Obezite için laparoskopik sleeve gastrektemi’nin 4 yıllık uzun dönem metabolik, ghrelin seviyesi ve komorbidite değişimi üzerine etkileri ve sonuçları.

Abstract

Purpose: The aim of this study is to investigate the moderate and long-term effects of Laparoscopic Sleeve Gastrectomy (LSG), the comparison of pre-op and post-op long-term (4 years) ghrelin levels, whether patients have gained weight again after LSG or not, and the change of the comorbidities accompanying obesity. Basis and background: Laparoscopic sleeve gastrectomy has become quite common as a single and definitive treatment for morbid obesity. There are publications regarding the positive short-term outcomes, but long-term outcomes and studies revealing the correlation of ghrelin and LSG are still insufficient. Method: LSG was administered as an obesity treatment between January 2009 and December 2011 in a total of 34 patients selected for surgery with the diagnosis of morbid obesity, whose pre-treatment ghrelin levels were measured, at Pamukkale University Department of General Surgery. 1st month, 3rd month, 6th month, 12th month and then annual controls of the patients after the surgery were conducted. Finally, patients were contacted in the post-op 4th year and they were called for their final control and examinations. Findings: The mean pre-op weight of the 34 patients included in the study was 132.93±19.25 kg, whereas the mean weight in the post-op 4th year was 83±13.90 kg. During the surgery, mean BMI: was 49.8±7.3 kg/m2. At the end of 4th year after the LSG surgery, BMI: was found as 29.18±5.6 kg/m2. While the pre-op ghrelin value of the patients included in the study was 672±143 pg/ml, their post-op 4th year ghrelin value became 164±43 pg/ml. The difference between the pre-op and post-op 4th year was statistically significant. None of the patients in the study group had any major complications or mortality during follow-up. Conclusions: The ghrelin level after LSG gradually reduces the carbohydrate and fat consumption due to the resection of the fundus and the body of the stomach. Obesity therapy with LSG has a direct beneficial effect on the health status of the patients by reducing the symptoms of the comorbidities such as Type 2 DM and HT. According to the findings, LSG is a safe and effective method in the treatment of morbid obesity, has long-term positive metabolic effects, and is a procedure that increases the quality of life and comfort.