Person: GÜNAL, ÖMER
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GÜNAL
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ÖMER
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Publication Metadata only PARKİNSON HASTALIĞININ TEDAVİSİNDE SÜREKLİ LEVODOPA- KARBİDOPA BAĞIRSAK JELİ (LCIG) İNFÜZYONU İÇİN PERKÜTAN ENDOSKOPİK TRANSGASTRİK JEJUNOSTOMİ (PEG-J) TÜPÜ TAKILMASI TEKNİĞİ VE TEK MERKEZ SONUÇLARIMIZ(2021-10-30) AKMERCAN, TAYFUN; UPRAK, TEVFİK KIVILCIM; COŞKUN, MÜMİN; GÜNAL, ÖMER; GÜNAL, DİLEK; AKMERCAN T., UPRAK T. K. , COŞKUN M., GÜNAL Ö., GÜNAL D.Publication Metadata only The Effects of Perioperative Factors on Early Postoperative Morbidity in Bariatric Surgery(2022) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Orhon Ergun, Meliha; Gunal, OmerPublication Open Access Comparing the Effects of Antiadhesive Materials after Abdominal Surgery(DUZCE UNIV, 2020-03-02) GÜNAL, ÖMER; Dogan, Sami; Cetin, Mehmet Fuat; Gunal, Omer; Erdem, HavvaObjective: We aimed to evaluate and compare the effects of anti-adhesion materials, Seprafilm, Suprofilm, olive oil, and olive oil containing Vitamin E by measuring tension forces. Methods: 60 male Wistar-Albino rats were divided into six groups. The front side of the cecum and right abdominal parietal peritoneal wall were abrased. The rats were euthanized on the 14th postoperative day. Adhesions between intestines, omentum, other abdominal organs, cecum, incisionsites, and abdominal anterior wall peritoneum were all evaluated. Adhesion strength was measured with dynamometer. Histopathological evaluations of the adhesion area was performed. Results: Stage-I (0.43Newton) in Group-I, stage-IV (1.0540N) in Group-II, stage-II (0.6370N) in Group-III, stage-II in Group-IV (0, 5230N), stage-III (0.7620N) in Group-V, stage-IV (1.3560N) in Group-VI, were detected. A significant difference was found between these findings. P = 0.001, (p<0.05). Histopathological examination: It was found that GroupV-VI reduced inflammation, increased collagen production, fibroblastic activity and vascular proliferation. Conclusions: More objective evaluation can be made by measuring the tension force of the adhesions. Suprafilm can also be effectively used as an antiadhesive, such as Seprafilm. Olive oil and vitamin E require more studies to be used as antiadhesives.Publication Open Access The effects of perioperative factors on early postoperative morbidity in bariatric surgery(2022-04-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; GÜNAL, ÖMER; Zengin S. Ü., Orhon Ergün M., Günal Ö.Purpose This study aims to examine the predictive role of obesity-type-related indexes and perioperative intraabdominal pressure measurements for early postoperative complications following bariatric surgery. Materials and Methods Sixty-seven female patients with obesity who underwent bariatric surgery (laparoscopic sleeve gastrectomy or gastric bypass) were included in this study. Obesity-related indexes (BMI, waist/hip ratio, and waist/height ratio) were calculated using patient data. Intraoperative hemodynamic measurements and intraabdominal pressure measurements were done at the beginning and at the end of the operation. Intraabdominal pressure measurements were done using both bladder port and trocar port. Patients were followed for early postoperative complications. Results Among 67 patients included, 22 developed early postoperative complications (32.8%), mostly pulmonary (20.9%). Trans-trocar IAP measured at the beginning of the operation emerged as the single