Transit Bipartisyon Cerrahisinde Komplikasyonların Erken Öngörülmesi İçin Ameliyat Öncesi ve Ameliyat Sonrası Nötrofil/Lenfosit Oranının Karşılaştırılması

Year 2022, Volume: 5 Issue: 3, 421 - 427, 31.12.2022

Serdar Yormaz

https://doi.org/10.36516/jocass.1159016

Abstract

GİRİŞ ve AMAÇ:
Bariatrik cerrahi tüm dünyada morbid obezitenin global güncel tedavi yöntemidir. Bu nedenle son yıllarda prediktör parametreler önem kazanmaktadır. Amacımız, Transit Bipartisyonun (TB-SG) sonuçlarını değerlendirmek ve ayrıca komplikasyonları erken bir aşamada öngörmede nötrofil/lenfosit oranının (NLR) değerini değerlendirmektir.


YÖNTEM ve GEREÇLER: Bu retrospektif araştırmamızda Mayıs 2019-Mart 2021 tarihleri ​​arasında üçüncü basamak bariatri kliniğinde TB-SG uygulanan katılımcıları değerlendirdik. NLO sonuçları postoperatif 1. ve 3. günlerde belirlendi.


BULGULAR: Bu araştırmaya 21 kadın ve 19 erkek katılımcı dahil edilmiştir. Yaş ortalaması 42,7 yıl ve vücut kitle indeksi (BMI) 46.4 kg/m2 idi. Ortalama hastanede kalış süresi 3.4 gündü (aralık2,3−6,7 gün) (p < 0.05). Çok değişkenli lojistik regresyon analizinde, yalnız NLR'nin özellikle post-bariatrik komplikasyonlarla belirgin bir korelasyonu olduğu ve kesme noktalarının da öncekine benzer olduğu gösterilmiştir.


TARTIŞMA ve SONUÇ: TB-SG cerrahisinde NLR'nin postoperatif erken dönemde erken komplikasyonları saptamada pozitif ilişkisi olduğunu gösterdik

Keywords

OBEZITE, BARIATRIK, BIPARTISYON, Keywords: Diabetes mellitus, metabolic surgery, transit bipartition

The Comparison of the Preoperative and Postoperative Neutrophil to Lymphocyte Ratio for Early Prediction of Complications in Transit Bipartition Surgery

Abstract

Abstract
Aim: Metabolic surgery is a newly applied and effective treatment method in type 2 diabetes all over the world. For this reason, blood parameters have come to the fore more frequently in the last decade to predict possible complications early.
Our aim is to evaluate the neutrophil/lymphocyte ratio (NLR), which is a convenient and cheaper parameter for early diagnosis of complications in Transit Bipartition (TB-SG) surgery, which is the last modality in diabetes surgery.
Methods: In our study, we retrospectively evaluated diabetic patients who underwent TB-SG in the metabolic surgery clinic between May 2019 and March 2021 and their surgical results. NLR parameter values of the patients were examined on the 1st and 3rd postoperative days.
Results: 21 female and 19 male participants were included in our study. The mean age of the patients was 42.7 years and their body mass index (BMI) was 46.4 kg/m2. The mean hospital stay of the patients was 3.4 days (2.3−6.7 days) (p < 0.05). In the logistic regression study applied, it was shown that the NLR value showed a significant direct ratio with the complications and a correlation was determined.
Conclusions: In the new metabolic surgery method such as TB-SG, NLR was found to be a useful and appropriate parameter in detecting possible complications in the postoperative period.

