Morbid obez hastalarda Sleeve Gastrektomi Operasyonunun hastaların biyokimyasal bulguları, vücut kompozisyonları ve yeme tutumları üzerine etkisi
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2017
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Bu çalışma, laparoskopik sleeve gastrektomi uygulamasından sonra hastaların beslenme durumunun ve preoperatif, postopoperatif yeme tutum davranışındaki değişimlerin değerlendirilmesi; bununla beraber beden kütle indeksi değerinin ve bazı laboratuvar bulgularının kısa dönem değişimlerinin bildirilmesi amacıyla yapılmıştır. Araştırma için Eylül 2015-Ocak 2017 tarihleri arasında, Özel Medicana Bahçelievler Hastanesinde genel cerrahi polikliniğine başvurarak laparoskopik sleeve gastrektomi operasyonu geçiren 59 hastanın verileri geriye dönük taranmıştır. Bireylerin kişisel özellikleri, beslenme ve fiziksel aktivite alışkanlıkları anket formu ile sorgulanmış olup, beslenme durumları besin tüketim sıklığı ile belirlenmiştir. Çalışmaya katılan bireylerin yeme tutum ve davranışları Yeme Tutumu Testi (EAT -40) ve Hollanda Yeme Davranışı Anketi (DEBQ) ölçekleri ile saptanmıştır. Çalışmanın sonuçlarında hastaların preoperatif (preop) beden kütle indeksi (BKİ) ortalaması 41,4 iken postoperatif (postop) 1. ayda 37,8'e, postop 3. ayda ise 33,8'e düştüğü saptanmıştır. Cinsiyetler arasında ise operasyon öncesine göre 1. ay ve 3. ay beden kütle indeksinde görülen düşüş miktarları açısından istatistiksel olarak anlamlı bir farklılık bulunmamaktadır (p>0.05). Araştırmada operasyon öncesine göre 1. ayda kadınlar ortalama -11,81±6,83 kg, 3. aylarında ise ortalama -22,61±6,28 kg vermişlerdir. Erkeklerin 1. ayda ortalama -14,55±6,36 kg, 3. aylarında ise ortalama - 28,07±10,25 kg ağırlık kaybettikleri kaydedilmiştir. Cinsiyetler arasında operasyon öncesine göre 1.ay ağırlıklarında görülen düşüş miktarları açısından istatistiksel olarak anlamlı bir farklılık bulunmamaktadır (p>0.05). Ancak erkeklerde operasyon öncesi ağırlığına göre 3.ay ağırlığında görülen düşüş miktarı, kadınlardan istatistiksel olarak anlamlı düzeyde yüksektir (p:0.025; p<0.05). Labaratuvar bulgularında preop açlık kan şekeri (AKŞ) düzeyine göre postop 1.ay ve 3.ay AKŞ düzeylerinde görülen düşüşler istatistiksel olarak anlamlı bulunmuştur (p<0.05). Preop serum albumin düzeyine göre postop 1.ayda istatistiksel olarak anlamlı bir değişim görülmezken (p>0.05); 3.ay serum albümin düzeylerinde görülen düşüşler istatistiksel olarak anlamlı bulunmuştur (p<0.05). ii Araştırmada preop ALT düzeyine göre postop 1.ayda istatistiksel olarak anlamlı bir değişim görülmezken (p>0.05); 3.ay ALT düzeylerinde görülen düşüşler istatistiksel olarak anlamlı bulunmuştur (p<0.05). Postop 1.aya göre 3.ay ALT düzeylerinde görülen düşüşler de istatistiksel olarak anlamlı bulunmuştur (p<0.05). Preop AST düzeyine göre postop 1.ayda istatistiksel olarak anlamlı bir değişim görülmezken (p>0.05); 3.ay AST düzeylerinde görülen düşüşler istatistiksel olarak anlamlı bulunmuştur (p<0.05). 1. aya göre 3. ay vitamin B12 ve folik asit düzeylerinde görülen düşüş istatistiksel olarak anlamlı bulunmuştur (p<0.05). Hastaların besin tüketim sıklıkları incelemesinde preop ve postop 3. Ay kıyaslandığında hastaların süt, yoğurt, esmer ekmek tüketimlerinde anlamlı bir artış gözlenmiştir (p<0.05). Buna karşın hastaların işlenmiş et ürünleri, beyaz ekmek, pilav, makarna, hamur işi ve tatlı tüketimlerinde anlamlı bir düşüş görülmüştür (p<0.05). Araştırmada hastaların alkollü içecek, kola, meyve suyu, gazlı içecek tüketimlerinde anlamlı düşüş gözlenmiştir (p<0.05). Hastaların yeme davranışlarını belirlemede kullanılan ölçeklerde preop EAT -40 toplam puanlarına göre postop 3.ay EAT-40 toplam puanlarında görülen artış istatistiksel olarak anlamlıdır (p:0.000; p<0.05). Hollanda yeme tutumu ölçeği; preop duygusal yeme alt boyutu puanlarına postop 3.ay duygusal yeme alt boyutu, kısıtlayıcı yeme alt boyutu ve dışsal yeme alt boyutu puanlarında görülen düşüş istatistiksel olarak anlamlıdır (p:0.000; p<0.05). Preop DEBQ toplam puanlarına göre postop 3.ay DEBQ toplam puanlarında görülen düşüş istatistiksel olarak anlamlıdır (p:0.000; p<0.05). Anahtar Kelimeler: Bariyatrik Cerrahi, Beslenme Alışkanlıkları, Yeme Tutumu, Biyokimyasal Bulgular
