EVALUATION OF LAPAROSCOPIC BARIATRIC SURGERY OUTCOMES AT OUR HOSPITAL

Yıl 2025, Cilt: 58 Sayı: 3, 126 - 129, 24.02.2026

Hüseyin Hakan Amioğlu , Turan Eray Seven , Gökhan Karaca

https://izlik.org/JA67AM73RB

Öz

Aim
Obesity is defined by the World Health Organization as excessive fat accumulation that may harm health. Initial treatments usually include diet, exercise, and lifestyle changes. However, surgery is becoming an important option. This study shares our experience with laparoscopic bariatric surgery.
Material and Method
With approval from the Ethics Committee of University of Health Sciences Sincan Training and Research Hospital, we retrospectively reviewed records of 71 patients who had laparoscopic bariatric surgery by a single surgeon between July 2023 and August 2024.
Results
The average age of patients was 34.8 years (median 33). There were 55 females (77.5%) and 16 males (22.5%). Smokers made up 32.4%. The mean preoperative BMI was 45.3 kg/m² (median 44.1). ASA scores were ASA I for 4 patients (5.6%), ASA II for 31 patients (43.6%), and ASA III for 36 patients (50.7%).
Complications occurred in 5.6% of patients. The most common complaints after surgery were nausea (13 patients), pain (12 patients), and vomiting (9 patients). Gender and smoking did not significantly affect complications. Twenty-one patients (29.5%) had comorbidities, most commonly hypertension (14.1%) and type 2 diabetes (12.7%). There was no significant difference in baseline BMI or excess weight loss between those with or without these conditions. Complication rates were slightly higher in patients with hypertension or diabetes, but not statistically significant. At six months, 80% of hypertensive and 44.4% of diabetic patients showed improvement.
The average BMI dropped from 45.3 to 31.0 kg/m² after six months (p < 0.001). Total weight loss was 31.6 ± 6.1%.
Conclusion:
Based on the findings of our study, considering the low mortality and morbidity rates as well as the improvement in comorbid conditions, we believe that surgical intervention should be considered earlier in the treatment algorithm for patients with obesity.

Anahtar Kelimeler

obesity , surgery , sleeve gastrectomy

Etik Beyan

Our study was approved by the Health Sciences University Sincan Training and Research Hospital Ethics Committee with the decision numbered 2025-25 and dated 16.09.25.

Destekleyen Kurum

None

Teşekkür

None

HASTANEMİZDE UYGULADIĞIMIZ LAPAROSKOPİK OBEZİTE CERRAHİSİ SONUÇLARIMIZIN DEĞERLENDİRMESİ

https://izlik.org/JA67AM73RB

Öz

Amaç:
Dünya Sağlık Örgütü tarafından “vücutta, sağlığı bozacak şekilde aşırı yağ birikmesi” olarak tanımlanan obezite tedavisine genellikle diyet, egzersiz programları ve yaşam alışkanlıkları değişikliği ile başlanmaktadır. Ancak cerrahinin yeri giderek artmaktadır. Çalışmamızda obezite cerrahisinde edindiğimiz deneyimlerimizi paylaşacağız.
Gereç ve Yöntem:
SBÜ Sincan Eğitim ve Araştırma Hastanesi etik kurul onayı ile, 31.07.2023 ile 26.08.2024 tarihleri arasında tek hekim tarafından laparoskopik obezite cerrahisi uygulanan 71 olgunun dosyaları retrospektif olarak incelendi.
Bulgular:
Katılımcıların yaş ortalaması 34,8 medyan yaşı 33’tü. Hastaların 55 tanesi kadın (%77,5) 16 tanesi erkekti (%22,5). Sigara kullananların oranı %32,4’tür. Başlangıç VKİ ortalaması 45,3 kg/m², medyanı ise 44,1 kg/m²’dir. Hastaların pre-operatif değerlendirilmelerinde 4 hastaya ASA1 (%5,6), 31 hastaya ASA2 (%43.6), 36 hastaya ASA3 (%50,7) skoru verildi.
Komplikasyon gelişen hasta oranı %5.6 idi. Ameliyat sonrası hastalarda şikayet olarak en sık bulantı (13 hasta), ağrı (12 hasta) ve kusma (9 hasta) görülmüştür. Cinsiyet ve sigara kullanımı, komplikasyon gelişimi üzerinde anlamlı bir etkiye sahip değildir . Hastaların 21 inde (% 29,5) en az bir ek hastalık mevcuttu. En sık görülen hastalıklar hipertansiyon (%14,1) ve tip 2 diyabet (12,7%) idi. HT ve tip 2 DM varlığı ile başlangıç VKİ ve EWL % (fazla kilo kaybı yüzdesi) arasında anlamlı bir fark bulunmamıştır. Komplikasyon oranları HT ve tip 2 DM olanlarda hafif yüksek olmakla birlikte, bu farklar istatistiksel olarak anlamlı değildir. 6. ayda HT hastalarının 8'inde (%80) ve tip 2 DM hastalarının 4'ünde (%44,4) hastalıklarında düzelme görülmüştür.
Hastaların başlangıç VKİ ortalaması 45,3 kg/m² iken, 6. ayda bu değer 31,0 kg/m²’ye düşmüştür. Ortalama VKİ değişimi 14,3 kg/m² olup, bu azalma istatistiksel olarak anlamlıdır (p<0,001). Total kilo kaybı(TWL) oranı 6. ayda 31.6 ± 6.1 olarak bulunmuştur.
Sonuç:
Çalışmamız sonucunda, mortalite ve morbiditenin düşüklüğü ve ek hastalıklardaki düzelme ile birlikte değerlendirildiğinde, obezite hastalarında cerrahi seçeneğinin tedavi basamağında daha erken düşünülmesi gerektiği görüşündeyiz.