independent predictor of postoperative complications (OR, 40.3; p=0.002). Based on ROC analysis, AUC for predicting complications was 0.955 (p<0.01). Optimal cutof point (≥14.5 mmHg) was associated with 100% sensitivity and 82% specifcity. In addition, there were weak but signifcant positive correlations between trans-trocar IAP-beginning and BMI (r=0.443, p<0.001), waist/hip ratio (r=0.434, p<0.001), and waist/height ratio (r=0.539, p<0.001). Conclusion Findings of this study suggest that a high baseline intraabdominal pressure predicts a higher risk for early postoperative complications following bariatric surgery. This information would help improve patient care. Further large studies are warranted.Publication Metadata only Compari̇ng the anastomoti̇c techni̇que of the mi̇ni̇mally invasi̇ve and open ivor-lewi̇s esophagectomy for esophageal cancer(2021-10-30) GÜNAL, ÖMER; UPRAK, TEVFİK KIVILCIM; ŞİMŞEK, OĞUZHAN; GÜNAL Ö., UPRAK T. K., KARATAŞ S. A., CİCİBOĞA K., ŞİMŞEK O., ŞİMŞEK O.Publication Metadata only Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Pain and Intraoperative Opioid Consumption in Bariatric Surgery(SPRINGER, 2021) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Ergun, Meliha Orhon; Gunal, OmerBackground Bariatric surgery is often associated with moderate to severe pain. In patients with obesity, opioids have the potential to induce ventilatory impairment; thus, opioid use needs to be limited. This study aimed to compare the novel ultrasound-guided erector spinae plane block (ESPB) technique with controls in terms of intraoperative opioid consumption and postoperative pain control. Methods A total of 63 patients with morbid obesity who underwent laparoscopic bariatric surgery were included in this randomized study. Patients were randomly assigned to the bilateral erector spinae plane block (ESPB) group or the control group. To evaluate perioperative pain and to adjust opioid dose, analgesia nociception index (ANI) was monitored during surgery. Total opioid dose was recorded for each patient. In addition, pain was evaluated using visual analogue scale (VAS) scores for 24 h following the operation. Results Total intraoperative remifentanil dose was significantly lower in the ESPB group when compared to controls (1356.3 +/- 177.8 vs. 3273.3 +/- 961.9 mcg, p < 0.001). In the ESPB group, none of the patients required additional analgesia during follow-up. In contrast, all control patients required analgesia. ESPB group had significantly lower VAS scores at all postoperative time points (p < 0.001 for all). Conclusion Bilateral ultrasound-guided ESPB appears to be a simple and effective technique to improve perioperative pain control and reduce intraoperative opioid need in patients with morbid obesity undergoing bariatric surgery.Publication Metadata only Bariyatrik cerrahi sonrası hibrit egzersiz modelinin vücut kompozisyonu, bazal metabolizma hızı ve kas kuvvetine etkisi(2023-10-07) BAHAR, ASLI NUR; GÜNAL, ÖMER; KASIMAY ÇAKIR, ÖZGÜR; CİNGİ, ASIM; YAVUZ, DİLEK; KÜÇÜK YETGİN, MERAL; Köksalan B., Bahar A. N., Günal Ö., Kasımay Ö., Özbar N., Cingi A., Yavuz D., Küçük Yetgin M.Bariyatrik cerrahi sonrası hibrit egzersiz modelinin vücut kompozisyonu, bazal metabolizma hızı ve kas kuvvetine etkisiBürke Köksalan1, Aslı Nur Bahar2, Ömer Günal3, Özgür Kasımay2, Nurper Özbar4, Asım Cingi3, Dilek Gogas Yavuz5, Meral Küçük Yetgin61 Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü, Hareket ve Antrenman Bilimleri Doktora Programı2 Marmara Üniversitesi, Tıp Fakültesi, Fizyoloji