{"id":1611,"date":"2018-12-11T15:02:16","date_gmt":"2018-12-11T13:02:16","guid":{"rendered":"https:\/\/halukunalp.com\/en\/\/?p=1611"},"modified":"2018-12-11T15:13:06","modified_gmt":"2018-12-11T13:13:06","slug":"tup-mide-ameliyati-sonrasi-kilo-aldim-revizyon-ameliyati-istiyorum","status":"publish","type":"post","link":"https:\/\/halukunalp.com\/en\/tup-mide-ameliyati-sonrasi-kilo-aldim-revizyon-ameliyati-istiyorum\/","title":{"rendered":"T\u00fcp Mide Ameliyat\u0131 Sonras\u0131 Kilo Ald\u0131m : Revizyon Ameliyat\u0131 \u0130stiyorum !"},"content":{"rendered":"<p><span style=\"color: #000000;\"><strong>Obezite cerrahisi<\/strong> sonras\u0131 tekrar kilo al\u0131nmas\u0131 veya ameliyattan sonra yeterli kilo veilememesi <strong>revizyon<\/strong> ameliyat\u0131n\u0131 gerektirebilir. <em>Revizyon<\/em> ameliyatlar\u0131na karar verilmeden \u00f6nce en \u00f6nemli konu hastan\u0131n neden kilo ald\u0131\u011f\u0131n\u0131 veya ilk ameliyatta nerede ba\u015far\u0131s\u0131zl\u0131k oldu\u011funun belirlenmesidir. <strong>T\u00fcp mide<\/strong>\u00a0ameliyatlar\u0131n\u0131n gerekip gerekmedi\u011fi, gerekiyor ise hangi y\u00f6ntemle d\u00fczeltme ameliyat\u0131n\u0131n yap\u0131laca\u011f\u0131n\u0131 konular\u0131nda b\u00f6ylece bir \u00f6n fikrimiz olur.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>T\u00fcp mide<\/strong> ameliyatlar\u0131ndan sonra hastalar\u0131n bir k\u0131sm\u0131n\u0131n ula\u015ft\u0131\u011f\u0131 kiloyu koruyamad\u0131klar\u0131n\u0131, tekrar kilo ald\u0131klar\u0131n\u0131 bilmekteyiz. \u00dclkeden \u00fclkeye de\u011fi\u015fik rakamlar bildirilmi\u015f ise de <em>t\u00fcp mide<\/em> ameliyatlar\u0131 sonras\u0131 tekrar kilo alma oran\u0131 % 20-30 gibidir. Yani<strong> t\u00fcp mide ameliyat\u0131<\/strong> olmu\u015f her 5 hastadan biri veya\u00a0 daha sinir bozucu olarak her 3 hastadan biri <strong>obezite<\/strong> hastal\u0131\u011f\u0131na tekrar yakalan\u0131r. Tekrar ile alma d\u00f6nemi genellikle ameliyat\u0131n 3. Y\u0131l\u0131ndan sonra g\u00f6r\u00fclmeye ba\u015flan\u0131r. Hastalar\u0131n daha erken kilo al\u0131\u015flar\u0131n\u0131n nedeni genellikle <strong>cerrahi teknik<\/strong> sorunlara ba\u011fl\u0131d\u0131r. T\u00fcp mide ameliyat\u0131 sonras\u0131 tekrar kilo alman\u0131n nedenlerini \u015f\u00f6yle \u00f6zetleyebiliriz :<\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Yetersiz cerrahi :<\/span>\n<ul>\n<li><span style=\"color: #000000;\"><em>T\u00fcp mide ameliyat\u0131<\/em> s\u0131ras\u0131nda cerrah\u0131n midenin fundus denilen b\u00f6l\u00fcm\u00fcnn\u00fc tamamen \u00e7\u0131kartmas\u0131 gerekir. Fundus denilen b\u00f6l\u00fcm a\u00e7l\u0131k hormonunun sal\u0131nd\u0131\u011f\u0131 aland\u0131r. Bu b\u00f6l\u00fcm tam \u00e7\u0131kar\u0131lamaz ise a\u00e7l\u0131k hissi kaybolmaz.