Sleeve gastrectomy-induced endocrine changes in the remnant stomachs of premenopausal and postmenopausal rats: role of the estrogen receptors.

BACKGROUND: Although alterations in the plasma levels of leptin, glucagon-like peptide-1, and gastrin were linked with bariatric surgery outcomes, gastric production of these peptides was not elucidated before. OBJECTIVE: The aim was to evaluate the impact of estrogen depletion and estrogen receptors (ERs) on sleeve gastrectomy (SG)-induced alterations in gastric hormone production, gastric mucosal integrity, and bone mass. SETTING: Physiology Research Lab at the University. METHODS: Female Sprague-Dawley rats underwent ovariectomy or sham operation (control), and 2 months later SG or sham SG was performed. Rats received either nonselective agonist 17 ß, ER-α agonist, ER-ß agonist, or vehicle for 3 weeks. Trunk blood and gastric tissues were collected for biochemical measurements, while histopathologic examination was performed in gastric and femur samples. RESULTS: In the presence of intact ovaries, SG-induced weight loss was accompanied by reductions in the gastric synthesis of leptin and gastrin, while gastric glucagon-like peptide-1 was additionally decreased when SG was performed at the postmenopausal state. SG elevated the depleted serum estradiol levels of menopause, implicating a beneficial effect, but the occurrence of severe gastric mucosal injury was triggered. On the other hand, using ER agonists upregulated gastrin-expressing cells, ameliorated gastric injury, and improved bone loss. CONCLUSIONS: SG, either at premenopausal or postmenopausal state, resulted in considerable loss in bone mass, along with reductions in the gastric levels of gastrin and leptin. Functional status of the ovaries needs to be taken into consideration when monitoring the outcomes of SG, and ER agonists could be of value in controlling SG-induced complications.

Laparoscopic resection for colorectal diseases: short-term outcomes of a single center.

OBJECTIVE: Even though, laparoscopy is not accepted as the current gold standard in colorectal surgery, it can be performed as safely as open surgery. It is also widely accepted that the technique has many advantages. In this study, we evaluated the results of 33 patients with laparoscopic colorectal resection. MATERIAL AND METHODS: Thirty-three patients who underwent laparoscopic colon surgery between January 2013 and September 2014 in the General Surgery Clinic at Marmara University Hospital were included in the study. Patients were evaluated in terms of their demographic and tumor histopathologic characteristics, type of surgery and early postoperative complications. RESULTS: Laparoscopic colorectal resection was performed for 33 patients who had malignant or benign lesions. The median age was 60 (35-70), and 18 (55%) were male patients. The majority of the patients (90%) were diagnosed with colorectal adenocarcinoma. Half of the patients were T3 and 67% had N0 stage. The median number of retrieved lymph nodes was 17 (4-28). Negative surgical margins were obtained in all patients. The postoperative hospital stay was 5 (4-16) days. Postoperative early complications were observed in only 5 patients. The majority of complications were treated without the need for surgery. No mortality was recorded in this series of patients. CONCLUSION: This study showed that laparoscopic colorectal surgery could be performed safely based on its low complication rate, short length of hospital stay, providing sufficient surgical resection and lymph node dissection.