Metabolik sendrom modeli oluşturulan ratlarda elle ve manyetik bası ile oluşturulan gastrojejunal anastomozun etkilerinin karşılaştırılması
Küçük Resim Yok
Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: Metabolik sendrom, birden fazla metabolik sorunun bir arada görüldüğü bir durumdur. Tanısı, hipertansiyon, bel çevresi genişliği, yüksek trigliserid, düşük HDL kolesterol ve yüksek açlık glukozundan en az üçünün varlığıyla konur. Tedavisinde ise temel olarak yaşam tarzı değişiklikleri yapılır; gerekirse cerrahi ve medikal tedaviler uygulanabilir. Cerrahi yöntemlerden biri olan loop bipartition ameliyatında, mide ile ince bağırsak arasında bir bağlantı oluşturularak besin emilimi azaltılır. Bu geçişi oluştururken kullanılan yeni tekniklerden biri, mıknatıslarla yapılan anastomozdur. Bu yöntemle basıya uğrayan dokularda doğal birleşme sağlanır ve dikişsiz bir geçiş oluşturulur. Bu çalışmada, metabolik sendrom modeli oluşturulan ratlarda klasik el ile anastamoz yapılan cerrahi yöntem ile mıknatıs kullanılarak manyetik bası ile anastomoz yapılan yöntem arasındaki farklılıkların araştırılması amaçlandı. Sonuçlar kan analizleri, doku incelemeleri ve anastomoz hattının dayanıklılığı ile değerlendirildi. Gereç ve yöntem: Bu çalışmada toplam 36 Wistar -Albino ırkı erkek rat kullanıldı. Kontrol grubunda 6, diğer deney gruplarında 10ar adet olacak şekilde (1 kontrol ve 3 deney grubu) planlama yapıldı. Deneklere fruktoz kullanılarak metabolik sendrom modeli oluşturuldu ve farklı yöntemler ile gastrojejunal anastamoz yapılarak iki yöntemin metabolik sendrom parametreleri üzerine etkisi karşılaştırıldı. Deney Grupları: 1.Grup-Kontrol Grubu (n:6): Deney boyunca normal gıda ve normal içme suyu verildi. 8 hafta sonra sham laparotomi uygulandı. 4 hafta işlem sonrası takip edildi ve sakrifiye edildi. 2.Grup,Metabolik Sendrom kontrol (MetS + K) grubu (n:10): 8 hafta metabolik sendrom modeli uygulandı ve 8 hafta sonra sham laparotomi uygulandı. 4 hafta işlem sonrası takip edildi ve sakrifiye edildi. 3.Grup, Metabolik Sendrom + Elle Gastrojejunal anastamoz (MetS + EGJ) grubu(n:10): 8 hafta metabolik sendrom modeli uygulandı ve el ile gastrojejunal anastamoz yapıldı. 4 hafta işlem sonrası takip edildi ve sakrifiye edildi. 4.Grup, Metabolik sendrom + Manyetik Bası ile Gastrojejunal Anastamoz grubu (MetS + MGJ) (n:10): 8 hafta metabolik sendrom modeli uygulandı ve manyetik bası ile gastrojejunal anastamoz yapıldı. 4 hafta işlem sonrası takip edildi ve sakrifiye edildi. Denekler deney başlangıcında, 8. haftada ve deney sonunda tartılarak ağırlıkları not alındı, kan şekeri ölçümleri yapıldı. Metabolik sendrom modeli oluşturulmak istenen deneklere %20 fruktoz ile hazırlanmış içme suyu per libidum olarak verildi. Tüm denekler 8. Haftada laparotomi uygulanarak gerekli işlem yapıldıktan sonra işlem sonrası 4 hafta takip edildi ve anestezi sonrasında kalpten kan alınarak sakrifiye edildi. Kan numuneleri Total Kolesterol, Trigliserid, Low Density Lipoprotein (LDL) kolesterol, High Density Lipoprotein (HDL) kolesterol, HbA1C, İnsülin ,glukoz , Malondialdehyde (MDA) ölçümleri için kullanıldı. Bulgular: Kontrol grubuna göre diğer gruplarda 8. Haftada açlık kan şekeri ve vücut ağırlığı anlamlı düzeyde yüksek izlendi. 12. Haftada ise açlık kan şekeri, vücut ağırlığı ve biyokimyasal parametrelerin çoğunda anlamlı farklılıklar izlenmedi. Tüm gruplara yapılan oral glukoz tolerans testinde sonuçlar benzerdi. Antioksidan seviyesi görülen parametreler de aynı şekilde anlamlı olarak farklılık görülmedi. Mıknatıs ile anastomoz işleminin işlem süresi daha kısa gözlemlendi ve histopatolojik olarak incelendiğinde elle anastomoza göre daha düzenli bir hat görüldü. Sonuç: Mıknatıs ile anastomoz yeni gelişen bir tekniktir. El ile anastomoz ya da günümüzde daha sık kullanılan stapler ile anastomozlar yerine alternatif olarak tercih edilebilir. Bu çalışmada el ile ve mıknatıs ile anastomoz uygulanarak iki yöntemin biyokimyasal etkileri 1 aylık takip sonrasında benzer sonuçlanmıştır. Mıknatıs ile anastomozda teknik olarak işlem süresinin kısa olması ve işlemin uygulanmasının elle anastomoza göre daha basit gerçekleşiyor olması bu iki yöntem arasındaki en belirgin farklardandır. Deney tasarımı değiştirilerek ileri araştırmalar yapılması bu iki yöntem arasındaki uzun dönem sonuçlarda ya da farklı parametrelerde farklılıklar tespit etmekte faydalı olabilir.
