Laparoskopik sleeve gastrektomi uygulanan hastalarda biyoelektrik empedans analizi sonuçlarının değerlendirilmesi ve postoperatif takibe etkisi

Öz

Amaç: Obezite bir sağlık sorunudur. Laparoskopik sleeve gastrektomi (LSG) ameliyatı obezite tedavisinde en yaygın kullanılan cerrahi yöntemdir. LSG sonrası takip, ameliyatın kendisi kadar önemlidir. Bu çalışma, yağ ve kas gibi vücut kompozisyonlarındaki değişiklikleri inceleyerek LSG'nin postoperatif takibinde izlenmenin en doğru yolunu incelemeyi amaçlamaktadır. Gereç ve Yöntem: Eylül 2019-Mart 2020 tarihleri arasında Kırşehir Eğitim ve Araştırma Hastanesinde tek cerrah tarafından LSG ameliyatı geçiren 19 kadın hasta çalışmaya dahil edildi. Hastaların ortalama yaşı 35,73 yıldı. Ortalama vücut kitle indeksi (VKİ) 43.03 idi. Hastalara ameliyat öncesi, ameliyat sonrası 1. ve 2. aylarda biyoelektrik empedans analizi yapıldı. Sonuçların istatistiksel değerlendirmesi yapıldı. Bulgular: Kilo, VKİ ve yağ gibi birçok istenmeyen değer önemli ölçüde azaldı (p <0.05). Ancak mineral, protein ve sıvı değerlerinde özellikle 2. ay ölçümlerinde anlamlı değerler elde edilmedi (sırasıyla p = 0,582, p = 0,160, p = 0,376). Ekstremite kası değerlerine bakıldığında sağ ve sol bacak ve sol kol kaslarında 2. ay ölçümlerinde istatistiksel olarak anlamlı olmayan değerler elde edildi (sırasıyla p = 0,431, p = 0,132, p = 0,413). Sağ kol kas değerlerinde sadece istatistiksel olarak anlamlı bir düşüş vardı (p <0.05). Sonuç: LSG ameliyatı sonrası diyet ve egzersiz gibi takiplerde çok yönlü bir yaklaşım ve iyi bir algoritma edinilmesi, hastaların daha sağlıklı kilo vermesini sağlayacaktır.

Anahtar Kelimeler

• Laparoscopic sleeve gastrectomy
• bioelectric impedance analysis
• obesity
• laparoskopik sleeve gastrektomi
• bioelektrik impedans analizi
• obezite

Proje Numarası

Ahi Evran Üniversitesi Tıp Fakültesi Yerel Etik Kurulu, 23 Mart 2021, 2021-06 / 54 sayılı

Evaluation of the results of bioelectrical impedance analysis in patients undergoing laparoscopic sleeve gastrectomy and its effect on postoperative follow-up

Öz

Aim: Obesity is a health problem. Laparoscopic sleeve gastrectomy (LSG) surgery is the most widely used surgical method in the treatment of obesity. Post-LSG follow-up is as important as the surgery itself. This study aims to examine the most accurate way to follow in the postoperative follow-up of LSG by examining the changes in body compositions such as fat and muscle. Material and Method: 19 female patients who underwent LSG surgery by a single surgeon in Kırşehir Training and Research Hospital between September 2019 and March 2020 were included in our study. The mean age of the patients was 35.73 years. The mean body mass index (BMI) was 43.03. Bioelectric impedance analysis was performed on the patients before the surgery, at the 1st and 2nd months after the surgery. Statistical evaluation of the results was performed. Results: Many undesirable values such as weight, BMI, and fat were significantly reduced (p<0.05). However, no significant values were obtained in mineral, protein, and fluid values, especially in the 2nd month measurements (p=0.582, p=0.160, p=0.376, respectively). Statistically insignificant values were obtained in the 2nd month measurements in the right and left leg and left arm muscles when extremity muscle values were examined (p=0.431, p=0.132, p=0.413, respectively). There was only a statistically significant decrease in right-arm muscle values (p<0.05). Conclusion: Acquiring a multifaceted approach and a good algorithm in follow-up such as diet and exercise after LSG surgery will ensure that patients lose more weight healthily.

Anahtar Kelimeler

• Laparoscopic sleeve gastrectomy
• bioelectric impedance analysis
• obesity

Destekleyen Kurum

her hangi bir kurumdan destek alınmadı

Proje Numarası

Ahi Evran Üniversitesi Tıp Fakültesi Yerel Etik Kurulu, 23 Mart 2021, 2021-06 / 54 sayılı

Teşekkür

.

