Reinforcement in Laparoscopic Sleeve Gastrectomy: Is It Effective?

BACKGROUND: Despite the success of bariatric surgery in treating obesity, it can still lead to complications. The most serious and feared technical complications are bleeding and leakage from the gastric staple line. In this study, stapler line reinforcement was investigated to determine whether it affects postoperative leakage and bleeding rates and their management. MATERIALS AND METHODS: Overall, 510 patients who underwent sleeve gastrectomy were evaluated retrospectively. They were divided into 2 groups according to whether reinforcement of the staple line with running imbricating sutures was performed. RESULTS: In the reinforcement group, there were two leaks (0.7%), which were diagnosed seven and eight days after surgery. In the non-reinforcement group, there were nine leaks (4%). There was no difference between the two groups in staple line bleeding. CONCLUSIONS: This study shows that reinforcement with continuous imbricating sutures is associated with less stapler line leakage and a lower reoperation rate at the cost of increased operative time.

Neuropathic pain in pregnant Turkish women with lumbopelvic pain and its impact on health-related quality of life.

OBJECTIVES: To investigate the prevalence of neuropathic pain in pregnant women and to state its influence on the functional status and health-related quality of life (HRQoL) in terms of physical, social, and emotional functioning. METHODS: A total of 90 pregnant women with lumbopelvic pain (LPP) and non-pregnant and healthy controls were included. The presence of neuropathic pain was determined using the Leeds assessment of neuropathic symptoms and signs (LANNS) questionnaire. The HRQoL was assessed using the Nottingham Health Profile (NHP), and the functional status was evaluated using the Oswestry Disability Index (ODI). The severity of pain was measured using a visual analog scale. RESULTS: The LANNS score was ≥12 in 34 pregnant women (37.8%). The prevalence of neuropathic pain was higher in pregnant women with LPP (odds ratio=6.22; 95% confidence interval=2.68-14.44) (p<0.001) than in controls. The LANNS score was found to be correlated with the physical mobility subgroup in the NHP at high levels (p=0.002, r=0.32) and with the ODI and pain subgroup in the NHP at moderate levels (p=0.013, r=0.26 and p=0.038, r=0.22, respectively). CONCLUSION: The present study is the first to demonstrate that neuropathic pain is associated with pregnancy-related LPP and strongly correlated with functional impairment and deterioration in the HRQoL. A better understanding of neuropathic pain mechanisms in pregnancy-related LPP will help us find more effective treatment strategies.

Relationship between core stability and dynamic balance in women with postmenopausal osteoporosis.

OBJECTIVES: The aim of this study was to investigate the relationship between core stability and dynamic balance in women with postmenopausal osteoporosis. PATIENTS AND METHODS: A total of 100 females (mean age 59.9±7.5 years; range, 42 to 73 years) with postmenopausal osteoporosis between January 2016 and June 2016 were included in this study. All patients were evaluated for dynamic balance with the Star Excursion Balance Test (SEBT) and for core stability with trunk flexion, extension, and Side Bridge Test (SBT). RESULTS: There was a significant correlation between age and the reach directions of anterior (A), posteromedial (PM), and posterolateral (PL) of the right limb (p<0.001, p=0.009, p=0.012) and the reach directions of A and PM of the left limb (p<0.001, p=0.004). There was no correlation between the lumbar spine, femoral neck, and total hip Bone Mineral Density (BMD) and the reach directions of SEBT (p>0.05). There was a significant correlation between the trunk flexion test results and the reach directions of A, PM, and PL of the right limb (p=0.005, p=0.001, p=0.002), (r=0.277, r=0.333, r=0.308) and the reach directions of A, PM, and PL of the left limb (p=0.008, p=0.016, p=0.005), (r=0.265, r=0.239, r=0.276). There was a significant correlation between the SBT results and the reach directions of A, PM, and PL of the right limb (p<0.001, p<0.001, p=0.005), (r=0.423, r=0.366, r=0.281) and the reach directions of A, PM, and PL of the left limb (p<0.001, p<0.001, p=0.001), (r=0.418, r=0.356, r=0.316). There was a significant correlation between the trunk extension test results and the reach directions of A, PM, and PL of the right limb (p<0.001, p<0.001, p=0.006), (r=0.383, r=0.471, r=0.276) and the reach directions of A, PM, and PL of the left limb (p<0.001, p<0.001, p=0.003) (r=0.407, r=0.401, r=0.297). CONCLUSION: Our study results showed that age and core stability were associated with dynamic balance in women with postmenopausal osteoporosis.