The Causes, Prevention, and Management of Gastric Leakage after Laparoscopic Sleeve Gastrectomy: A Review Article

Obesity has been considered a chronic relapsing disease. The increasing number of obese individuals has resulted in an increase in the demand for bariatric surgeries annually. Post-laparoscopic sleeve gastrectomy complications are challenging for both patients and surgeons. Thus, this paper reviews the most common and significant risk factors for leakage occurrence after laparoscopic sleeve gastrectomy and presents new tools, techniques, management options, and recommendations, gathered from newly published articles, for post-laparoscopic sleeve gastrectomy leakage. Causes of post-laparoscopic sleeve gastrectomy leakage include technical factors such as bougie size, transection point, reinforcement materials, and patient co-morbidities as well as ischemic reasons. Ischemic leakage, which is most commonly seen in laparoscopic sleeve gastrectomy, occurs usually after the fourth day, although some leakage may appear earlier within 1-3 days due to technical issues. Use of varied bougie sizes results in similar excess weight loss % at the one-year follow-up. Buttressing materials also reduce post-laparoscopic sleeve gastrectomy bleeding, but not the leakage rate. Endoscopic stents play a significant role in gastric leakage treatment in post-laparoscopic sleeve gastrectomy patients. Intra-operative or even early postoperative diagnostic tools can help in detecting early leaks, but minor leaks as well as those due to ischemic causes may be missed. In conclusion, laparoscopic sleeve gastrectomy is still one of the most effective bariatric surgeries, exhibiting approximately 70% excess weight loss. Although complications of post-laparoscopic sleeve gastrectomy are severe and may be life-threatening, most patients can be treated conservatively. However, those with persistent fistula require surgical intervention.

Divorce rates among cancer patients - a Saudi Arabian study

Introduction: divorce has been a serious problem of major prevalence in our community. According to Saudi Ministry of Justice, divorce rate was estimated to be 27.84% in 2015. Therefore, this study aimed to obtain the incidence of divorce among cancer patients in Princess Noura Oncology Center to know whether being diagnosed with cancer would affect the marital status in terms of divorce

Patients and Methods: the study included 125 patients with age of 15-70 years, have been married, and diagnosed with cancer. Patients were interviewed in the clinic. For data analysis, we used SPSS. Institutional Review Board approval was obtained

Results: divorce rate among cancer patients was significantly lower than that of the general population [P value <0.001]. It was found to be higher in patients with breast cancer 50%, followed by non-solid tumor 33% of all divorces. 66% of divorced cancer patients were females

Conclusion: divorce rate in cancer patients is lower than that of the general population. Therefore, we believe that cancer has led to stronger relationships. Cancer by itself does not increase the rate of divorce. Interestingly, it is generally found to be higher in female patients and breast cancer