Kaynakça

1. School of Public Health (Harvard T.H. Chan) Obesity causes. October 2017, https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/
2. Chung AY, Thompson R, Overby DW, et al. Sleeve gastrectomy: surgical tips. J Laparoendosc Adv Surg Tech A. 2018; 28(8):930-937. doi: 10.1089/lap.2018.0392
3. Brajcich BC, Hungness ES. Sleeve gastrectomy. JAMA. 2020; 324(9):908. doi: 10.1001/jama.2020.14775
4. Mohammed MS, Sendra S, Lloret J, et al. Systemsand WBANs for controlling obesity. J Healthc Eng. 2018; 1564748. doi: 10.1155/2018/1564748
5. Puzziferri N, Almandoz JP. Sleeve gastrectomy for weight loss. JAMA. 2018; 319(3):316. doi: 10.1001/jama.2017.18519
6. Benaiges D, Más-Lorenzo A, Goday A, et al. Laparoscopic sleeve gastrectomy: Morethan a restrictive bariatric surgery procedure?. World J Gastroenterol. 2015; 21(41):11804-14. doi: 10.3748/wjg.v21.i41.11804
7. World Health Organization. Obesity data and statistics. October 2017, http://www.euro.who.int/en/health-topics/noncommunicable-diseases/obesity/data-and-statistics.
8. Chambers AP, Smith EP, Begg DP, et al. Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy. Am J Physiol Endocrinol Metab. 2014; 306(4):424-32. doi: 10.1152/ajpendo.00469

9. Vitiello V, Germani A, Dolcetta EC, et al. The new modern mediterranean diet Italian pyramid. Ann Ig. 2016;28(3):179-86. doi: 10.7416/ai.2016.2096
10. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient – 2013 update: cosponsored by America Association of Clinical Endocrinologists, The Obesity Surgery, and the American Society for Metabolic&Bariatric Surgery. Obesity. 2013;21(1):1–27.
11. Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: Systematic review. Obes Surg. 2012;22(1):70–89.
12. Bach-Faig A, Berry EM, Lairon D, et al. Mediterranean diet foundation expert group. Mediterrane a diet pyramid today. Science and cultural updates. Public Health Nutr. 2011;14(12):2274–84.
13. Schiavo L, Pilone V, Rossetti G, et al. The role of the nutritionist in a multidisciplinary bariatric surgery team. Obes Surg. 2019;29(3):1028–30.
14. Eaton D, Kann L, Kinchen S, et al. Youth risk behavior surveillance. Centers For Disease Control And Prevention: Centers For Disease Control And Prevention. 2010;59(5);1-142
15. Karakaş S, Dişçigil G, Bilgin MD, et al. Evaluation of a thropometric measurements of a group of elderly from Turkey. Turkish Journal of Geriatrics. 2012; 15 (4) 403-408
16. World Health Organization. Obesity. October 2017, http:// www.who.int/topics/obesity/en/
17. Frisard MI, Greenway FL, DeLany JP. Comparison of methods to assess body composition changes during a period of weight loss. Obes Res. 2005;13(5):845-54. doi: 10.1038/oby.2005.97
18. Pateyjohns IR, Brinkworth GD, Buckley JD, et al. Comparison of three bioelectrical impedance methods with DXA in over weight and obese men. Obesity. 2006;14(11):2064-70. doi: 10.1038/oby.2006.241
19. Thomson R, Brinkworth GD, Buckley JD, et al. Good agreement between bioelectrical impedance and dual-energy X-ray absorptiometry for estimating changes in body composition during weight loss in overweight young women. Clin Nutr. 2007;26(6):771-7. doi: 10.1016/j.clnu.2007.08.003
20. Chang SH, Stoll CRT, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis 2003-2012. JAMA. 2014; 149 (3): 275-287.
21. Zhou X, Yu J, Li L, et al. Effects of bariatric surgery on mortality, cardiovascular events, and cancer outcomes in obese patients: systematic review and meta-analysis. Obesity Surgery. 2016; 26 (11): 2590-2601.
22. Dizlek D, Catal E. Morbid obezitede bariatrik cerrahi sonrası hasta sonuçları. Düzce Üniversitesi Bilim ve Teknoloji Dergisi. 2018;6(2):501-512
23. Moroshko I, Brennan L, Warren N, et al. Patients' perspectives on laparoscopic adjustable gastric banding (LAGB) aftercare attendance: Qualitative assessment. Obesity Surgery. 2014; 24 (2): 266-275.