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Introduction: The prevalence of obesity is increasing all over the world. Laparoscopic sleeve gastrectomy (LSG) has become the most common bariatric surgery in the world today. Unlike other bariatric surgeries, laparoscopic sleeve gastrectomy yields a pathological examination. The aim of this study was to describe unexpected histopathological findings following LSG. Methods: In this study, the pathologies of 1364 patients who underwent LSG between March 2013 and September 2019 were analyzed retrospectively. Patients were evaluated by a multidisciplinary team in the preoperative period. Patients who met the criteria for LSG were operated. These criteria were; Body Mass index (BMI) >= 40 kg/m(2) or BMI >35 kg/m(2) and comorbidities or BMI between 30 and 35 kg/m2 with accompanying Type 2 diabetes Mellitus or Metabolic syndrome. Two hundred four of the patients underwent gastroscopy preoperatively. Results: One thousand three hundred sixty four patients underwent LSG. The mean age was 40.93 +/- 10.86 years; 974 patients (71.48%) were female. The mean BMI was 42.23 +/- 7.28. The most common findings in the pathologies were normal gastric specimen (50%), gastritis (30%) and changes due to proton pump inhibitor use (23%) respectively. Conclusion: Gastroscopy should be added to the preoperative preparation process in cases where there is no gastric specimen after the operation. Preoperative gastroscopy is not a necessity for laparoscopic sleeve gastrectomy. It can be performed in selected cases. WOS:000520493300002

Obesity is an increasing problem worldwide. Laparoscopic sleeve gastrectomy is gaining popularity. Although it has unique complications such as leakage, bleeding, and stenosis, it is a reliable procedure. A total of 1200 consecutive patients who underwent sleeve gastrectomy and omentopexy between March 2013 and December 2018 were enrolled in this retrospective study. Body mass index, age, sex, and postoperative complications were recorded in all patients. Of 1200 patients, 864 (72%) were female and 336 (28%) were male. The median age was 38 years (13 to 69 y). Preoperative median body mass index was found as 40.87 kg/m(2) (30 to 88 kg/m(2)). Operative complications included strictures which occurred in 16 (1.33%) patients, bleeding in 7 (0.58%), stapler line leaks in 3 (0.25%), wound infection in 1 (0.08%), fat necrosis in 1 (0.08%), splenic arterial injury in 1 (0.08%), and intra-abdominal abscess in 1 (0.08%) patient. There was no mortality. Sleeve gastrectomy and omentopexy is a safe procedure with low complication rates. WOS:000504096600027 31517747 Q3

Laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. This retrospective cohort study evaluated the outcomes of a large cohort of patients with obesity who underwent LSG in a Bariatric Center of Excellence. All consecutive patients who underwent LSG between July 2013 and April 2016 were identified retrospectively. Preoperative and postoperative variables and comorbidities were recorded. The study consisted of 750 patients. Their mean age was 37.4 years; 72% were women, and the mean body mass index was 42.8 kg/m. The most common preoperative comorbidities were diabetes (23.3%), hyperlipidemia (21.9%), hypertension (21.1%), and obstructive sleep apnea (21.1%). The rates of comorbidity resolution during follow-up were 80.6%, 74.4%, 82.9%, and 94.3%, respectively. The percentage average excess weight loss 1, 3, and 6 months and 1 and 2 years after surgery was 29.4%±11.3%, 54.4%±17.7%, 76.9%±20.9%, 85.5%±23.6%, and 89.7%±27.6%, respectively. There was no mortality. LSG effectively and safely induced weight loss and comorbidity resolution.

Objectives: The prevalence of obesity and its associated comorbidities are increasing all over the world. Laparoscopic sleeve gastrectomy has become the most common bariatric surgery in the world today, especially in the treatment of Type 2 diabetes mellitus, which is one of the effective surgical methods. The present study aims to investigate the effects on glucose metabolism in patients following laparoscopic sleeve gastrectomy. Methods: In this study, the files of 174 patients who had laparoscopic sleeve gastrectomy with a body mass index between 30-35kg/m2 between March 2013 and September 2019 were analyzed retrospectively. Patients were evaluated by a multidisciplinary team in the preoperative period. Patients who met the criteria for laparoscopic sleeve gastrectomy were operated according to American Metabolic and Bariatric Surgeons criteria. Demographic data, body mass index, insulin, glycosylated hemoglobin (HbA1c), glucose, homeostasis model insulin resistance (HOMA-IR) values were recorded. The patients were followed up with visits to the outpatient clinic scheduled for 1-3-6 and 12 months postoperatively. Results: The mean age of the 174 patients who underwent laparoscopic sleeve gastrectomy was 39.57±9.40, and the mean body mass index was 32.70±2.65. 149 patients (85.6%) were female. The mean hospital stay was 3.1±0.7 days. When glucose, HbA1c, HOMAR-IR and insulin values of the patients were examined, it was observed that the decrease was statistically significant at 12 months follow-up. There was a significant decrease in body mass index compared to the preoperative period. Conclusion: Laparoscopic sleeve gastrectomy is an effective surgery on glucose metabolism in patients with a body mass index of 30-35kg/m2.