Anahtar Kelimeler

obezite , cerrahi , sleeve gastrektomi

Etik Beyan

Çalışmamıza Sağlık Bilimleri Üniversitesi Sincan Eğitim ve Araştırma Hastanesi Etik Kurulu tarafından 16.09.25 tarih ve 2025-25 sayılı etik kurul kararı ile onay alınmıştır.

Destekleyen Kurum

Yok

Teşekkür

Yok

Kaynakça

• 1. World Health Organization (WHO). Obesity: preventing and managing the global epidemic Report of a WHO Consultation (WHO Technical Report Series 894). https://www.who.int/nutrition/ publications/obesity/WHO_TRS_894/en/. Erişim tarihi: 2.05.20.
• 2. World Health Organization (WHO). Obesity and overweight. https://www.who.int/news-room/factsheets/detail/obesity-and-overweight. Erişim tarihi: 12.05.2022.
• 3. Türkiye İstatistik Kurumu (TUIK) 2022. Türkiye Sağlık Araştırması. 2019. https://tuikweb.tuik.gov. tr/PreHaberBultenleri. do?id=33661. Erişim tarihi: 30.01.2022
• 4. Clarke B, Swinburn B, Sacks G. Understanding the LiveLighter® obesity prevention policy processes: An investigation using political science and systems thinking. Social Science and Medicine 2020; 246:1-10. doi 10.1016/j.socscimed.2019.112757
• 5. Akkayaoğlu H, Çelik S. Eating attitudes, perceptions of body image and patient quality of life before and after bariatric surgery. Applied Nursing Research 2020; 53:151270 doi: 10.1016/j. apnr.2020.151270
• 6. Cho EJ, Kim SM. Revisional surgery after removal of eroded adjustable gastric bands. Asian J Surg 2019;42(6):688–695. doi: 10.1016/j.asjsur.2018.11.003
• 7. Viscido G, Gorodner V, Signorini FJ, Biasoni AC, Navarro L, Rubin G, et al. Obese Patients with Type 2 Diabetes: Outcomes After Laparoscopic Sleeve Gastrectomy. J Laparoendosc Adv Surg Tech A 2019;29(5):655–662. doi: 10.1089/lap.2018.0652
• 8. Almerie MQ, Rao VSR, Peter MB, Sedman P, Jain P. The Impact of Laparoscopic Gastric Bypass on Comorbidities and Quality of Life in the Older Obese Patients (Age > 60): Our UK Experience. Obes Surg 2018;28(12):3890–3894. doi: 10.1007/s11695- 018-3414-6
• 9. Minhem MA, Safadi BY, Habib RH, Raad EPB, Alami RS. Increased adverse outcomes after laparoscopic sleeve gastrectomy in older super-obese patients: analysis of American College of Surgeons National Surgical Quality Improvement Program Database. Surg Obes Relat Dis 2018;14(10):1463–1470. doi: 10.1016/j. soard.2018.06.023
• 10. Gumbs AA, Gagner M, Dakin G, Pomp A. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17(7):962-969. doi:10.1007/s11695-007-9151-x.
• 11. E Büyükerkmen, T Yavuz, Ö Sert, ED Bakı, M Akıcı, A Yuksek, et al. Hastanemizde Uygulanan Laparoskopik Obezite Cerrahisi Vakalarının Geriye Dönük Değerlendirilmesi. Kocatepe Tıp Dergisi,, Volume: 22 Issue: 4, 282 - 286, 01.07.2021. doi:10.18229/ kocatepetip.762856
• 12. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724-37. doi: 10.1001/ jama.292.14.1724. Erratum in: JAMA. 2005 Apr 13;293(14):1728. PMID: 15479938.
• 13. Candiotti K, Sharma S, Shankar R. Obesity, obstructive sleep apnoea, and diabetes mellitus: anaesthetic implications. Br J Anaesth. 2009; 103 (suppl_1): i23-i30.
