Résumé
Background: Obesity an important health problem which has become a worldwide epidemic that effects both developed countries and developing countries. Bariatric surgery is the most efficient cure for morbid obesity. Authors retrospectively reviewed the results of different techniques in bariatric surgery to assess the efficiency of initial operations.Methods: The medical files and operation notes and the one-year follow-up of patients were reviewed. The outcomes of sleeve gastrectomy (SG) and gastric roux-n-y bypass (RYGBP) operations were reviewed and their effects on excess weight loss were investigated.Results: Overall, there were 97 patients included in the study, the majority of which were female (87/97, or 90%). The mean age of the SG group was 42.01±8.48 years versus 36±8.32 years in the RYGBP group, with p=0.007. Excess weight loss percentages were 51.7% and 57% for sleeve gastrectomy and RYGBP, respectively, p=0.491. Both operations are effective in reducing comorbidities.Conclusions: In the RYGBP procedure there is more excess weight loss than the results of SG procedure but the difference is not statistically significant. In both procedures, the initial results on weight loss and reduction of comorbidities are comparable. Because SG is less traumatic and relatively easier to perform, it can be the preferred operation for morbid obesity.
Résumé
ABSTRACT BACKGROUND: Despite advances in surgical approaches, emergency colorectal surgery has high mortality and morbidity. OBJECTIVE: We aimed to create a simple and distinctive scoring system, for predicting mortality among patients undergoing emergency colorectal surgery. DESIGN AND SETTING: Prediction model development study based on retrospective data-gathering. METHODS: Patients who underwent emergency colorectal surgery between March 2014 and December 2016 at a single tertiary-level referral center were included in our study. Patient demographics, comorbidities, type of surgery, etiology and laboratory and radiological findings were collected retrospectively and analyzed. A new clinical score (named the Numune emergency colorectal resection score) was constructed from the last logistic regression model, in which one point was assigned for the presence of each predictive factor. RESULTS: 138 patients underwent emergency colorectal surgery. These comprised 64 males (46.4%) and 74 females (53.6%), with a mean age of 64 years. Multivariate analysis revealed that blood urea nitrogen level > 65 mg/dl (odds ratio, OR: 8.03; 95% confidence interval, CI: 2.16-15.77), albumin level < 0.7 mg/dl (OR: 4.43; 95% CI: 1.96-14.39) and American Society of Anesthesiologists score ≥ 3 (OR: 3.47; 95% CI: 0.81-9.18) were associated with postoperative complications. The Numune score was graded from I to III. The risk of mortality was found to be 63.2% in the group with grade III, which accounted for 35.2% of the subjects. There were 37 postoperative deaths. CONCLUSIONS: Surgeons need scoring systems, especially to predict postoperative mortality. We propose the Numune emergency colorectal resection score for emergency surgical procedures as a practical, usable and effective system for predicting postoperative morbidity.