Sleeve gastrektomi operasyonu öncesi ve sonrası alt özofagus sfinkterinin hıgh resulatıon manometre (HRM) ile değerlendirilmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Laparoskopik Sleeve Gastrektomi (LSG) operasyonu, günümüz dünyasında obezite için en çok uygulanan tedavi seçeneklerinden biri olmuştur. Sleeve Gastrektomi operasyonunda; büyük kurvatura pilorun 2-3 cm proksimalinden, His açısına kadar serbestleştirildikten sonra staplerlar ile mide rezeksiyonu gerçekleştirilir. His açısı; özofagus ile fundus arasındaki dar açıdır. Bu dar açı ve gazla dolu fundus, kardianın kapalı kalmasını sağlar. Sonuç olarak gastroözofegeal reflü önlenir. Sleeve Gastrektomi operasyonu sırasında fundus serbestleştirilmesi His açısının bozulmasına ve dolayısıyla reflü mekanizmalarının bozulmasına sebep olur. Bu nedenle çalışmamızın amacı; Düzce Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde yapılan Sleeve Gastrektomi operasyonlarında, preoperatif ve postoperatif High Resulation Manometre (HRM) ile Alt Özofagus Sfinkter Basıncının nicel olarak ölçülmesi ve postoperatif reflü yapma olasılığını ortaya konması olmuştur. Yaptığımız çalışmada sonucunda, LSG yapılan preoperatif ve postoperatif 28 hastada HRM ile Alt Özofagus Sfinkteri Dinlenim Basıncı ölçüldü. Ölçümler sonucunda postoperatif dönemde Alt Özofagus Sfinkter Basıncının düştüğü görüldü. (p=0,048) Cinsiyetler arasında istatistiksel olarak anlamlı bir fark görülmedi. (p>0,05) Ancak, BMI düşüş hızına göre Alt Özofagus Sfinkter Basıncının istatistiksel anlamda daha çok düştüğü görüldü. (p=0,026) Sonuç olarak, günümüz dünyasında çok fazla yapılan LSG operasyonlarından sonra, gelişebilecek reflü ve reflüye bağlı komplikasyonlardan (özofajit, Barrett Özofagusu gibi) korunmak için postoperatif LSG hastalarına her zaman daha uyanık olunması gerektiğini düşünmekteyiz.
Laparoscopic Sleeve Gastrectomy (LSG) operation has become one of the most commonly used treatment options for obesity in today's world. In Sleeve Gastrectomy operation; after releasing the greater curvature from 2-3 cm proximal to the pylorus to the angle of His, stomach resection is performed with staplers. His angle; it is the narrow angle between the esophagus and fundus. This narrow angle and gas-filled fundus ensure that the cardia remains closed. As a result, gastroesophageal reflux is prevented. Releasing the fundus during Sleeve Gastrectomy operation causes disruption of the His angle and thus reflux mechanisms. Therefore, the aim of our study is; In Sleeve Gastrectomy operations performed at Düzce University Faculty of Medicine General Surgery Clinic, preoperative and postoperative High Resulation Manometer (HRM) was used to quantitatively measure Lower Esophageal Sphincter Pressure and reveal the possibility of postoperative reflux. As a result of our study, Lower Esophageal Sphincter Resting Pressure was measured with HRM in 28 preoperative and postoperative patients who underwent LSG. As a result of the measurements, it was observed that the Lower Esophageal Sphincter Pressure decreased in the postoperative period. (p=0.048) There was no statistically significant difference between genders. (p>0.05) However, it was observed that Lower Esophageal Sphincter Pressure decreased statistically more than the BMI decrease rate. (p=0.026) As a result, LSG operations which are performed frequently in today's world, we think that postoperative LSG patients should always be more wathful in order to be protected from reflux and reflux-related complications (such as esophagitis, Barrett's Esophagus) that may develop after.
Laparoscopic Sleeve Gastrectomy (LSG) operation has become one of the most commonly used treatment options for obesity in today's world. In Sleeve Gastrectomy operation; after releasing the greater curvature from 2-3 cm proximal to the pylorus to the angle of His, stomach resection is performed with staplers. His angle; it is the narrow angle between the esophagus and fundus. This narrow angle and gas-filled fundus ensure that the cardia remains closed. As a result, gastroesophageal reflux is prevented. Releasing the fundus during Sleeve Gastrectomy operation causes disruption of the His angle and thus reflux mechanisms. Therefore, the aim of our study is; In Sleeve Gastrectomy operations performed at Düzce University Faculty of Medicine General Surgery Clinic, preoperative and postoperative High Resulation Manometer (HRM) was used to quantitatively measure Lower Esophageal Sphincter Pressure and reveal the possibility of postoperative reflux. As a result of our study, Lower Esophageal Sphincter Resting Pressure was measured with HRM in 28 preoperative and postoperative patients who underwent LSG. As a result of the measurements, it was observed that the Lower Esophageal Sphincter Pressure decreased in the postoperative period. (p=0.048) There was no statistically significant difference between genders. (p>0.05) However, it was observed that Lower Esophageal Sphincter Pressure decreased statistically more than the BMI decrease rate. (p=0.026) As a result, LSG operations which are performed frequently in today's world, we think that postoperative LSG patients should always be more wathful in order to be protected from reflux and reflux-related complications (such as esophagitis, Barrett's Esophagus) that may develop after.
Açıklama
Anahtar Kelimeler
Genel Cerrahi, General Surgery, Laparoskopik Sleeve Gastrektomi, High Resulation Manometre, Alt Özofagus Sfinkter Basıncı, Reflü, Laparoscopic Sleeve Gastrectomy, High Resulation Manometer, Lower Esophageal Sphincter Pressure, Reflux