• 14. Brethauer SA, Kim J, el Chaar M, Papasavas P, Eisenberg D, Rogers A, Ballem N, Kligman M, Kothari S; ASMBS Clinical Issues Committee. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015 May-Jun;11(3):489-506. doi: 10.1016/j.soard.2015.02.003. PMID: 26093765.
• 15. Grover BT, Morell MC, Kothari SN, Borgert AJ, Kallies KJ, Baker MT. Defining Weight Loss After Bariatric Surgery: a Call for Standardization. Obes Surg. 2019 Nov;29(11):3493-3499. doi: 10.1007/s11695-019-04022-z. PMID: 31256357.
• 16. Sanchez-Cordero S, Garcia Ruiz de Gordejuela A, Vilallonga R, Gonzalez O, Ciscar A, Ciudin A, et al. Analysis of the Variability in Different Criteria to Define the Success of Bariatric Surgery: Retrospective Study 5-Year Follow-Up after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass. J Clin Med. 2022 Dec 26;12(1):187. doi: 10.3390/jcm12010187. PMID: 36614988; PMCID: PMC9820931.
• 17. van de Laar AW, Emous M, Hazebroek EJ, Boerma EJ,. www.kjim.org The Korean Journal of Internal Medicine Vol. 40, No. 1, January 2025 https://doi.org/10.3904/kjim.2024.219. Faneyte IF, Nienhuijs SW. Reporting weight loss 2021: position statement of the Dutch Society for Metabolic and Bariatric Surgery (DSMBS). Obes Surg 2021;31:4607-4611.
• 18. van de Laar AW, Acherman YI. Weight loss percentile charts of large representative series: a benchmark defining sufficient weight loss challenging current criteria for success of bariatric surgery. Obes Surg 2014;24:727-734.
• 19. Peterli R, Wölnerhanssen BK, Peters T, Vetter D, Kröll D, Borbély Y, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial. JAMA. 2018 Jan 16;319(3):255-265. doi: 10.1001/ jama.2017.20897. PMID: 29340679; PMCID: PMC5833546. 129
• 20. Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial. JAMA. 2018 Jan 16;319(3):241- 254. doi: 10.1001/jama.2017.20313. PMID: 29340676; PMCID: PMC5833550.
• 21. Wölnerhanssen BK, Peterli R, Hurme S, Bueter M, Helmiö M, Juuti A, et al. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: 5-year outcomes of merged data from two randomized clinical trials (SLEEVEPASS and SM-BOSS). Br J Surg. 2021 Jan 27;108(1):49-57. doi: 10.1093/bjs/znaa011. PMID: 33640917.
• 22. Park JY, Heo Y, Kim YJ, Park JM, Kim SM, Park DJ, et al. Long-term effect of bariatric surgery versus conventional therapy in obese Korean patients: a multicenter retrospective cohort study. Ann Surg Treat Res. 2019 Jun;96(6):283-289. doi: 10.4174/ astr.2019.96.6.283. Epub 2019 May 29. PMID: 31183332; PMCID: PMC6543048.
• 23. Heo YS, Park JM, Kim YJ, Kim SM, Park DJ, Lee SK, et al. Bariatric surgery versus conventional therapy in obese Korea patients: a multicenter retrospective cohort study. J Korean Surg Soc. 2012 Dec;83(6):335-42. doi: 10.4174/jkss.2012.83.6.335. Epub 2012 Nov 27. PMID: 23230551; PMCID: PMC3514475.
• 24. Park DJ, An S, Park YS, Lee JH, Lee HJ, Ha TK, et al. Bariatric surgery versus medical therapy in Korean obese patients: prospective multicenter nonrandomized controlled trial (KOBESS trial). Ann Surg Treat Res. 2021 Oct;101(4):197-205. doi: 10.4174/ astr.2021.101.4.197. Epub 2021 Oct 1. PMID: 34692591; PMCID: PMC8506022.