Yıl 2020, Cilt 13 , Sayı 1, Sayfalar 193 - 198 2020-01-21

Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.
Obezite için laparoskopik sleeve gastrektemi’nin 4 yıllık uzun dönem metabolik, ghrelin seviyesi ve komorbidite değişimi üzerine etkileri ve sonuçları.

Onur KILIÇ [1] , Asli METE [2] , Onur BİRSEN [3]


Purpose: The aim of this study is to investigate the moderate and long-term effects of Laparoscopic Sleeve Gastrectomy (LSG), the comparison of pre-op and post-op long-term (4 years) ghrelin levels, whether patients have gained weight again after LSG or not, and the change of the comorbidities accompanying obesity.

Basis and background: Laparoscopic sleeve gastrectomy has become quite common as a single and definitive treatment for morbid obesity.  There are publications regarding the positive short-term outcomes, but long-term outcomes and studies revealing the correlation of ghrelin and LSG are still insufficient.

Method: LSG was administered as an obesity treatment between January 2009 and December 2011 in a total of 34 patients selected for surgery with the diagnosis of morbid obesity, whose pre-treatment ghrelin levels were measured, at Pamukkale University Department of General Surgery. 1st month, 3rd month, 6th month, 12th month and then annual controls of the patients after the surgery were conducted. Finally, patients were contacted in the post-op 4th year and they were called for their final control and examinations.

Findings: The mean pre-op weight of the 34 patients included in the study was 132.93±19.25 kg, whereas the mean weight in the post-op 4th year was 83±13.90 kg. During the surgery, mean BMI: was 49.8±7.3 kg/m2. At the end of 4th year after the LSG surgery, BMI: was found as 29.18±5.6 kg/m2. While the pre-op ghrelin value of the patients included in the study was 672±143 pg/ml, their post-op 4th year ghrelin value became 164±43 pg/ml. The difference between the pre-op and post-op 4th year was statistically significant. None of the patients in the study group had any major complications or mortality during follow-up.

Conclusions: The ghrelin level after LSG gradually reduces the carbohydrate and fat consumption due to the resection of the fundus and the body of the stomach. Obesity therapy with LSG has a direct beneficial effect on the health status of the patients by reducing the symptoms of the comorbidities such as Type 2 DM and HT. According to the findings, LSG is a safe and effective method in the treatment of morbid obesity, has long-term positive metabolic effects, and is a procedure that increases the quality of life and comfort.

 

Amaç: Laparoskopik Sleeve Gastrektemi’nin (LSG) orta ve uzun dönem etkilerini, pre-op ve post-op uzun dönem (4 yıl) ghrelin düzeylerinin karşılaştırılması, hastaların LSG sonrası uzun dönemde tekrar kilo alıp almadıkları, obeziteye eşlik eden komorbiditelerin değişimini araştırmaktır.

Dayanak ve arka plan: Laparoskopik sleeve gastrektomi, morbid obezite için tek ve nihai tedavi olarak oldukça yaygın yapılmaya başlanmıştır.  Olumlu kısa vadeli sonuçları içeren yayınlar mevcut, ancak uzun vadeli sonuçlar ve ghrelin ile LSG’nin ilişkisini ortaya koyan çalışmalar hala yetersiz.

Yöntem: Pamukkale Üniversitesi Genel Cerrahi Anabilim Dalı’nda morbid obezite tanısı ile cerrahi için seçilen, işlem öncesi ghrelin düzeylerine bakılan toplam 34 hastada, Ocak 2009 ve Aralık 2011 tarihleri arasında obezite tedavisi olarak LSG uygulandı. Hastaların ameliyattan sonra 1. ay, 3. ay, 6. ay, 12. ay ve daha sonrasında yıllık kontrolleri yapıldı. En sonunda, post-op 4. yılda hastalarla iletişim kurulup son kontrol ve tetkikleri için çağrıldı.

