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  • Kapalı Erişim
    Yayın
    Differential impact of laparoscopic sleeve gastrectomy and roux-en-Y gastric bypass on postoperative constipation: insights for optimized patient care
    (Mary Ann Liebert Inc., 2025) Kudaş, İlyas; Başak, Fatih; Çalışkan, Yahya Kemal; Tosun, Hüsna; Acar, Aylin; Canbak, Tolga; Şişik, Abdullah; Erdem, Olgun
    Background: While bariatric surgery effectively treats morbid obesity, its impact on postoperative bowel habits, particularly constipation, remains underexplored. This study compared constipation prevalence and changes after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB).Methods: A prospective observational study included 120 patients undergoing LSG or RYGB, evaluated preoperatively and 6 months postoperatively. Constipation was assessed using bowel habit parameters and the Wexner Constipation Score (WCS). Incontinence was assessed using the Cleveland Clinic Incontinence Score (CCIS).Results: Preoperative constipation prevalence was similar between groups. At 6 months, trends toward improvements in WCS (LSG: 4.9 to 4.3; RYGB: 5.1 to 4.8) and CCIS (LSG: 8.5 to 8.1; RYGB: 8.7 to 8.4) were observed, with more patients reporting better bowel habits. WCS and CCIS scores decreased in both groups at 6 months compared with baseline, but these changes were not statistically significant.Conclusion: No significant differences in postoperative constipation outcomes (WCS) were observed between RYGB and LSG patients, although both showed a trend toward improved bowel habits. Similarly, CCIS changes were not significantly different. These findings suggest potential benefits for bowel function, but further research is needed to determine their clinical importance and underlying causes.
  • Küçük Resim
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    Rethinking post-bariatric care: anorectal morbidity following sleeve gastrectomy and roux-en-Y gastric bypass
    (Lippincott Williams and Wilkins, 2026) Erdem, Olgun; Acar, Aylin; Canbak, Tolga; Başak, Fatih; Kudaş, İlyas; Tosun, Hüsna; Tekesin, Kemal; Şişik, Abdullah
    BACKGROUND: Bariatric surgery is a prevalent and effective treatment for morbid obesity, yet its potential long-term effects on anorectal health remain an under-investigated aspect of post-operative care. This study aimed to meticulously evaluate the incidence and the degree of severity of two common anorectal conditions, anal fissures and hemorrhoids, in a substantial cohort of patients following either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB), two frequently performed bariatric procedures. Understanding these potential post-surgical morbidities is crucial for a comprehensive approach to patient management. METHODS: A retrospective cohort study at a large tertiary referral center (2015-2023) included 280 patients (200 SG, 80 RYGB). Detailed pre- and post-operative data on anorectal conditions, bowel habits, and surgical outcomes were extracted from electronic records and statistically analyzed. RESULTS: The overall incidence of new-onset anorectal disorders (defined as the development of at least one of the conditions) was significantly higher in the RYGB group (47.5%) compared to the SG group (32.5%) ( P <0.001). Specifically, the incidence of new-onset hemorrhoids (36.5% vs. 23.5%, P =0.02) and anal fissures (29.0% vs. 16.0%, P =0.01) occurred more frequently in the RYGB group. The mean severity scores were also higher (Goligher score: 2.6±0.8 vs. 2.1±0.7, P = 0.01; fissure severity: 2.9±1.0 vs. 2.3±0.9, P = 0.02). Post-operative constipation and diarrhea were associated with higher risk, and RYGB was an independent predictor. Multivariate analysis, adjusting for age, sex, and baseline BMI, confirmed RYGB (OR 1.7, 95% CI 1.1-2.5, P =0.01) and post-operative constipation (OR 2.0, 95% CI 1.3-3.0, P =0.001) as independent predictors of new-onset anorectal disorders. CONCLUSIONS: Our findings highlight that not all bariatric procedures carry the same risk for anorectal complications, and RYGB specifically warrants closer attention. These findings underscore the clinical importance of incorporating proactive assessment and management of anorectal health, including bowel habit regulation and symptom monitoring, into the routine post-operative care of bariatric surgery patients to optimize their overall well-being.