Publications (9) View all
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Article: Is gastro-gastric fixation suture necessary in laparoscopic adjustable gastric banding? A prospective randomized study.
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ABSTRACT: The reason for gastro-gastric suture (GGS) in laparoscopic adjustable gastric banding (LAGB) is to prevent migration, slippage, and pouch dilatation. Despite various suturing techniques, these complications are still quite common. In our study, we prospectively randomized patients for GGS and analyzed outcome. Between September 2006 and February 2008, eighty patients were randomized before LAGB procedure with pars flaccida technique. Forty patients had GGS for band fixation (Group 1), and 40 patients did not (Group 2). Groups were compared for length of surgery (LOS), length of hospital stay (LOHS), early and late complications, and percent of excess weight loss (%EWL). Mann-Whitney U test was used to define statistical differences between groups. P<.05 was accepted as significant. Mean body mass index (BMI) of groups 1 and 2 were 43.3±4.9 and 42.2±4.3 kg/m(2), respectively. Mean LOHS was 29.2±9.3 and 25.2±10.5 hours in groups 1 and 2, respectively. There was no statistically significant difference between groups 1 and 2 in comparison of %EWL (P=.344 and P=.132, respectively). There was a significant difference in LOS between groups, and it was shorter in group 2 (P<.05). In terms of complications, slippage rate was higher, migration and port complications were lower in group 2 although not statistically significant (P>.05). Pouch dilatation rate was similar in both groups. LOS is shorter without GGS. There is no difference in rates of slippage, migration, pouch dilatation complications, and %EWL between either approach. In light of our findings, we think that routine use of GGSs should be revisited.Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2011; 21(10):953-6. · 1.40 Impact Factor -
Article: Comparison of early and late changes in immunoglobulins and acute phase reactants after laparoscopic adjustable gastric banding in patients with morbid obesity.
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ABSTRACT: There are differences in the levels of inflammation mediators, lipids, and formed elements of the blood in morbidly obese patients compared with individuals of normal weight. In the current study, the change in these parameters was determined in patients who achieved weight loss by undergoing laparoscopic adjustable gastric banding (LAGB) by comparing preoperative, and early (3 months) and late (12 months) postoperative values. The body mass index (BMI), weight, blood pressure, and waist circumference of 72 patients treated by LAGB procedures between September 2006 and February 2009 were measured and recorded. Pre- and postoperative 3- and 12-month C-reactive protein (CRP), immunoglobulin (Ig) G, IgA, IgM, fibrinogen (Fbg), complement components C3 and C4, total cholesterol, triglycerides, low-density lipoprotein-C and high-density lipoprotein-C levels, and leukocyte, neutrophil, lymphocyte, and platelet counts were also measured. Results were presented as mean +/- SD. The preoperative values were compared with the 3- and 12-month values. A p value < 0.05 was considered statistically significant. BMI, weight, blood pressure, and waist circumference measurements were reduced at 3 and 12 months postoperatively compared with preoperative values (p < 0.05). Among the inflammatory mediators, IgG, IgM, and Fbg were reduced to near-normal values, beginning in the early postoperative period (p < 0.05). There was no significant reduction parallel to weight loss with respect to CRP, C3, C4, and IgA values at 3 months postoperatively (p > 0.05). However, the 12-month values of these parameters were significantly reduced (p < 0.05). Morbid obesity leads to significant changes in the levels of inflammation mediators. While there is a significant reduction in some of these mediators accompanying slight weight loss in the early period following an LAGB procedure, significant changes occur in other mediators in the late period when there is a larger amount of weight loss.Obesity Surgery 05/2010; 20(5):610-5. · 3.29 Impact Factor -
Article: Changes in Comorbid Diseases in Morbidly Obese Patients Treated by Laparoscopic Adjustable Gastric Banding
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ABSTRACT: Objectives: Morbid obesity is often accompanied by several comorbid diseases which reduce lifespan and impair quality of life. Laparoscopic adjustable gastric banding (LAGB) is a minimal invasive procedure effective in the treatment of morbid obesity. The aim of this study was to determine the change in comorbidities in patients treated by LAGB who achieved weight loss. Methodology: Among 134 morbidly obese patients treated by LAGB, 127 patients who were followed regularly and evaluated regarding the change in comorbidities, and laboratory and clinical measurements were recorded. Excess weight loss (EWL) and the percent improvement in comorbid diseases (PICD) were calculated by using the Friedman's test. P value of <0.05 was considered statistically significant. Results: Of 127 cases with a mean age of 29.51±6.7 years. Pre-operative BMI was 48.38±7.81 kg/m 2 . Comorbid disease was present in 62 (48.8%) patients. The mean follow-up duration was 23.83±8.78 months. The EWL was 52.6% (p<0.05) and the PICD was 74.8% (p<0.05). Complications were noted in 34 patients (26.8%). Conclusions: LAGB is a minimally invasive procedure which is effective in the treatment of morbid obesity, and reduces the length of hospital stay. Comorbid diseases are significantly improved in patients who achieve weight loss by the LAGB procedure.Pak J Med Sci Sci January -March. 01/2010; 26(1):6-10. -
Article: Does N ratio affect survival in D1 and D2 lymph node dissection for gastric cancer?
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ABSTRACT: To identify whether there could have been changes in survival if lymph node ratio (N ratio) had been used. We assessed 334 gastric adenocarcinoma cases retrospectively between 2001 and 2009. Two hundred and sixteen patients out of 334 were included in the study. Patients were grouped according to disection1 (D1) or dissection 2 (D2) dissection. We compared the estimated survival and actual survival determined by Pathologic nodes (pN) class and N ratio, and SPSS 15.0 software was used for statistical analysis. Ninety-six (44.4%) patients underwent D1 dissection and 120 (55.6%) had D2 dissection. When groups were evaluated, 23 (24.0%) patients in D1 and 21 (17.5%) in D2 had stage migration (P = 0.001). When both D1 and D2 groups were evaluated for number of pathological lymph nodes, despite the fact that there was no difference in N ratio between D1 and D2 groups, a statistically significant difference was found between them with regard to pN1 and pN2 groups (P = 0.047, P = 0.044 respectively). In D1, pN0 had the longest survival while pN3 had the shortest. In D2, pN0 had the longest survival whereas pN3 had the shortest survival. N ratio is an accurate staging system for defining prognosis and treatment plan, thus decreasing methodological errors in gastric cancer staging.World Journal of Gastroenterology 09/2011; 17(35):4007-12. · 2.47 Impact Factor -
Article: Frantz's tumor (solid pseudopapillary tumor) of the pancreas. A case report.
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ABSTRACT: A solid pseudopapillary tumor of the pancreas is a rare neoplasm which, for the most part, affects young women and has a relatively favorable prognosis with a low malignant potential. These tumors usually have unclear clinical features and may form very large masses before being diagnosed. We report the case of a 29-year-old woman who underwent complete resection of the tumor using a distal pancreatectomy and splenectomy procedure. The patient is being followed-up and in good condition. A review of the relevant literature is also presented. A solid pseudopapillary tumor of the pancreas is a rare condition with a low potential for malignancy and favorable prognosis; surgical resection is generally curative.JOP: Journal of the pancreas 02/2009; 10(2):209-11.