<\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mide ameliyat\u0131 s\u0131ras\u0131nda mide hacmi geni\u015f b\u0131rak\u0131l\u0131r ise tokluk uyar\u0131s\u0131 i\u00e7in hastan\u0131n daha fazla yemek yemesi gerekecektir. Yetersiz kilo vermenin veya sonradan tekrar kilo alman\u0131n nedenlerinden olan bu durumu hasta kolayca anlayabilir. Ameliyat \u00f6ncesine yak\u0131n yemek yedi\u011fini s\u00f6yleyen hastada bu geni\u015flemi\u015f veya geni\u015f b\u0131rak\u0131lm\u0131\u015f mideden \u015f\u00fcphe edilmelidir. Mide hacminin geni\u015f b\u0131rak\u0131ld\u0131\u011f\u0131ndan \u015f\u00fcphe ediliyorsa hastaya bir endoskopi yapmak ve\/veya skopi ile mide hacmini g\u00f6r\u00fcnt\u00fclemek faydal\u0131 olacakt\u0131r.<\/span><\/li>\n<li><span style=\"color: #000000;\">Midenin ameliyattan sonra bir miktar geni\u015flemesi normaldir. Ancak \u00e7ok geni\u015flemesi veya kum saati g\u00f6r\u00fcn\u00fcm\u00fc cerrahi tekni\u011fe ba\u011fl\u0131 olabilir.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Do\u011fru ameliyat tercihinde bulunmamak<\/span>\n<ul>\n<li><span style=\"color: #000000;\"><strong>T\u00fcp mide ameliyat\u0131 sonras\u0131<\/strong> hekim hastan\u0131n neden kilo ald\u0131\u011f\u0131n\u0131 veya neden yeterince veremedi\u011fini sorgulamal\u0131d\u0131r. Ki\u015fiden ki\u015fiye farketse de, Kaba bir deyim ile t\u00fcp mide ameliyat\u0131ndan sonra hastalar kendi a\u011f\u0131rl\u0131\u011f\u0131n\u0131n ancak %30 unu verirler. \u00d6rne\u011fin 100 kilo ile ameliyat olan hastan\u0131n ortalama ula\u015faca\u011f\u0131 de\u011fer 70 kilo civar\u0131d\u0131r. Bu oran g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda daha y\u00fcksek kilosu olan hastalar i\u00e7in t\u00fcp mide ameliyat\u0131 bazen yetersiz kal\u0131r. \u00d6rne\u011fin 180 kiloluk bir hastay\u0131 t\u00fcp mide yapmakla o hastadan 60-70 kilo kaybettirebiliriz. Bu \u015fekilde hastan\u0131n 110-120 kiloya inmesi beklenir. Bu sonu\u00e7 hastay\u0131 tatmin etmeyebilir ve yetersiz cerrahi san\u0131labilir. Oysa\u00a0 t\u00fcp mide ameliyat\u0131n\u0131n kapasitesi bellidir. Tabii bu s\u00f6yledi\u011fim rakamlar ortalama beklenti rakam\u0131d\u0131r. <em>Metabolizma<\/em> herkezde farkl\u0131 oldu\u011fu i\u00e7in verilen kilo oranlar\u0131 da ki\u015fiden ki\u015fiye de\u011fi\u015fir. Bu nedenle net bir rakam vermedi\u011fimi s\u00f6ylemek zorunday\u0131m. Ameliyatla sonras\u0131 ya\u015fant\u0131n\u0131za spor eklerseniz verilen kilo oran\u0131 artacakt\u0131r. Sonu\u00e7 olarak herkese kapasitesi belirli olan t\u00fcp mide ameliyat\u0131n\u0131 yapmak ba\u015far\u0131s\u0131zl\u0131\u011f\u0131n nedeni olabilir. \u00c7ok say\u0131da obezite ameliyat\u0131 y\u00f6ntemi var. Her hasta i\u00e7in en uygun obezite cerrahisini belirlemek, o hastaya \u00f6zel ameliyat\u0131 yapmak gerekir.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Uyumsuz hasta<\/span>\n<ul>\n<li><span style=\"color: #000000;\"><em>T\u00fcp mide ameliyat\u0131 sonras\u0131<\/em> hastalar\u0131n mutlaka ya\u015fam tarz\u0131n\u0131 ameliyata uygun de\u011fi\u015ftirmesi ve eski yeme al\u0131\u015fkanl\u0131klar\u0131n\u0131 terk etmesi gereklidir. Hasta zay\u0131flad\u0131\u011f\u0131da bu ula\u015ft\u0131\u011f\u0131 noktan\u0131n kal\u0131c\u0131 olmas\u0131 i\u00e7in olmazsa olmaz kural\u0131 budur. T\u00fcp mideliyim kilo almam dememek gerekir. \u00c7\u00fcnk\u00fc obezitenin mekani\u011fi \u00e7ok basittir : ald\u0131\u011f\u0131n\u0131z kalori ve harcad\u0131\u011f\u0131n kalori sizin gelecekte tekrar kilo al\u0131p almayaca\u011f\u0131n\u0131z\u0131 belirler. T\u00fcp mide ameliyat\u0131 sonras\u0131 \u00a0tekrar kilo alamayanlar veya yeterince kilo veremeyenlerin neredeyse hepsinin eski yeme al\u0131\u015fkanl\u0131klar\u0131n\u0131 devam ettirdi\u011fini g\u00f6r\u00fcr\u00fcz. Y\u00fcksek kalorili at\u0131\u015ft\u0131rmalar, yatmaya yak\u0131n yemek yemeler, hareketsiz ya\u015fam hasta i\u00e7in risktir.