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    Impact of body weight-based dosing of palonosetron and ondansetron on postoperative nausea and vomiting following laparoscopic sleeve gastrectomy: a randomized, double-blind study
    (Taylor & Francis Ltd, 2024) Burcu, Buesra; Hacim, Nadir Adnan; Caliskan, Ozan; Demirgan, Serdar; Aktokmakyan, Talar Vartanoglu; Meric, Serhat; Duymaz, Tomris
    Background Postoperative nausea and vomiting (PONV) is a frequent adverse effect following laparoscopic sleeve gastrectomy. Palonosetron with a standard dosing (75 mu g) schedule has been questioned due to its low efficiency in obese patients. This study aimed to investigate the effectiveness and safety of the body weight-based dosing of palonosetron in managing PONV following laparoscopic sleeve gastrectomy. Methods A single-center, prospective, double-blinded randomized study was conducted between August 2021 and December 2021. Patients who underwent laparoscopic sleeve gastrectomy were prospectively recruited in the study. One hundred patients were randomly divided into palonosetron (Group P) and ondansetron (Group O). The demographic and clinical variables were recorded. The primary outcome of the study was the incidence of PONV between the two groups during the hospitalization. The secondary outcomes were the number of rescue anti-emetic and analgesic medications and the Functional Living Index-Emesis scores. Results There were 50 patients in each group (Group P and Group O). There were significant differences in the scores of POVN, nausea, and vomiting favoring Group P. In Group P, the rate of patients using rescue anti-emetics was significantly lower. The incidence of complete response and proportion of patients with higher Functional Living Index-Emesis scores were significantly higher in patients using palonosetron. Conclusions The use of palonosetron significantly reduced the incidence of PONV following laparoscopic sleeve gastrectomy. There was a significant improvement in the scores of Functional Living Index-Emesis in patients using palonosetron.
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    Unveiling the Safety and Efficacy of Bariatric Surgery in Geriatric Patients: A Comprehensive Analysis of Three Years' Experience
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Aktokmakyan, Talar Vartanoglu; Peksen, Caghan; Savaş, Osman Anıl; Sumer, Aziz
    Bariatric surgery has gained popularity as an effective method for achieving and maintaining weight loss. Despite higher mortality/morbidity risks and uncertain long-term outcomes due to age-related factors, bariatric surgery can also be beneficial for geriatric obese patients. In this study, we aimed to examine the outcomes of bariatric surgery performed on geriatric patients in our clinic. A retrospective analysis was conducted on 14 patients aged 65 and above who underwent bariatric surgery between March 2019 and 2021. Patients were evaluated preoperatively through a multidisciplinary approach. Among the 14 patients included in the study (11 females, 3 males), the mean a ge was 67 [65-74]. The mean Body Mass Index (BMI) was 42 kg/m² [40-60.4]. Comorbidities included hypertension (HT) in 11 patients, diabetes mellitus (DM) in 8 patients, and hyperlipidemia in 11 patients. A total of 9 patients had a history of antiplatelet use due to Chronic Arterial Disease (CAD). Among the patients, ten underwent Laparoscopic Sleeve Gastrectomy, while four opted four Mini Gastric Bypass. The mean hospital stay was 3 days, and all patients were discharged smoothly after this period (100%). No patient required postoperative intensive care (0%), and there were no observed mortalities (0%). At the 6th postoperative month, the mean BMI was 31.6 kg/m². Our study suggests that bariatric surgery can be effective and safe for well-selected geriatric obese patients. It is crucial to carefully consider patient selection and manage comorbidities to achieve positive outcomes. In well-selected geriatric obese patients, bariatric surgery can be an effective and safe method. Further research with larger sam ples is warranted to validate our findings and improve patient care in this population. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.