Background/aims Helicobacter pylori infection is very common in Eastern countries. Little is known about the impact this infection has on bariatric surgery outcomes. This retrospective cohort study conducted on obese Turkish adults who underwent sleeve gastrectomy at a single center aimed to determine the prevalence of H. pylori infection and the effect of this infection on the rate of early major postoperative complications. Materials and methods All consecutive patients who underwent sleeve gastrectomy for obesity between 2014 and 2015 and who had complete data were enrolled. A single surgeon performed all procedures. All resected specimens were sent to pathology for analysis. Results Of the 460 patients who met the eligibility criteria, 326 (71%) were female. The average (±standard deviation) age and body mass index were 37.5±10.0 years and 42.7±7.7 kg/m2, respectively. Histology revealed that 150 (33%) patients had H. pylori infection. The H. pylori-infected group developed two complications (leakage and intra-abdominal collection). The uninfected group developed three complications (all bleeding related). The two groups did not differ significantly regarding postoperative complication rates (1.3% vs. 1.0%; p=0.717). Conclusion H. pylori infection did not affect the rate of early complications after sleeve gastrectomy. This suggests that H. pylori screening or eradication policy is not essential for asymptomatic candidates who have undergone sleeve gastrectomy.

PubMed: 31107849 Obesity is associated with nonalcoholic fatty liver disease which is one of the most common causes of chronic liver disease. FibroScan is a noninvasive tool for liver stiffness measurement and controlled attenuation parameter to evaluate liver steatosis and fibrosis. We aimed to demonstrate the effect of laparoscopic sleeve gastrectomy on liver steatosis and fibrosis. Of the 120 consecutive patients screened, 72 were enrolled in this study. FibroScan M probe and XL probe were used for the evaluation of liver steatosis and fibrosis. Fifty-two patients (72.2%) were female individuals and 20 (27.8%) were male individuals; the mean age was 37.9 +/- 10.4 years. Percentage of excess weight loss was significant at the third and sixth months: 57.2 +/- 18.3 (P

The aim of our study was to compare short-term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neadjuvant chemoradiotherapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and and pathology results were compared between the two groups. The patient characteristics did not differ significantly between the two groups. Median operating time was longer in the R-TME than in the L-TME group (182 min versus 140 min). Only two conversions occurred in the L-TME group. No difference was found between groups regarding perioperative recovery and postoperative complication rates. The median number of harvested lymph nodes was higher in the RTME than in the L-TME group (32 versus 23, p = 0.008). The median circumferential margin (CRM) was 10 mm in the R-TME group, 6.5 mm in the L-TME group (p = 0.047. The median distal resection margin (DRM) was 27.5 mm in the R-TME, 15 mm in the L-TME group (p = 0.014). Macroscopic grading of the specimen in the R-TME group was complete in all patients. In the L-TME group, grading was complete in 52 (80 %) and incomplete in 13 (20 %) cases (p = 0.109). R-TME is a safe and feasible procedure that facilitates performing of TME in male patients with mid-low RC after NCRT. © 2015, Springer-Verlag London.

Background: Obesity is an increasing problem worldwide regardless of age. Bariatric surgery is highly effective both in the treatment of obesity and in the improvement of obesity-related comorbidities. Laparoscopic sleeve gastrectomy is gaining popularity in both adolescents and the elderly.Methods: A total of 64 patients who underwent laparoscopic sleeve gastrectomy, aged under 19 and older 65 between March 2013 and December 2019 were enrolled in this retrospective study. Demographic characteristics were recorded in all patients.Results: Between March 2013 and December 2019, 64 patients who underwent laparoscopic sleeve gastrectomy were enrolled in this study. Fourty-five patients were smaller than 19 years old and 19 patients were older than 65 years old. After 1-year follow-up, there was a significant improvement in glucose, insulin level, excess weight loss and body mass index in both groups (p

