Background To be able to prevent morbid obesity in the long-term, laparoscopic sleeve gastrectomy (LSG) is one of the most effective surgical interventions. However, leakage and bleeding from the stapler line are significant complications. The aim of this study was to determine the role of the levels of plasma presepsin in the detection of stapler leakage. Materials and methods The study included 300 patients with LSG due to morbid obesity and 40 control subjects. Before any medical treatment was applied, blood samples were taken from patients at 12 h preoperatively and on days 1, 3, and 5 postoperatively. Evaluation was made of plasma presepsin levels, white blood count (WBC), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR), in all patients with sleeve gastrectomy line leakage. Results The WBC, CRP, NLR and presepsin values measured on days 1, 3 and 5 postoperatively were determined to be higher in patients with leakage compared to those without. The predictive value of presepsin (p = 0.001), CRP (p = 0.001) and NLR (p = 0.001) was determined to be statistically significantly higher than that of WBC (p = 0.01). Conclusion The results of the study suggest that presepsin levels could have a role in the detection and follow-up of stapler line leaks after LSG. Elevated presepsin levels, on postoperative day 1 in particular, could have a key role in the early detection of possible complications which are not seen clinically.

Background The aim of this study was to investigate the importance of fibrinopeptide-A and fibrinopeptide-B, which occur during the formation of D-dimer, the most commonly used laboratory parameter, in the early diagnosis of acute mesenteric ischemia (AMI). Materials and methods This experimental study was performed in 30 male pathogen-free Wistar albino rats. The experimental animals were divided into 3 equal groups: Control group (n = 10), Sham group (n = 10) and Ischemia group (n = 10). Blood samples were taken 0, 1, 3, and 6 h after the simulation of mesenteric ischemia. Results Fibrinopeptide-A and fibrinopeptide-B levels increased significantly in the first 6 h in the ischemic group, similar to the increase in D-dimer levels. The statistical change between 0, 1, 3 and 6 h was more significant for fibrinopeptide-A and fibrinopeptide-B. Conclusion Fibrinopeptide-A and fibrinopeptide-B may be markers that can be used for early diagnosis of mesenteric ischemia, early diagnosis is highly important for decreasing mortality and morbidity.

Background Autologous platelet rich plasma (PRP) is the platelet concentration obtained from thrombocytes in the plasma. During the healing process, the platelets are activated and then release the granules which stimulate the inflammatory cascade and healing process. Platelet derived growth factor, vascular endothelial growth factor (VEGF), transforming growth factor β (TGFβ), epidermal growth factor (EGF) and fibroblast growth factor (FGF) are valuable markers used for cell regeneration. The aim of this study was to investigate the potential effects of PRP treatment on the neomucosa formation, a potential technique for increasing the intestinal surface area in patients with short bowel syndrome (SBS). Materials and methods Thirty-two male Wistar-Hannover rats were divided into: sham, control, PRP-treated and last group for PRP preparation (n=8). Plasma levels of VEGF, TGFβ, EGF and FGF were quantified by ELISA. En-bloc resection of anastomotic part was performed and stained with hematoxylin-eosin. Results VEGF, FGF, TGFβ and EGF levels were found significantly increased in PRP-treated group compared to others (p<0.001). Neomucosa formation was observed in experimental groups but the area increased significantly in PRP group, compared to other groups (p<0.001). Conclusion PRP therapy in gastrointestinal anastomoses is truly beneficial and surgically applicable treatment in SBS patients.