Assessment of the diagnostic efficacy of abdominal ultrasonography and cine magnetic resonance imaging in detecting abdominal adhesions: A double-blind research study.

PURPOSE: This cohort aimed to determine the efficacy and safety of abdominal ulrasonography and cine-MRI by a double-blind study in the diagnosis of intraabdominal organs and abdominal wall adhesions in patients with previous abdominal operations. METHODS: Between 2017 and 2019, 108 consecutive patients were prospectively included in the study. Visceral slide and induced visceral slide were measured during AU and cine-MRI. An abdominal map consisting of nine segments was created to document the location and extent of the adhesion. The degree and severity of the adhesions detected by the radiologist preoperatively and detected in surgery as the gold standard was recorded in the same abdominal zones. AU, c-MRI and intraoperative findings were correlated. RESULTS: The mean age was 53.0 ±â€¯10.3 years, body mass index was 30.4 ±â€¯3.4, male (52.8 %) and female (47.2 %). According to the total nine zones, the sensitivity of AU was 91.4 %, specificity was 100 %, positive predictive value was 90.7 %, negative predictive value was 100 % and diagnostic accuracy was 87.9 %. Considering the total zones, the sensitivity of c-MRI was 90.8 %, specificity was 100 %, PPV was 90.7 %, NPV was 100 % and diagnostic accuracy was 91.7 %. A comparison of AU and c-MRI showed no significant difference in the detection of adhesions to the abdominal wall; however, c-MRI was superior in detecting intraabdominal organs adhesion. CONCLUSION: We have demonstrated that AU and c-MRI are accurate for diagnosing adhesions in patients undergoing repeated surgery and may have a place on planning elective laparoscopic or open surgery to avoid bowel injury.

Re-Sleeve Gastrectomy for Failed Primary Laparoscopic Sleeve Gastrectomy.

OBJECTIVE: To investigate the effectiveness of re-sleeve gastrectomy (LRSG) in patients who had insufficient weight loss or weight regain after laparoscopic sleeve gastrectomy (LSG). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Ortadogu Private Hospital, Turkey, between March 2013 and January 2017. METHODOLOGY: Patients who underwent LRSG following LSG due to inadequate weight loss or weight regain retrospectively evaluated. Patients' demographics, comorbidities, and bariatric surgery outcomes, as well as hospitalisation rate, excess weight loss percentage (EWL%), and body mass index (BMI ) were recorded. Scheduled follow-up visits after surgery at 1, 3, 6, and 12 months post-surgery and every six months subsequently were done. RESULTS: A total of 21 patients that underwent LRSG after LRG due to inadequate weight loss or a regain in weight. Of them, 7 (33.3%) were males, and 14 (66.7%) were females. The mean body weight index (BMI) before primary LSG was 52.3 ±4.7 Kg/m² and EWL% was 32.7 ±4.6. After an average follow-up of 24 months. BMI of patients before LRSG was 46.1 ±4.3 Kg/m². Following a 1-year observation, there was a substantial (p<0.001) improvement in BMI (21.6 ±3.1 Kg/m 2 ) and excess weight loss percentage (86.82% of EWL). CONCLUSION: LRSG is an available and efficient method to correct the regain of weight or inadequate weight loss following LSG.