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GÜNAL, ÖMER

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GÜNAL

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ÖMER

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2022 - 20244
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Subject: CLINICAL MEDICINE ×

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Now showing 1 - 4 of 4
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    PublicationOpen 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.
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    PublicationOpen 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 Bölümü
    Reduced 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.
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    PublicationOpen Access
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    PublicationOpen Access
    Management of staple line leaks after laparoscopic sleeve gastrectomy: Single-center experience
    (2024-05-31) UPRAK, TEVFİK KIVILCIM; COŞKUN, MÜMİN; UĞURLU, MUSTAFA ÜMİT; GÜNAL, ÖMER; CİNGİ, ASIM; YEGEN, ŞEVKET CUMHUR; UPRAK T. K., COŞKUN M., UĞURLU M. Ü., GÜNAL Ö., CİNGİ A., YEGEN Ş. C.
    Objective: In obesity surgery, laparoscopic sleeve gastrectomy (LSG) is a frequently applied method. However, there are certain complications. Leakage is one of the most serious complications after surgery, causing postoperative morbidity and sometimes mortality. There is no consensus about management of leaks after LSG. In our study, we aimed to present our experience on the management of LSG leaks. Patients and Methods: Patients who underwent LSG between 2010-2017 in a tertiary university hospital were analyzed retrospectively. Demographic characteristics, endoscopic and surgical interventions, morbidity, and mortality rates of patients diagnosed with LSG leak were analyzed from prospectively recorded data. Results: Leak was observed in 11 (2.15%) of a total of 510 LSG patients. Six (54%) patients were diagnosed as acute and 5 were early leaks. Stent was applied to most of the patients (72%) with or without surgical exploration. The average length of stay in hospital was 21 days. Mortality was observed in 2 patients. Conclusions: Consequently, leakage after LSG is a complication that requires multimodal therapy. Surgical treatment combined with endoscopic intervention may increase success.