Sleeve gastrektomi'nin kısa ve orta dönem sonuçları ve komplikasyonlara yaklaşım
Approach to complications and breast and surgical results of Sleeve gastrectomy
- Tez No: 506712
- Danışmanlar: PROF. DR. YUSUF YAĞMUR
- Tez Türü: Tıpta Uzmanlık
- Konular: Genel Cerrahi, General Surgery
- Anahtar Kelimeler: Morbid Obesity, Laparoscopic Sleeve Gastrectomy, Complication
- Yıl: 2017
- Dil: Türkçe
- Üniversite: Sağlık Bilimleri Üniversitesi
- Enstitü: Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi
- Ana Bilim Dalı: Genel Cerrahi Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
ÖZET Amaç: Morbid obezite nedeniyle laparoskopik sleeve gastrektomi operasyonu olan hastaların operasyon sonrası erken ve orta vadede VKI'indeksine göre kilo kayıpları, ameliyata bağlı erken ve geç komplikasyonları ile bu gelişen komplikasyonların yönetiminin incelenmesi amaçlanmıştır. Materyal ve Metot: Bu çalışma, Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği tarafından 1 Ocak 2013 – 1 Mart 2017 tarihleri arasında, Morbid Obezite nedeniyle laparoskopik sleeve gastrektomi operasyonu olan 21-56 yaş arası toplam 57 hasta üzerinde retrospektif olarak gerçekleştirildi. Hastaların demografik verilerinin yanı sıra, preoperatif vücut kitle endeksi (VKI), postoperatif 3 ay, 6. ay, 1.yıl, 2 yıl ve 3 yıl VKI değerleri, hastanın preoperatif rutin biyokimyasal değerlerine bakıldı. İstatiksel analiz SPSS 23.0 for Windows (SPSS, Inc.; Chicago, USA) paket programı kullanılarak yapılmıştır. İstatistiksel anlamlılık düzeyini belirlemek için, %95 güven aralığında ve p<0,05 anlamlı kabul edildi.
Özet (Çeviri)
ABSTRACT Objective: It is aimed to examine the management of these complications with early and late complications due to weight loss, amelia and early and late complications of the patients with laparoscopic sleeve gastrectomy due to morbid obesity according to BMI in the early and middle stages of the operation. Materıals And Methods: This study was retrospectively performed by Diyarbakır Gazi Yaşargil Training and Research Hospital General Surgery Clinic between January 1, 2013 and March 1, 2017 on 57 patients with laparoscopic sleeve gastrectomy due to Morbid Obesity, 21-56 years of age. In addition to demographic data, preoperative body mass index (BMI), postoperative 3 months, 6 months, 1 year, 2 years and 3 years BMI values and preoperative routine biochemical values of the patients were evaluated. Statistical analysis was performed using the SPSS 23.0 for Windows (SPSS, Inc., Chicago, USA) packet program. To determine the statistical significance level, 95% confidence interval and p <0.05 were considered significant. Findings: A total of 57 patients with morbid obesity were included in the study. Eight of the patients (14,04%) were male and 49 (85,96%) were female. The mean age of the female patients was 34,40 ± 8,49 years (min-max: 21-54) and that of male patients was 36,25 ± 12,73 years (min-max: 21-56). The mean age of all patients is 34,64 ± 9,18 years (min-max: 21-56). The mean age of the female patients was 34,40 ± 8,49 years (min-max: 21-54) and that of male patients was 36,25 ± 12,73 years (min-max: 21-56). The mean age of all patients is 34,64 ± 9,18 years (min-max: 21-56). When we evaluated the BMI values in our study, 39,13 kg / m2 was observed at 3 month control after operation and 33,19 kg / m2 at 6 month control. year, average 29,02 kg / m2, average 28,77kg / m2 during the second year control and average 30,75kg / m2 during the third year control. According to the preoperative period, after 3 months 6 months, 1 year, 2 years and 3 years after the operation, there was a decrease in VKI. When two comparisons were made, the BMI at the 1st year control was less than at the 3rd month and 6th month (P <0.05). In the third year control, an increase in VKI was observed compared to the second year (P <0.05). However, the BMI at the 3 rd year control was less than the pre-operative, 3 rd and 6 th month controls. Hypertension was found in 21.05% of the patients in our study and it was found that only 5.2% of these patients had hypertension in the postoperative period. Decrease in the frequency of diabetes and hypertension after LSG was determined according to the preoperative period. (P <0.005). Complications in LSG patients were stenosis in 3.51%, leakage in 3.51% and bleeding in 1.75%. A second operation has been performed on this disease. Two patients (3.51%) underwent total gastrectomy with Roux-en-Y gastritis bypass (1.75%) as a second operation type. In addition, no major complications or mortality during follow-up were observed Coclusion: In conclusion, short, medium and long term results of LSG applied as primer bariatric surgical method supports LSG as a reliable method with very effective, low mortality and morbidity rates. However, there is a need for a larger group of randomized trials evaluating long-term outcomes of LSG
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