Trans-mesocolic Pull-Through Maneuver: A Safe Operative Technique for Short and Thick Mesentery in Severe Obesity

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dc.authorwosidDemirel, Tugrul/JAC-3486-2023
dc.contributor.authorDemirel, Tugrul
dc.date.accessioned2024-06-12T11:08:23Z
dc.date.available2024-06-12T11:08:23Z
dc.date.issued2022
dc.departmentTrakya Üniversitesien_US
dc.description.abstractAlthough right gastric artery ligation is efficient to enhance a lower-tension anastomosis, still in severe intra-abdominal adiposity, antecolic approach may not provide sufficient length for a safe duodenoenterostomy anastomosis. Combining right gastric artery ligation with trans-mesocolic pull-through overcomes the thick mass of the transverse colon to achieve low-tension anastomosis. Trans-mesocolic pull-through operative technique was performed in duodenal switch, duodenojejunal bypass, and single anastomosis duodenoileal bypass with sleeve gastrectomy procedures. Demographic data, body mass index, operation time, perioperative, and postoperative complications were analyzed. A total of 70 patients were included in the study between January 2013 to December 2016. The male/female ratio was 0.4 (male/female: 20/50). The mean age was 41.1 years (age:18-67). A total of 28 patients had single anastomosis duodenoileal bypass with sleeve gastrectomy, 34 had duodenal switch, and 8 had duodenojejunal bypass operations. The mean BMI was 51.9 kg/m(2) (35-64), mean duration of surgery was 232.9 min (134-346), and mean hospital stay was 5.2 days (3-9). No early or late postoperative mortality was observed. The overall complication rate related with operative technique was 4.3% (n:3) including post-pyloric duodenal necrosis, duodenal stump fistula, and intra-abdominal abscess. A total of 67 patients were discharged uneventfully with a follow-up of mean of 75.9 (52-96) months in term. The current paper put into a modified approach with right gastric artery ligation and pull-through of the gastric sleeve and may be a safe technique in short and thick mesentery patients for a low-tension anastomosis.en_US
dc.identifier.doi10.1007/s12262-021-03198-y
dc.identifier.endpage1307en_US
dc.identifier.issn0972-2068
dc.identifier.issn0973-9793
dc.identifier.issue6en_US
dc.identifier.scopus2-s2.0-85123846521en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage1303en_US
dc.identifier.urihttps://doi.org/10.1007/s12262-021-03198-y
dc.identifier.urihttps://hdl.handle.net/20.500.14551/22402
dc.identifier.volume84en_US
dc.identifier.wosWOS:000748675000001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherSpringer Indiaen_US
dc.relation.ispartofIndian Journal Of Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectMetabolic Surgeryen_US
dc.subjectDuodenal Switchen_US
dc.subjectVisceral Obesityen_US
dc.subjectThick Mesenteryen_US
dc.subjectGastric Bypassen_US
dc.titleTrans-mesocolic Pull-Through Maneuver: A Safe Operative Technique for Short and Thick Mesentery in Severe Obesityen_US
dc.typeArticleen_US

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