This study was undertaken to evaluate changes in the nutritional status of patients and preoperative and postoperative eating behavior after laparoscopic sleeve gastrectomy; with the purpose of reporting the body mass index value and short-term changes in some laboratory findings. Between September 2015 and January 2017, the data of 59 patients who had undergone laparoscopic sleeve gastrectomy at the General Hospital of Private Medicana Bahçelievler Hospital were retrospectively surveyed. The personal characteristics, nutrition and physical activity habits of the individuals were questioned by the questionnaire form and nutritional status was determined by the frequency of food consumption. Eating attitudes and behaviors of the subjects participating in the study were determined by Eating Attitude Test (EAT -40) and Dutch Eating Behavior Questionnaire (DEBQ) scales. The results of the study revealed that the preoperative average body mass index (BMI) of the patients decreased from 41.4 to 37.8 in the first postoperative month and to 33.8 in the postoperative third month. There was no statistically significant difference between the genders in terms of the decrease in the body mass index of the first month and the third month according to the preoperative period (p> 0.05). According to the preoperative survey, women gave a mean of -11,81 ± 6,83 kg in the first month and - 22,61 ± 6,28 kg in the third month. It was recorded that males lose weight -14,55 ± 6,36 kg in the first month and -28,07 ± 10,25 kg in the third month. There was no statistically significant difference between the genders in terms of the decrease in the weight of the 1st month according to the preoperative period (p> 0.05). However, the amount of decrease in weight of 3 months according to pre-operation weight in males is statistically higher than that of females (p: 0.025, p <0.05). According to preop fasting blood sugar (FL) levels in laboratory findings, the decreases in postoperative 1st and 3rd FLAS levels were statistically significant (p <0.05). There was no statistically significant change (p> 0.05) in postoperative 1 st postoperative serum albumin level. The decrease in serum albumin levels at 3 months was statistically significant (p <0.05). There was no statistically significant change (p> 0.05) in postoperative 1st week iv according to preop ALT level in the study; The decreases in 3rd month ALT levels were statistically significant (p <0.05). Decreases in 3rd month ALT levels according to Postop 1 were found statistically significant (p <0.05). There was no statistically significant change (p> 0.05) in postoperative 1st week according to preop AST level; The decreases in the 3rd month AST levels were statistically significant (p <0.05). The decrease in vitamin B12 and folic acid levels at 3 months according to month 1 was statistically significant (p <0.05). A significant increase in the consumption of milk, yoghurt and brown bread was observed in the patients when the pre - and postop 3 months were compared (p <0.05). On the other hand, there was a significant decrease in patients' processed meat products, white bread, rice, pasta, pastry and dessert consumption (p <0.05). In the study, alcoholic beverage, cola, fruit juice and carbonated beverages decreased significantly (p <0.05). The scales used to determine the eating behaviors of the patients were statistically significant (p: 0.000, p <0.05) in the postop 3.ay EAT-40 total scores compared to preop EAT -40 total scores. The Netherlands eating attitude scale; The decrease in postop 3 emotional eating subdimension, restrictive eating subdimension and external eating subdimension scores to preop emotional subdimension scores was statistically significant (p: 0.000, p <0.05). The decrease in postop 3 month DEBQ total scores according to preop DEBQ total scores was statistically significant (p: 0.000, p <0.05). Keywords: Bariatric Surgery, Eating Habits, Eating Attitudes, Biochemical Findings