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Karbonhidrat sevgisi:<\/span>\n<ul>\n<li><span style=\"color: #000000;\">\u00d6zellikle karbonhidrat sevgisi yani \u015fekerli g\u0131dalara olan d\u00fc\u015fk\u00fcnl\u00fck tekrar kilo alman\u0131n zeminini haz\u0131rlar. Daha k\u00f6t\u00fcs\u00fc \u015fekerli g\u0131dalar\u0131n t\u00fcketilmesi halinde pankreas daha fazla ins\u00fclin \u00fcretir ve birka\u00e7 saat i\u00e7inde kan \u015fekeri azal\u0131r. B\u00f6ylece hasta tekrar \u015fekerli g\u0131da almak zorunda kal\u0131r. Her g\u0131da al\u0131\u015fta al\u0131nan kalori artar. Bu k\u0131s\u0131r d\u00f6ng\u00fcy\u00fc k\u0131rmak i\u00e7in hastan\u0131n karbonhidrattan uzak durmay\u0131 \u00f6\u011frenmesi gerekir.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Alkol :<\/span>\n<ul>\n<li><span style=\"color: #000000;\">Y\u00fcksek oranda alkol alma al\u0131\u015fkanl\u0131\u011f\u0131 varsa kilo almak neredeyse ka\u00e7\u0131n\u0131lmazd\u0131r. Bir gram alkolde 7 kalori vard\u0131r. Y\u00fcksek doz alkol al\u0131m\u0131 ile y\u00fcksek doz kalori al\u0131n\u0131r ve v\u00fccut y\u00fcksek doz kaloriyi ya\u011f olarak depo eder.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li><span style=\"color: #000000;\">Kalori harcamamak, sedanter ya\u015fam tarz\u0131<\/span>\n<ul>\n<li><span style=\"color: #000000;\">Hastalar\u0131n \u00f6nemli k\u0131sm\u0131 maalesef t\u00fcp mide ameliyat\u0131n\u0131n zay\u0131flamak i\u00e7in yeterli oldu\u011funu d\u00fc\u015f\u00fcnmektedir. Ameliyattan sonra yeme oran\u0131 d\u00fc\u015fer ve al\u0131nan kalori azal\u0131r ancak harcanan kalorinin de bu d\u00f6nemde dengelenmesi gerekir. Biz hastalar\u0131m\u0131za mutlaka g\u00fcnl\u00fck aktivitelerine ilave olarak y\u00fcr\u00fcy\u00fc\u015fler yapmas\u0131n\u0131 istiyoruz. Bu sadece verilen kilolar\u0131n korunmas\u0131 i\u00e7in de\u011fil, ayn\u0131 zamanda ya\u015fama enerjisinin ve ya\u015fam kond\u00fcsyonunun artmas\u0131 i\u00e7indir.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\">T\u00fcp mide ameliyat\u0131 sonras\u0131 hangi revizyon ameliyat\u0131 yap\u0131lacak ?<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\">Ba\u015far\u0131s\u0131z t\u00fcp mide ameliyatlar\u0131 sonras\u0131 revizyon se\u00e7enekler \u00e7ok fazlad\u0131r. Bu se\u00e7eneklerden bir k\u0131sm\u0131 a\u015fa\u011f\u0131dad\u0131r :<\/span><\/p>\n<blockquote>\n<ul>\n<li><span style=\"color: #000000;\">T\u00fcp mideden tekrar <strong>t\u00fcp mideye revizyon<\/strong><\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mideden RY <strong>gastrik bypass<\/strong> ameliyat\u0131na revizyon<\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mideden <strong>mini gastrik