidences of wound infection rate after surgery than OS group (4.8%, 7.4%, respectively; P = 0.06). CONCLUSION: LS is a safe and effective alternative to OS for treatment of splenic diseases in patients of all ages.

An Unusual Cause of Inguinal Hernia in a Male Patient: Endometriosis

No abstract available.