Introduction and Aim Metabolic syndrome is a condition characterized by the coexistence of multiple metabolic disorders. The diagnosis is made when at least three of the following criteria are present: hypertension, increased waist circumference, elevated triglycerides, low HDL cholesterol, and elevated fasting glucose. The primary treatment involves lifestyle modifications; however, surgical and medical interventions may be employed when necessary. One of the surgical techniques used in metabolic surgery is loop bipartition, which aims to reduce nutrient absorption by creating a connection between the stomach and the small intestine. Among the innovative techniques used to achieve this connection is magnetic compression anastomosis. This method promotes natural tissue fusion through compression and establishes a suture-free passage. This study aimed to investigate the differences between the traditional hand-sewn anastomosis technique and the magnetic compression anastomosis technique using magnets in rats with an experimentally induced metabolic syndrome model. The outcomes were evaluated based on blood analyses, histological examinations, and the durability of the anastomosis line. Materials and Methods A total of 36 male Wistar-Albino rats were included in the study. The study was designed with one control group (n=6) and three experimental groups (n=10 in each group). A metabolic syndrome model was established in the rats using fructose-enriched drinking water, and gastrojejunal anastomosis was performed using different methods to compare the effects of these techniques on metabolic syndrome parameters. Experimental Groups Group 1 - Control Group (n=6): Rats were given a normal diet and normal drinking water throughout the study. After eight weeks, sham laparotomy was performed. The rats were monitored for four weeks postoperatively and then sacrificed. Group 2 - Metabolic Syndrome Control Group (MetS + C, n=10): A metabolic syndrome model was established for eight weeks, followed by sham laparotomy. The rats were observed for four weeks postoperatively and then sacrificed. Group 3 - Metabolic Syndrome + Hand-Sewn Gastrojejunal Anastomosis Group (MetS + HGJ, n=10): A metabolic syndrome model was established for eight weeks, followed by hand-sewn gastrojejunal anastomosis. The rats were monitored for four weeks postoperatively and then sacrificed. Group 4 - Metabolic Syndrome + Magnetic Compression Gastrojejunal Anastomosis Group (MetS + MGJ, n=10): A metabolic syndrome model was established for eight weeks, followed by magnetic compression gastrojejunal anastomosis. The rats were monitored for four weeks postoperatively and then sacrificed. The body weights of the rats were recorded at the beginning of the study, at the end of the eighth week, and at the end of the experiment. Blood glucose levels were measured. Rats in the metabolic syndrome model groups were provided with 20% fructose-enriched drinking water ad libitum. At the end of the eighth week, laparotomy was performed, and the necessary surgical procedures were conducted. The rats were monitored for 4weeks postoperatively and sacrificed under anesthesia by cardiac puncture. Blood samples were collected and analyzed for total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, HbA1c, insulin, glucose, and malondialdehyde (MDA) levels. Results Compared to the control group, fasting blood glucose and body weight were significantly higher in the other groups at the 8th week. However, at the 12th week, no significant differences were observed in fasting blood glucose, body weight, and most biochemical parameters. The results of the oral glucose tolerance test were similar across all groups. Likewise, no significant differences were observed in the measured antioxidant levels. The anastomosis procedure performed with a magnet was observed to have a shorter procedure time, and histopathological examination revealed a more regular line compared to manual anastomosis. Conclusion Magnetic anastomosis is a newly emerging technique. It can be considered as an alternative to manual anastomosis or stapler anastomosis, which is more commonly used today. In this study, the biochemical effects of manual and magnetic anastomosis were compared, showing similar results after a one-month follow-up. The most notable differences between these two methods are the shorter procedure time and the technically simpler application of magnetic anastomosis compared to manual anastomosis. Conducting further research by modifying the experimental design may be beneficial in identifying differences in long-term outcomes or various parameters between these two methods.