This study was undertaken to evaluate changes in the nutritional status of patients and preoperative and postoperative eating behavior after laparoscopic sleeve gastrectomy; with the purpose of reporting the body mass index value and short-term changes in some laboratory findings. Between September 2015 and January 2017, the data of 59 patients who had undergone laparoscopic sleeve gastrectomy at the General Hospital of Private Medicana Bahçelievler Hospital were retrospectively surveyed. The personal characteristics, nutrition and physical activity habits of the individuals were questioned by the questionnaire form and nutritional status was determined by the frequency of food consumption. Eating attitudes and behaviors of the subjects participating in the study were determined by Eating Attitude Test (EAT -40) and Dutch Eating Behavior Questionnaire (DEBQ) scales. The results of the study revealed that the preoperative average body mass index (BMI) of the patients decreased from 41.4 to 37.8 in the first postoperative month and to 33.8 in the postoperative third month. There was no statistically significant difference between the genders in terms of the decrease in the body mass index of the first month and the third month according to the preoperative period (p> 0.05). According to the preoperative survey, women gave a mean of -11,81 ± 6,83 kg in the first month and - 22,61 ± 6,28 kg in the third month. It was recorded that males lose weight -14,55 ± 6,36 kg in the first month and -28,07 ± 10,25 kg in the third month. There was no statistically significant difference between the genders in terms of the decrease in the weight of the 1st month according to the preoperative period (p> 0.05). However, the amount of decrease in weight of 3 months according to pre-operation weight in males is statistically higher than that of females (p: 0.025, p <0.05). According to preop fasting blood sugar (FL) levels in laboratory findings, the decreases in postoperative 1st and 3rd FLAS levels were statistically significant (p <0.05). There was no statistically significant change (p> 0.05) in postoperative 1 st postoperative serum albumin level. The decrease in serum albumin levels at 3 months was statistically significant (p <0.05). There was no statistically significant change (p> 0.05) in postoperative 1st week iv according to preop ALT level in the study; The decreases in 3rd month ALT levels were statistically significant (p <0.05). Decreases in 3rd month ALT levels according to Postop 1 were found statistically significant (p <0.05). There was no statistically significant change (p> 0.05) in postoperative 1st week according to preop AST level; The decreases in the 3rd month AST levels were statistically significant (p <0.05). The decrease in vitamin B12 and folic acid levels at 3 months according to month 1 was statistically significant (p <0.05). A significant increase in the consumption of milk, yoghurt and brown bread was observed in the patients when the pre - and postop 3 months were compared (p <0.05). On the other hand, there was a significant decrease in patients' processed meat products, white bread, rice, pasta, pastry and dessert consumption (p <0.05). In the study, alcoholic beverage, cola, fruit juice and carbonated beverages decreased significantly (p <0.05). The scales used to determine the eating behaviors of the patients were statistically significant (p: 0.000, p <0.05) in the postop 3.ay EAT-40 total scores compared to preop EAT -40 total scores. The Netherlands eating attitude scale; The decrease in postop 3 emotional eating subdimension, restrictive eating subdimension and external eating subdimension scores to preop emotional subdimension scores was statistically significant (p: 0.000, p <0.05). The decrease in postop 3 month DEBQ total scores according to preop DEBQ total scores was statistically significant (p: 0.000, p <0.05). Keywords: Bariatric Surgery, Eating Habits, Eating Attitudes, Biochemical Findings
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Beslenme ve Diyetetik, Beslenme alışkanlıkları, Beslenme durumu, Biyokimya, Nutrition and Dietetics, Gastrektomi, Nutritional habits, Nutritional status, Obezite, Biochemistry, Gastrectomy, Obezite cerrahisi, Obesity, Obezite-morbid, Bariatric surgery, Obesity-morbid, Vücut bileşimi, Body composition
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