Mutlu ŞAHIN, Hakan BULUŞ, Veysel Barış TURHAN, Abdulkadir ÜNSAL

Laparoskopik Sleeve Gastrektomi Sırasında Kullanılan Hyoscine-Butylbromide, Çıkarılan Mide Hacmini Artırır

Amaç: Obezite en sık görülen hastalıklardan biridir. Obezite ameliyatlarında temel amaç mide hacmini azaltmaktır. Ayrıca çalışmalar, karın hacminin azalması ve kilo kaybını ilişkilendirmiştir. Bu çalışmada amacımız, intraoperatif uygulanan hyoscine butylbromide(HBB)'in çıkarılan mide hacmi üzerine etkisinin araştırılmasıdır. Gereç ve Yöntemler: Retrospektif cohort çalışması olarak planlanan çalışmaya laparoskopik sleeve gastrektomi (LSG) uygulanan 67 hasta dahil edildi. Ameliyat öncesi 32 hastaya 20 mg HBB verildi(grup II). Kontrol grubundaki 35 hastaya benzer bir işlem uygulandı ancak HBB verilmedi(grup I). Hastaların demografik özellikleri, vücut kütle indeksleri ve laboratuvar değerleri kaydedildi. Kilo kaybı ve vücut kütle indeksleri (VKİ)ndeki değişiklikler birinci ve altıncı ay kontrollerinde kaydedildi. Veriler, Shapiro-Wilk testi ile dağılımın normalliği için analiz edildi. Gruplar arasında genel farklılıklar, parametrik olmayan değerler için Mann-Whitney U testi ile, parametrik değerler ise Student-t testi ile analiz edildi. Bulgular: Grup II'de çıkarılan mide hacmi daha fazlaydı. Birinci ve altıncı ay VKİ 'lerinde gruplar arasında anlamlı fark vardı. Grup II, istatistiksel olarak daha fazla kilo verdi ve sonuç olarak VKİ'leri önemli ölçüde azalmıştı. Sonuç: Ucuz ve kolay ulaşılabilir HBB'nin obezite cerrahisinde çıkarılan mide hacmini arttırdığı ve kilo kaybına katkı sağladığı görüldü

Anahtar Kelimeler:

Sleeve, gastrektomi, hiyosin butilbromid, mide hacmi

Hyoscine-Butylbromide Used During Laparoscopic Sleeve Gastrectomy Increases Removed Gastric Volume

Aim: Obesity is one of the most common diseases, The main goal in bariatric surgeries is to reduce the gastric volume. Also, studies have linked reduced abdominal volume and weight loss. Our aim in this study is to investigate intraoperatively administered hyoscine butylbromide(HBB) on the removed gastric volüme(RGV). Material and Methods: The study, which was planned as a retrospective cohort study, included 67 patients who underwent laparoscopic sleeve gastrectomy (LSG). HBB at a dose of 20 mg was given to 32 patients preoperatively(Group II). A similar procedure was applied to 35 patients in the control group(Group I), but HBB was not given. Demographic characteristics, body mass indexes, and laboratory values of the patients were recorded. Weight loss and changes in BMI were recorded at the first and sixth month controls. Data were analyzed for normality of distribution with the Shapiro-Wilk test. Non-parametric values for general differences between groups were analyzed with the Mann-Whitney U test and parametric values were analyzed with Student t-test . Results: In Group II, the removed gastric volume was greater. In the first and sixth month BMI, there was a significant difference between the groups. Group II lost more weight statistically, and as a result, their BMI decreased significantly. Conclusion: It was observed that inexpensive and easily accessible HBB increased the removed gastric volume in bariatric surgery and contributed to weight loss.

Keywords:

sleeve, gastrectomy, gastric volume, hyoscine butylbromide,

PDF

___

Melissas, J et al. Sleeve gastrectomy—a restrictive procedure?. Obes Surg , 2007: 17(1), 57.
Marceau, P. et al. Biliopancreatic diversion with a new type of gastrectomy. Obes Surg 1993: 3(1), 29-35.
Roa, P. E. et al. Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obes Surg , 2006: 16(10), 1323-1326.
Braghetto, I. et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg , 2007: 17(11), 1442-1450.
Ariyasu, H. et al. Stomach is a major source of circulating ghrelin, and feeding state determines plasma ghrelin-like immunoreactivity levels in humans. The Journal of Clinical Endocrinology & Metabolism, 2001: 86(10), 4753-4758.
Gutzeit, A. et al. Evaluation of the anti-peristaltic effect of glucagon and hyoscine on the small bowel: comparison of intravenous and intramuscular drug administration. European radiology, 2012: 22(6), 1186-1194.
Staritz M. Pharmacology of the sphincter of Oddi. Endoscopy 1988;20 Suppl 1:171–4.
East, J. E. et al. Mechanisms of hyoscine butylbromide to improve adenoma detection: A case-control study of surface visualization at simulated colonoscope withdrawal. Endosc Int Open. 2015;3(6):E636-E641.
Cottam, D. et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc 2006; 20: 859-63.
Regan, J. P. et al. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 2003; 13: 861-4.
Stacher G. et al. Effects of oral cyclotropium bromide, hyoscine N-butylbromide and placebo on gastric emptying and antral motor activity in healthy man. Gut. 1984 May;25(5):485-90.
Yoshikawa I. et al. Comparison of glucagons and scopolamine butylbromide as premedications for colonoscopy in unsedated patients Dis. Colon Rectum 2006: 49 1393–8
Weiner, R. A. et al. Laparoscopic Sleeve Gastrectomy — Influence of Sleeve Size and Resected Gastric Volume. Obes Surg 2007: 17, 1297
Deguines, J. B. et al. Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surgery for Obesity and Related Diseases 2013: 9.5 660-666.
Sista, F. et al. Effect of resected gastric volume on ghrelin and GLP-1 plasma levels: a prospective study. Journal of Gastrointestinal Surgery, 2016: 20(12), 1931-1941.
Du, X. et al. Resected gastric volume has no influence on early weight loss after laparoscopic sleeve gastrectomy. Surgery for Obesity and Related Diseases, 2018: 14(2), 129-135.