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    Comparison of the microvessel density of gastric regions in normal and sleeve gastrectomized rats
    (2018) Orman, Suleyman; Yol, Sinan; Uzun, Huseyin; Ceyran, Ayse Bahar
    Aim: Background: The aim of this study is to compare the microvessel densities of different normal gastric regions and to determine the effects of sleeve gastrectomy on the microvessel density of tissues alongside the remnant stomach. Material and Methods: Twenty male Wistar albino rats were divided into two groups. Rats in the control group were immediately sleeve gastrectomized under anesthesia and a wedge resection of the esophagogastric junction (EGJ), the fundus, corpus and antral gastric regions was performed, before sacrifice. Meanwhile, rats in the experiment group also underwent sleeve gastrectomy but were not sacrificed until the 5th postoperative day. At this point, gastric tissues alongside the sleeve gastrectomy area were then wedge-resected. The microvessel densities of these two groups were evaluated and compared. Results: When comparing distinctive gastric regions within the control group, the microvessel density of the esophagogastric junction was found to be less than in the corpus or fundus (20.04±4.45; 36.28±9.98, 39.4±9.57; p <0.01). When comparing the control and experiment groups, No significant difference in the microvessel density of the esophagogastric junction was found (20.04 ± 4.45, 24.63 ± 8.91, p> 0.05). The sleeve gastrectomy also had no significant effect on the microvessel densities at the esophagogastric junction or corpus (24.63±8.91, 22.24±7,63; p> 0.05). Conclusion: The esophagogastric junction has a lower microvessel density than the corpus in a normal stomach. Sleeve gastrectomy has no adverse effect on the microvessel density of the esophagogastric junction.
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    Effects of thyroid hormone supplementation on oxidative stress after sleeve gastrectomy in rats
    (2018) Orman, Suleyman; Isbilen Basok, Banu; Kisa, Ucler; Isman, Ferruh Kemal; Genc Kahraman, Nevin
    Aim: Sleeve gastrectomy has been used for the surgical treatment of morbid obesity. The aim of the present study was to determine the effects of triiodothyronine supplementation on oxidative stress parameters in anastomotic tissue level. Material and Methods: Twenty-four male Wistar albino rats were divided into control (n:12), and experimental (n:12) groups and underwent sleeve gastrectomy. Experimental group rats received a single dose of triiodothyronine (400 mg/100 g) in the operation day. Rats were sacrificed on postoperative day 7. Serum thyroid hormones were analysed. The supernatants were used to measure total oxidant status, total antioxidant status, nitric oxide and malondialdehyde levels. All tissue parameters were analysed by spectrophotometric methods. Oxidative stress index values were calculated. Results: Thyroid stimulating hormone levels in both the control and triiodothyronine group did not significantly change on the 7th postoperative day (p=0.663). Free triiodothyronine levels were significantly higher in triiodothyronine group rats than in control group rats (triiodothyronine vs control: p=0.004). Although total oxidant status levels did not altered by thyroid hormone treatment (p>0.05), total antioxidant status levels significantly decreased (p<0.05). Oxidative stress index values were not statistically different in tissues (p>0.05). Tissue nitric oxide levels were also similar in both groups (p>0.05). Malondialdehyde levels increased in triiodothyronine given rats compared with the control group (p<0.01). Conclusion: This study showed that total oxidant status levels and oxidative stress index values were similar in both groups. However, triiodothyronine supplementation induced lipid peroxidation by increasing tissue malondialdehyde levels that might deplete tissue antioxidant level.
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    The role of histopathologic alterations of gallbladder wall in conversion cholecystectomy
    (2018) Orman, Suleyman; Ceyran, Ayse Bahar
    Aim: We aimed to investigate the role of histopathologic alterations of gallbladder wall in conversion cholecystectomy. Material and Methods: 3338 laparoscopic cholecystectomies and 121 conversion cholecystectomies that were performed between January 2008 and June 2017 in our hospital were evaluated. Patients were divided into 2 groups as laparoscopic and conversion cholecystectomy groups. Both groups were compared retrospectively by examining the histopathologic data of 140 patients were randomly analyzed. Results: There was a statistically significant difference between the types of surgery according to necrosis, polymorfonuclear leucocystes, mononuclear cells, edema levels (p <0.01). The incidence of polymorfonuclear leucocystes and mononuclear cells was at the marked and massive levels in cases with conversion cholecystectomy which were higher than in those with laparoscopic cholecystectomy. The rate of severe edema seen in conversion cholecystectomy was higher than in laparoscopic cholecystectomy (p <0.01). There was a statistically significant difference between the types of surgery according to granulation tissue, neoangiogenesis and fibroblast levels (p <0.01). There was a statistically significant difference between the necrosis-edema duple levels and Verhofstadt scores of the cases according to the operation type (p <0.01). Conclusion: Cholelithiasis histopathology that evaluates intra-mural factors has significant effects on conversion cholecystectomy with extra-mural factors. The increase in Verhofstadt score and Necrosis-Edema duple has been shown to increase the risk of conversion cholecystectomy surgery with great sensitivity. Preoperative superb microvascular imaging and contrast-enhanced ultrasound may helpful in detecting the necrosis and edema in the gallbladder wall which has also the potential to predict the risk of conversion cholecystectomy