Laparoscopic mini-gastric bypass versus laparoscopic sleeve gastrectomy in metabolic surgery A single center experience.

AIM: The safety and effectiveness of MGB versus LSG remain unclear. In this study, we It has been shown by many clinical studies that laparoscopic sleeve gastrectomy (LSG) and mini-gastric bypass (MGB), two current methods in metabolic surgery, may be alternatives to Roux-en-Y gastric aimed to compare the postoperative outcomes of MGB and LSG procedures performed in bariatric surgery. MATERIAL METHODS: A total of 175 patients who underwent MGB and LSG surgery between 2016 and 2018 at a single metabolic surgery center were analyzed retrospectively. Two surgical procedures were compared in terms of the perioperative, early and late postoperative outcomes. RESULTS: There were 121 patients in the MGB group and 54 patients in the LSG group. No significant difference was found between the groups regarding the operating time, the conversion to open surgery and the early postoperative complications (p>0.05). The length of hospital stay was significantly shorter in the MGB group (p:0.001). The excess weight loss (EWL%) and total weight loss (TWL%) were significantly higher in the MGB group (90.3 vs. 79.2; and 36.4 vs 30.5, respectively). No significant difference was found between the two groups in terms of the remission rates of comorbidities. The symptoms of gastroesophageal reflux were observed in a significantly fewer number of the patients in the MGB group (6 patients 4.9% vs. 10 patients 18.5%). CONCLUSIONS: Both LSG and MGB are effective, reliable, and useful methods in metabolic surgery. The MGB procedure is superior to the LSG in terms of the length of hospital stay, EWL%, TWL% and the postoperative gastroesophageal reflux symptoms. KEY WORDS: Metabolic surgery, Mini gastric bypass, Postoperative outcomes, Sleeve gastrectomy.

The Effect of Adipose-Derived Stromal Vascular Fraction Cells to Abdominal Wall Fascia Defects in Rats: An Experimental Study.

OBJECTIVE: Various synthetic and biological meshes have been developed to reduce recurrence and complications in ventral incisional hernia repairs. Adipose tissue is a rich reserve for mesenchymal stromal cells. In the present study we aimed to examine the effects of adipose-derived mesenchymal stromal cells (AD-MSCs) on abdominal incisional hernia repairs in rats. MATERIALS AND METHODS: The study involved 32 male Wistar-Albino rats, weighing 200-250 g, which were divided into three groups. In Group 1 (control group) only an incisional hernia model was created. In Group 2, the incisional hernia model was created and 1 ml stromal vascular fraction (SVF), obtained from inguinal lipectomy material and containing mesenchymal stromal cells, was injected into the edges of the defect in the same session. In Group 3, only the incisional hernia model was created in the first stage and after 14 days, 1 ml of SVF was injected into the edges of the defect. Skin incisions of rats in Group 1 and 2 were opened on postoperative day 28 while in group 3 were opened on day 42. Peritoneal formation in abdominal wall defect was evaluated macroscopically and histopathologically. RESULTS: Peritoneal formation was significantly superior in Groups 2 and 3 than in Group 1 (p: 0.031). In histopathological evaluation, the structural distortion and polymorphonuclear leukocyte (PMNL) levels were significantly higher in Group 1 than in Group 3 (p: 0.048 and p: 0.046, respectively). Granulation, capillary density, fibrosis and collagen organization were higher in Group 2 and 3, however this difference was not statistically significant (p > 0.05). CONCLUSIONS: Adipose-derived stromal vascular fraction cells obtained from inguinal lipectomy material in rats positively affect the repair of abdominal incisional hernias by increasing peritoneal formation, and reducing structural distortion and PMNL infiltration.

Overactive bladder symptoms in patients with multiple sclerosis: Frequency, severity, diagnosis and treatment.

OBJECTIVE: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. DESIGN: Survey study. SETTING: Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. PARTICIPANTS: Consecutive MS patients scheduled for outpatient follow-up (n = 309). INTERVENTION: MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. RESULTS: The mean age ± SD was 39.3 ± 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P < 0.001), upper urinary tract assessment by ultrasound (P < 0.001), urodynamic assessment (P < 0.001), admitted to a doctor for urinary symptoms (P < 0.001), and current or past catheter use (P = 0.002). CONCLUSION: Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MS patients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.