Introduction and Aim Metabolic syndrome is a condition characterized by the coexistence of multiple metabolic disorders. The diagnosis is made when at least three of the following criteria are present: hypertension, increased waist circumference, elevated triglycerides, low HDL cholesterol, and elevated fasting glucose. The primary treatment involves lifestyle modifications; however, surgical and medical interventions may be employed when necessary. One of the surgical techniques used in metabolic surgery is loop bipartition, which aims to reduce nutrient absorption by creating a connection between the stomach and the small intestine. Among the innovative techniques used to achieve this connection is magnetic compression anastomosis. This method promotes natural tissue fusion through compression and establishes a suture-free passage. This study aimed to investigate the differences between the traditional hand-sewn anastomosis technique and the magnetic compression anastomosis technique using magnets in rats with an experimentally induced metabolic syndrome model. The outcomes were evaluated based on blood analyses, histological examinations, and the durability of the anastomosis line. Materials and Methods A total of 36 male Wistar-Albino rats were included in the study. The study was designed with one control group (n=6) and three experimental groups (n=10 in each group). A metabolic syndrome model was established in the rats using fructose-enriched drinking water, and gastrojejunal anastomosis was performed using different methods to compare the effects of these techniques on metabolic syndrome parameters. Experimental Groups Group 1 - Control Group (n=6): Rats were given a normal diet and normal drinking water throughout the study. After eight weeks, sham laparotomy was performed. The rats were monitored for four weeks postoperatively and then sacrificed. Group 2 - Metabolic Syndrome Control Group (MetS + C, n=10): A metabolic syndrome model was established for eight weeks, followed by sham laparotomy. The rats were observed for four weeks postoperatively and then sacrificed. Group 3 - Metabolic Syndrome + Hand-Sewn Gastrojejunal Anastomosis Group (MetS + HGJ, n=10): A metabolic syndrome model was established for eight weeks, followed by hand-sewn gastrojejunal anastomosis. The rats were monitored for four weeks postoperatively and then sacrificed. Group 4 - Metabolic Syndrome + Magnetic Compression Gastrojejunal Anastomosis Group (MetS + MGJ, n=10): A metabolic syndrome model was established for eight weeks, followed by magnetic compression gastrojejunal anastomosis. The rats were monitored for four weeks postoperatively and then sacrificed. The body weights of the rats were recorded at the beginning of the study, at the end of the eighth week, and at the end of the experiment. Blood glucose levels were measured. Rats in the metabolic syndrome model groups were provided with 20% fructose-enriched drinking water ad libitum. At the end of the eighth week, laparotomy was performed, and the necessary surgical procedures were conducted. The rats were monitored for 4weeks postoperatively and sacrificed under anesthesia by cardiac puncture. Blood samples were collected and analyzed for total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, HbA1c, insulin, glucose, and malondialdehyde (MDA) levels. Results Compared to the control group, fasting blood glucose and body weight were significantly higher in the other groups at the 8th week. However, at the 12th week, no significant differences were observed in fasting blood glucose, body weight, and most biochemical parameters. The results of the oral glucose tolerance test were similar across all groups. Likewise, no significant differences were observed in the measured antioxidant levels. The anastomosis procedure performed with a magnet was observed to have a shorter procedure time, and histopathological examination revealed a more regular line compared to manual anastomosis. Conclusion Magnetic anastomosis is a newly emerging technique. It can be considered as an alternative to manual anastomosis or stapler anastomosis, which is more commonly used today. In this study, the biochemical effects of manual and magnetic anastomosis were compared, showing similar results after a one-month follow-up. The most notable differences between these two methods are the shorter procedure time and the technically simpler application of magnetic anastomosis compared to manual anastomosis. Conducting further research by modifying the experimental design may be beneficial in identifying differences in long-term outcomes or various parameters between these two methods.
Açıklama
Anahtar Kelimeler
Endokrinoloji ve Metabolizma Hastalıkları, Endocrinology and Metabolic Diseases, Genel Cerrahi