Introduction: The reduction in the preferences for sweet and fat containing tastes in obese patients who underwent bariatric surgery was relatively well shown; however, there are only limited data on the changes in the sensitivity of other tastes like sour, salty, and bitter. Methods: We investigated the changes in gustatory sensitivity of 52 morbidly obese patients (M/F, 22/30; age range, 19-60 years; BMI range, 32.5-63.0 kg/m2) after laparoscopic sleeve gastrectomy. The surgery was performed by the same surgeon using 5 ports technique. Gustatory sensitivity was tested preoperatively and 1 and 3 months after the surgery using standardized Taste Strips test. Results: There was a statistically significant improvement in the taste acuity to sweet, sour, salty, and bitter tastants in morbidly obese patients after the laparoscopic sleeve gastrectomy during the follow-up period of 3 months. Median whole test scores of the patients were increased from 11.5 preoperatively to 14 in the first and third months. Conclusion: In this study, we were able to show the significant improvement in gustatory sensitivity of morbidly obese patients after laparoscopic sleeve gastrectomy for the first time in literature.

Olfactory abilities of the patients are known to be altered by eating and metabolic disorders, including obesity. There are only a number of studies investigating the effect of obesity on olfaction, and there is limited data on the changes in olfactory abilities of morbidly obese patients after surgical treatment. Here we investigated the changes in olfactory abilities of 54 morbidly obese patients (M/F, 22/32; age range 19–57 years; body mass index (BMI) range 30.5–63.0 kg/m2) after laparoscopic sleeve gastrectomy. A laparoscopic sleeve gastrectomy was performed by the same surgeon using five-port technique. Olfactory abilities were tested preoperatively and 1, 3, and 6 months after the surgery using a standardized Sniffin’ Sticks Extended Test kit. Analyses of variance indicated statistically significant improvement in T, D, and I scores of morbidly obese patients within time factors (preoperative vs. 1, 3, and 6 months; 1 vs. 3 and 6 months; and 3 vs. 6 months; p

A 46-year-old male patient presented with a 1-month history of solid food dysphagia and accompanying weight loss. His family history was negative. His physical examination was normal. A distal 1/3 esophageal mass was found on endoscopy and PET CT. He received 3 cycles of chemotherapy consisting of docetaxel, cisplatin, and capecitabine prior to his operation. He complained of tinnitus during this period, which was attributed to a side effect of chemotherapy. He was operated 1 month after the chemotherapy. Pathology revealed a moderately differentiated lymphadenopathypositive adenocarcinoma (T3 N3 M0). His chemotherapy was initiated post-operatively; he received 2 cycles of docetaxel, carboplatin, and capecitabine. The patient was admitted to the emergency department 2 months after the operation, with complaints of severe headache, facial numbness, generalized aches, back pain, and walking difficulties. He had nuchal rigidity, bifacial weakness, and moderate semi-symmetric quadriparesis more prominent in the lower extremities on his neurological examination. Deep tendon reflexes were absent, plantar reflexes equivocal. The patient presented a cranial MRI obtained the day before admission, which revealed subpial cerebellar parenchymal edema, diffuse and nodular leptomeningeal contrast enhancement of the cerebral sulci, cerebellar folia, basal cisterns and hypothalamic region, fourth ventricle and aquaductal compress ion with secondary hydrocephalus and transependymal CSF flow and bilateral II, V, VII, and VIIIth cranial nerves contrast enhancement. Analgesic therapy was initiated with parenteral paracetamol and fentanyl patch 25 mcg/h. The patient was given 100 mg IM tramadol 4 h later. The patient developed confusion and somnolence 2 h following the tramadol injection. A complete neuraxis MRI was obtained 10 h after the emergency department admission. Anesthesia was performed with sevoflurane and propofol during the procedure. The patient did not wake up after anesthetic discontinuation. The patient was admitted to the ICU. He had total areflexia on examination. The cranial MRI revealed increased periventricular edema, effacement of the basal cisterns, increased cerebellar edema, cerebral sulci and cerebellar folia effacement, and multiple contrast-enhancing lesions of the thalami and the hypothalamus (Figs. 1, 2, and 3). The spinalMRI revealed diffuse spinal cord and cauda equina enhancement. The patient developed diabetes insipidus during his stay in the ICU. He died on the 7th day. The family did not give consent for an autopsy. * Banu Tasci Fresko banutascifresko@yahoo.com