Bulgular: Çalışma kapsamına alınan 34 hastanın pre-op ağırlık ortalaması 132.93±19.25 kg iken, post-op 4. yıl 83±13.90 kg oldu. Ameliyat esnasında ortalama BMİ: 49.8±7.3 kg/m2 idi. LSG ameliyatı sonrası 4. yıl sonunda BMİ: 29.18±5.6 kg/m2 olarak bulundu. Çalışmaya dahil edilen hastalarda pre-op ghrelin değeri 672±143 pg/ml iken, post-op 4.yıl ghrelin değeri 164±43 pg/ml oldu. Pre-op ve post-op 4. yıl değerleri arasındaki fark istatistiksel olarak anlamlıydı. Çalışma grubundaki hiçbir hastada, majör komplikasyon ya da takip süresince mortalite izlenmedi.

Sonuç: LSG sonrası ghrelin düzeyi, midenin fundus ve gövdesinin rezeksiyonu nedeniyle azaltılarak karbonhidrat ve yağ tüketimini düşürür. LSG ile obezite tedavisi Tip 2 DM ve HT gibi komorbiditelerin semptomlarını azaltarak hastaların sağlık durumları üzerinde doğrudan yararlı etkiye sahiptir. Elde ettiğimiz verilere göre, LSG morbid obezitenin tedavisinde emniyetli ve etkin bir yöntemdir, uzun dönemli olumlu metabolik etkilere sahiptir, yaşam kalitesi ve konforunu artırıcı bir prosedürdür.

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Birincil Dil en
Konular Cerrahi
Yayımlanma Tarihi Ocak 2020
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0002-6833-6462
Yazar: Onur KILIÇ (Sorumlu Yazar)
Kurum: İZMİR ALSANCAK NEVVAR SALİH İŞGÖREN DEVLET HASTANESİ
Ülke: Turkey


Orcid: 0000-0002-5621-7407
Yazar: Asli METE
Kurum: PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0001-6064-5693
Yazar: Onur BİRSEN
Kurum: PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 21 Ocak 2020

Bibtex @araştırma makalesi { patd601112, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2020}, volume = {13}, pages = {193 - 198}, doi = {10.31362/patd.601112}, title = {Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.}, key = {cite}, author = {KILIÇ, Onur and METE, Asli and BİRSEN, Onur} }
APA KILIÇ, O , METE, A , BİRSEN, O . (2020). Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.. Pamukkale Tıp Dergisi , 13 (1) , 193-198 . DOI: 10.31362/patd.601112
MLA KILIÇ, O , METE, A , BİRSEN, O . "Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.". Pamukkale Tıp Dergisi 13 (2020 ): 193-198 <https://dergipark.org.tr/tr/pub/patd/issue/51998/601112>
Chicago KILIÇ, O , METE, A , BİRSEN, O . "Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.". Pamukkale Tıp Dergisi 13 (2020 ): 193-198
RIS TY - JOUR T1 - Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change. AU - Onur KILIÇ , Asli METE , Onur BİRSEN Y1 - 2020 PY - 2020 N1 - doi: 10.31362/patd.601112 DO - 10.31362/patd.601112 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 193 EP - 198 VL - 13 IS - 1 SN - -1308-0865 M3 - doi: 10.31362/patd.601112 UR - https://doi.org/10.31362/patd.601112 Y2 - 2020 ER -
EndNote %0 Pamukkale Tıp Dergisi Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change. %A Onur KILIÇ , Asli METE , Onur BİRSEN %T Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change. %D 2020 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 13 %N 1 %R doi: 10.31362/patd.601112 %U 10.31362/patd.601112
ISNAD KILIÇ, Onur , METE, Asli , BİRSEN, Onur . "Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.". Pamukkale Tıp Dergisi 13 / 1 (Ocak 2020): 193-198 . https://doi.org/10.31362/patd.601112
AMA KILIÇ O , METE A , BİRSEN O . Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.. Pamukkale Tıp Dergisi. 2020; 13(1): 193-198.
Vancouver KILIÇ O , METE A , BİRSEN O . Effects and results of laparoscopic sleeve gastrectomy for obesity on 4-year long-term metabolic, ghrelin level and comorbidity change.. Pamukkale Tıp Dergisi. 2020; 13(1): 198-193.