Anabilim Dalı, Spor Fizyolojisi Bilim Dalı3 Marmara Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı 4 Trakya Üniversitesi, Kırkpınar Spor Bilimleri Fakültesi, Antrenörlük Eğitimi Bölümü, Haraket ve Antrenman Bilimleri Anabilim Dalı5 Marmara Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Endokrinoloji ve Metabolizma Bilim Dalı 6 Marmara Üniversitesi, Spor Bilimleri Fakültesi Antrenörlük Eğitimi Bölümü, Spor Sağlık Bilimleri Anabilim DalıÖzetAmaç: Bu çalışmanın amacı bariatrik cerrahi ameliyatı sonrası uygulanan 4 aylık hibrit egzersiz modelinin vücut kompozisyonu, kas kuvveti ve bazal metabolizma hızı üzerine etkisinin incelenmesidir.Yöntem: Sleeve Gastrektomi (SG) ameliyatı olan 11 gönüllü katılımcı, Hibrit Egzersiz Grubu (HEG/ N=6; VKİ=30,350kg/m2) ve Kontrol Grubu (KG/ n=5; VKİ=33,62 kg/m2) olmak üzere 2 gruba ayrıldı. Programın başında ve sonunda tüm katılımcıların vücut kompozisyonu (Tanita BC-418MA), bazal metabolizma hızı (Cortex Metalyzer 3B), ve kas kuvveti (Lafayette) değerleri alındı. HEG, ameliyattan sonraki 13. haftada başlayarak 4 ay boyunca haftada 3 gün hibrit egzersiz programına tabi tutuldu. Araştırma değişkenlerinin normal dağılım gösterip göstermediğini belirlemek üzere basıklık ve çarpıklık değerleri incelendi. Değişkenlerin normal dağılım gösterdiği belirlendi ve verilerin analizinde parametrik yöntemler kullanıldı. Grup içi ön son test karşılaştırmalarında Paried Samples Test, gruplar arası karşılastırmalarda ise; İndependent Samples T-Tests kullanıldı. Anlamlılık düzeyi p<0.05olarakalındı.Bulgular: Bariatrik cerrahi ameliyatını takiben uygulanan hibrit egzersiz programı sonrasında her iki grubun ön ve son test değerlerinde vücut ağırlığı (HEG=11,790±6,48kg; KG=11,205±5,59kg), VKİ (HEG=12,052±6,482kg/m2; KG=11,214±5,687kg/m2), yağ yüzdesi (HEG=20,381±11,574; KG= 17,467±13,448), yağ kütlesi (HEG=29,085±14,325kg; KG=26,324±15,864kg), yağsız vücut kütlesi (HEG=3,827±2,817kg; KG=3.85±1.942kg) değerlerinde istatistiksel açıdan anlamlı farklılık (p<0,05) bulundu. Ancak gruplar arasında fark elde edilemedi (p>0,05). Bazal metabolizma hızında (HEG=7,329±20,406kcal/d; KG=10,717±10,708kcal/d) grup içi ve gruplar arasında herhangi bir istatistiksel farklılık oluşmadığı belirlendi (p>0,05) HEG grununun kas kuvveti değerine ilişkin ön son test değerlerinde üst sağ ekstremite kuvvet (HEG=33,744±5,442N; KG=2,961±6.276N), üst sol ekstremite kuvvet (HEG=43,573±7,387; KG=2,098±7,165), alt sağ ekstremite kuvvet (HEG=76,802±7,697; KG=12,208±19,921N), alt sol ekstremite kuvvet (HEG=82,486±8,763N; KG=14,122±15,435N) ve gruplar arası yüzdelik gelişimlerinde anlamlı farklılık bulundu (p<0,01). KG grubunda kas kuvveti değerinde grup içi değişimlerde bir farklılık elde edilemedi (p>0,05). Sonuç: Bariatrik cerrahi ameliyatı sonrası uygulanan 4 aylık hibrit antrenman modelinin kas kuvvetini geliştirdiği bulunmuştur. Her iki grupta da vücut kompozisyonu bileşenlerinde görülen anlamlı iyileşme gruplar arasında istatistiksel açıdan bir fark ortaya koymamıştır. Bazal metabolizma hızı değişkeninde gruplar arasında fark ortaya çıkmamıştır. Bariatrik cerrahi sonrası hızlı kilo verme döneminde uygulanan hibrit egzersiz modelinin hastaların kas kuvvetini arttırarak yaşam kalitesini iyileştirmeye katkı sağlayacağı sonucuna varılmıştır. Anahtar kelimeler: Slevee gastrektomi, hibrit egzersiz, bazal metabolizma,kas kuvvetiPublication Open Access Melatonin in preservation solutions prevents ischemic injury in rat kidneys(2022-08-01) YEGEN, ŞEVKET CUMHUR; GÜNAL, ÖMER; COSKUN A., YEGEN Ş. C. , ARBAK S., Attaallah W., GÜNAL Ö., Elmas M. A. , UÇAL Y., CAN Ö., Baş B., Yildirim Z., et al.