bypass<\/strong> ameliyat\u0131na revizyon<\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mideden <strong>SAD\u0130-S<\/strong> ameliyat\u0131na\u00a0 revizyon<\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mideden <strong>Duodenal Switch<\/strong> ameliyat\u0131na\u00a0 revizyon<\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mideden <strong>Transit bipartisyon<\/strong> ameliyat\u0131na\u00a0 <em><strong>revizyon<\/strong><\/em><\/span><\/li>\n<li><span style=\"color: #000000;\">T\u00fcp mideden <strong>Entero-enterostomi<\/strong> ameliyatlar\u0131na <strong>revizyon<\/strong><\/span><\/li>\n<\/ul>\n<\/blockquote>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\">G\u00f6r\u00fcld\u00fc\u011f\u00fc gibi ba\u015far\u0131s\u0131z <strong><em>t\u00fcp mide ameliyatlar\u0131<\/em><\/strong> sonras\u0131 <em>revizyon<\/em> se\u00e7enekleri \u00e7ok fazlad\u0131r. Ancak hangi revizyon tipinin hangi hasta i\u00e7in en do\u011frusu olaca\u011f\u0131n\u0131 belirlemek amac\u0131yla hastan\u0131n hekime uyumu, hekimin de\u00a0 deneyimi \u015fartt\u0131r. Revizyon ameliyatlar\u0131n\u0131n sa\u011flayaca\u011f\u0131 avantaj ve dezavantajlar\u0131 tek tek yazaca\u011f\u0131m.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Obezite cerrahisi sonras\u0131 tekrar kilo al\u0131nmas\u0131 veya ameliyattan sonra yeterli kilo veilememesi revizyon ameliyat\u0131n\u0131 gerektirebilir. Revizyon ameliyatlar\u0131na karar verilmeden \u00f6nce en \u00f6nemli konu hastan\u0131n neden kilo ald\u0131\u011f\u0131n\u0131 veya ilk ameliyatta nerede ba\u015far\u0131s\u0131zl\u0131k oldu\u011funun belirlenmesidir. T\u00fcp mide\u00a0ameliyatlar\u0131n\u0131n gerekip gerekmedi\u011fi, gerekiyor ise hangi y\u00f6ntemle d\u00fczeltme ameliyat\u0131n\u0131n yap\u0131laca\u011f\u0131n\u0131 konular\u0131nda b\u00f6ylece bir \u00f6n fikrimiz olur. T\u00fcp mide ameliyatlar\u0131ndan sonra [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[236,231,232,233,234,235,189,18,11,10,59,40,64,4],"class_list":["post-1611","post","type-post","status-publish","format-standard","hentry","category-blog","tag-tup-mideye-revizyon","tag-cerrahi-teknik","tag-tup-mide-ameliyati","tag-revizyon","tag-tup-mide-ameliyati-sonrasi","tag-entero-enterostomi","tag-transit-bipartisyon","tag-duodenal-switch","tag-gastrik-bypass","tag-mini-gastrik-bypass","tag-obezite","tag-obezite-cerrahisi","tag-sadi-s","tag-tup-mide"],"_links":{"self":[{"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/posts\/1611"}],"collection":[{"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/comments?post=1611"}],"version-history":[{"count":6,"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/posts\/1611\/revisions"}],"predecessor-version":[{"id":1618,"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/posts\/1611\/revisions\/1618"}],"wp:attachment":[{"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/media?parent=1611"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/categories?post=1611"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/halukunalp.com\/en\/wp-json\/wp\/v2\/tags?post=1611"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}