Keywords

metabolic surgery, transit bipartition, Diabetes mellitus

References

• 1. Grassmann S, Wirsching J, Eichelmann F, Aleksandrova K.Association between peripheral adipokines and inflammation markers: a systematic review and meta-analysis. Obesity 2017;25:1776–85.
• 2. Conroy MJ, Dunne MR, Donohoe CL, Reynolds JV. Obesity associated cancer: an immunological perspective. Proc Nutr Soc 2016;75:125–38.
• 3. Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci AMS 2017;13:851–63
• 4. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil– lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 2012;5:2.
• 5. Topart P, Becouarn G, Finel JB. Is transit bipartition a better alternative to biliopancreatic diversion with a duodenal switch for super obesity? Comparison of the early results of both procedures. Surg Obes Relat Dis. 2020;16(4):497–502.
• 6. Topart P, Becouarn G, Finel JB. Comparison of 2-year results of Roux-en-Y gastric bypass and transit bipartition with sleeve gastrectomy for super obesity. Obes Surg. 2020;30(9):3402–7.
• 7 Ece I, Yilmaz H, Yormaz S, Çolak B, Calisir A, Sahin M. The short-term efects of transit bipartition with sleeve gastrectomy and distal-Roux-en-Y gastric bypass on glycemic control, weight loss, and nutritional status in morbidly obese and type 2 diabetes mellitus patients. Obes Surg. 2021 May;31(5):2062–71.
• 8. Al M, Taskin HE. Sleeve gastrectomy with transit bipartition in a series of 883 patients with mild obesity: early efectiveness and safety outcomes. Surg Endosc. 2022;36(4):2631–42.
• 9. Gulaydin N, Ersoz F, Derici N, et al, Comparative evaluation of efficiency for gastroileostomy anastomosis in laparoscopic transit bipartition with sleeve gastrectomy between linear and circular staplers.Wideochir Inne Tech Maloinwazyjne. 2022 Mar;17(1):199-206. doi: 10.5114/wiitm.2021.107756. Epub 2021 Jul 13.
• 10. Yormaz S, Yılmaz H, Ece I, et al. Laparoscopic Ileal interpositionwith diverted sleeve gastrectomy versus laparoscopic transit bipartitionwith sleeve gastrectomy for better glycemic outcomes in T2DM patients. Obes Surg. 2018;28(1):77–86. https://doi.org/10.1007/s11695-017-2803-6.
• 11. Ece I,Yılmaz H, Alptekin H, et al. Minimally invasive managementof anastomotic leak after bariatric Roux-en-Y gastric bypass. JMinim Access Surg. 2015;11(2):160–2. https://doi.org/10.4103/0972-9941.144094.
• 12. Santoro S, Castro LC, Velhote MCP, et al. Sleeve gastrectomy withtransit bipartition: a potent intervention for metabolic syndrome andobesity. Ann Surg. 2012;256(1):104–10. https://doi.org/10.1097/SLA.0b013e31825370c0.
• 13. Santoro S, Malzoni CE, Velhote MC, et al. Digestive adaptationwith intestinal reserve: a neuroendocrine-based operation for morbidobesity. Obes Surg. 2006;16(10):1371–9. https://doi.org/10.1381/096089206778663841
• 14. Carbajo MA, Luque-de-León E, Jiménez JM, Solórzano JOD,Miranda MP, Alija MJC. Laparoscopic one-anastomosis gastric bypass: Technique, results, and long-term follow-up in 1200patients. Obes Surg 2017; 27(5):1153-67. doi: 10.1007/ s11695-016-2428
• 15. Kansou G, Lechaux D, Delarue J, Badic B, Gall ML, GuillermS, et al. Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: One year outcomes. Int J Surg 2016; 33:18-22. doi: 10.1016/j.ijsu.2016.07.0
• 16. Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil lymphocyte ratio: Experience in patients with cancer. Crit Rev Oncol Hematol 2013; 88(1):218-230. doi: 10.1016/j.critrevonc.2013.03.010.
• 17. Halazun KJ, Hardy KJ, Rana AA, Woodland DC, Luyten EJ, Mahadev S, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg 2009; 250(1):141-51. doi: 10.1097/SLA.0b013e3181a77e59.
• 18. Sato H, Tsubosa Y, Kawano T. Correlation between the pretherapeutic neutrophil to lymphocyte ratio and the pathologic response to neoadjuvant chemotherapy in patientswith advanced esophageal cancer. World J Surg 2012; 36(3):617-22. doi: 10.1007/s00268-011-1411-1.
• 19. Da Silva M, Cleghorn MC, Elnahas A, Jackson TD, Okrainec A, QuereshyFA. Postoperative day one neutrophil-to-Lymphocyte ratio as a predictor of30-day outcomes in bariatric surgery patients. Surg Endosc 2017;31(June(6)):2645–50.
• 20.Guclu M, Faruq Agan A, Association of Severity of Helicobacter pylori Infection with Peripheral Blood Neutrophil to Lymphocyte Ratio and Mean Platelet Volume.Euroasian J Hepatogastroenterol. 2017 Jan-Jun;7(1):11-16. doi: 10.5005/jp-journals-10018-1204. Epub 2017 May 5.
• 21. Yoon NB, Son C, Um SJ Role of the neutrophil-lymphocyte count ratio in the differential diagnosis between pulmonary tuberculosis and bacterial community-acquired pneumonia..Ann Lab Med. 2013 Mar;33(2):105-10. doi: 10.3343/alm.2013.33.2.105. Epub 2013 Feb 21.PMID: 23482854
• 22. Doğan M, Akyel A, Bilgin M, et al. Can Admission Neutrophil to Lymphocyte Ratio Predict Infarct-Related Artery Patency in ST-Segment Elevation Myocardial Infarction..Clin Appl Thromb Hemost. 2015 Mar;21(2):172-6. doi: 10.1177/1076029613515071. Epub 2013 Dec 9.PMID: 24322278
• 23. Ishizuka M, Shimizu T, Kubota K ,Neutrophil-to-lymphocyte ratio has a close association with gangrenous appendicitis in patients undergoing appendectomy..Int Surg. 2012 Oct-Dec;97(4):299-304. doi: 10.9738/CC161.1.PMID: 23294069 24. Chiang SF, Hung HY, et al. Can neutrophil-to-lymphocyte ratio predict the survival of colorectal cancer patients who have received curative surgery electively?,.Int J Colorectal Dis. 2012 Oct;27(10):1347-57. doi: 10.1007/s00384-012-1459-x. Epub 2012 Mar 31.PMID: 22460305
• 25. Cox S, Hurt C, Grenader T, Mukherjee S, Bridgewater J, Crosby T.The prognostic value of derived neutrophil to lymphocyte ratio inoesophageal cancer treated with definitive chemoradiotherapy.Radiother Oncol J Eur Soc Therapeut Radiol Oncol 2017;125:154–9.
• 26. Ethier JL, Desautels D, Templeton A, Shah PS, Amir E. Prognosticrole of neutrophil-to-lymphocyte ratio in breast cancer: asystematic review and meta-analysis. Breast Canc Res 2017;19:2.
• 27. Grenader T, Nash S, Adams R, Kaplan R, Fisher D, Maughan T,et al. Derived neutrophil–lymphocyte ratio is predictive ofsurvival from intermittent therapy in advanced colorectal cancer: a post hoc analysis of the MRC COIN study. Br J Canc 2016;114:612–5.
• 28. Halazun KJ, Hardy KJ, Rana AA, Woodland DC, Luyten EJ, Mahadev S, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellularcarcinoma. Ann Surg 2009; 250(1):141-51. doi:10.1097/SLA.0b013e3181a77e59.