© 2022 Coskun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Transplantation is lifesaving and the most effective treatment for end-stage organ failure. The transplantation success depends on the functional preservation of organs prior to transplantation. Currently, the University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) are the most commonly used preservation solutions. Despite intensive efforts, the functional preservation of solid organs prior to transplantation is limited to hours. In this study, we modified the UW solution containing components from both the UW and HTK solutions and analyzed their tissue-protective effect against ischemic injury. The composition of the UW solution was changed by reducing hydroxyethyl starch concentration and adding Histidine/Histidine-HCl which is the main component of HTK solution. Additionally, the preservation solutions were supplemented with melatonin and glucosamine. The protective effects of the preservation solutions were assessed by biochemical and microscopical analysis at 2, 10, 24, and 72 h after preserving the rat kidneys with static cold storage. Lactate dehydrogenase (LDH) activity in preservation solutions was measured at 2, 10, 24, and 72. It was not detectable at 2 h of preservation in all groups and 10 h of preservation in modified UW+melatonin (mUW-m) and modified UW+glucosamine (mUW-g) groups. At the 72nd hour, the lowest LDH activity (0.91 IU/g (0.63-1.17)) was measured in the mUW-m group. In comparison to the UW group, histopathological damage score was low in modified UW (mUW), mUW-m, and mUW-g groups at 10, 24, and 72 hours. The mUW-m solution at low temperature was an effective and suitable solution to protect renal tissue for up to 72 h.Publication Open Access Does Gastric Expansibility Affect Weight Loss Success After Laparoscopic Sleeve Gastrectomy?(2022-08-01) UPRAK, TEVFİK KIVILCIM; ERDİM, AYLİN; KARATAŞ, SABRİ ALPER; GÜNAL, ÖMER; UPRAK T. K. , ERDİM A., Karatas S. A. , GÜNAL Ö.; Marmara Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri BölümüReduced excess weight loss (EWL) or regain is a worrying problem after metabolic surgery. Factors attainable from the resected specimen that can predict this outcome are investigated. We retrospectively analyzed 64 patients who had undergone laparoscopic sleeve gastrectomy. We collected demographic data, preoperative gastric emptying measurements, volume, expansion capacity, and 6-dimensional measurements of sleeve gastrectomy specimens. Correlations between EWL, body mass index levels, and gastric specimen measurements related to gastric remnant dimensions were also scrutinized. We found a significant correlation between the gastric specimen and remnant gastric volume, the resection line length in the gastric specimen, and 12th-month EWL%. Antrum expansibility was significantly increased in patients with weight regain. There was also a negative correlation between weight loss and age at postoperative first and third years. Sleeve resection line measurement and resected antrum diameter measurements can be used to predict weight loss, especially in the first year postoperatively.Publication Open Access Letter to the editor-radiographic measurement of gastric remnant volume after laparoscopic sleeve gastrectomy: Assessment of reproducibility and correlation with weight loss(2022-07-01) UPRAK, TEVFİK KIVILCIM; GÜNAL, ÖMER; Ergenc M., UPRAK T. K., GÜNAL Ö.