Introduction: Laparoscopic Sleeve Gastrectomy (LSG) has become the most commonly performed bariatric procedure. LSG is known for its safety and effectiveness, shorter operative time, feasibility, and easiness of revision and conversion to a malabsorptive surgery. Surgeons are tailoring different techniques to avoid complications from arising. Twisting of the sleeved gastric tube is one of the causes of sleeve obstruction and persistent nausea and vomiting. This study aims to compare between the postoperative complications in sleeve gastrectomy with and without posterior fixation. Patients and methods:In this prospective comparative cohort study 643 patients were included; divided into two groups according to the surgical technique. Group 1 included 364 LSG operations without fixation and Group 2 included 279 LSG with sleeve fixation. The operations were performed at Ain Shams University Hospitals between June 2017 and June 2021. Fixation of the sleeve was performed by two or three absorbable stitches to the prepancreatic fascia and root of the mesocolon. Incidence of postoperative complications were compared in each group.Results: There were no statistically significant differences in baseline characteristics between the two groups included in the study. Group 2 showed highly significant increase in operative time (p<0.001) the overall incidence of complications was significantly less in the fixation group (p <0.0001). Incidence of vomiting, bleeding, GERD and re-operation was significantly lower in group 2 (p<0.05).Seven patients from group 1 were diagnosed with gastric twist as post operative complication with one patient suffering from leakage compared to three patients in group 2. There were no mortalities in both groups. Conclusion:Adding posterior fixation to LSG ensures decreases incidence of complications. Many randomized controlled trials are needed to draw a solid outcome.
Background Bariatric surgery remains the most effective means of treating severe obesity. The number of severely obese patients is increasing and, consequently, more people are seeking bariatric surgery. Aim of the Work The Aim of This Study is to Outcome of Anticoagulant during Bariatric Surgery and Relation of Bariatric Surgery to Coagulopathy Disease. Patients and Methods This prospective study was conducted on 50 morbidly obese patients admitted to Hospital (Ahmed Maher Teaching Hospital and Ain Shams University Hospitals), for a primary one-stage laparoscopic bariatric surgery procedure over a 6-month period. The study is performed on 50 Patients, Who met all Inclusion criteria and none of Exclusion criteria. Results The study revealed no statistically significant difference between Enoxaparin and Rivaroxaban according to outcome of anti-coagulation therapy following bariatric surgery. Conclusion a high protective value of Chemical Thromboprophylaxis combined to Mechanical Thromboprophylaxis in preventing DVT safely. New Oral Anticoagulant drugs showed equal and may be superimposed the other traditional anticoagulant, but it needs more studies regarding its prophylactic dose, number of patient and its cost benefit in comparison with other Anticoagulant drugs were used in our study or other studies we mentioned above.
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