Prediction Factors of Early Postoperative Bleeding after Bariatric Surgery

Golzarand, Mahdieh; Toolabi, Karamollah; Parsaei, Reza

doi:10.1007/s11695-022-06059-z

Cited by 7 publications

(3 citation statements)

References 35 publications

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“…All laparoscopic operations were completed safely [26]. Another study of 1860 LSG patients showed that 20 (1.1%) experienced post-LSG hemorrhaging and 11 required reoperation (0.6%) [9]. In our study, the postoperative bleeding rate was 1%, and the reoperation rate was 0.6% (Table 1).…”

Section: Comparison Of the Omentopexy And Control Groupssupporting

confidence: 48%

“…Bleeding can occur intra-abdominally or intraluminally, and the source of bleeding is typically the staple line, trocar site, dissected omental tissue, or damaged spleen or liver. Post-LSG bleeding is also associated with complications such as pneumonia, cardiac disease, surgical site infection, acute kidney injury, pulmonary embolism, reoperation, and mortality [6,7,8,9]. This knowledge…”

Section: Introductionmentioning

confidence: 91%

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Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy

Kara,

Ozel,

Yardimci

2024

OBES SURG

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Background Laparoscopic sleeve gastrectomy (LSG) is a commonly performed type of bariatric surgery. Early complications of LSG include bleeding, leakage, pulmonary embolism, and surgical site infections. Most surgeons try to implement preventive methods, such as omentopexy. Staple line-imbrication, which has a difficult learning curve, often prevents complications. This study aimed to evaluate the effect of omentopexy on patients with imbricated LSG. Material and Methods The study applied a retrospective data analysis design to patients who underwent LSG between 2020 and 2023. All patients’ staple lines were imbricated, and patients were then divided into two groups: omentopexy group and control group. Patients’ demographic features, such as age, gender, height, weight, body mass index(BMI), bleeding, leakage, and reoperations, were recorded and examined retrospectively. Results A total of 1356 patients were included in the study (540 in omentopexy, 816 in control), of which the mean age was 37.9 ± 10.5 years, 82.3% were women, and mean BMI was 40.9 ± 5.8 kg/m2. The mean bleeding rate was 1.0% (1.3–0.7%), the mean leakage rate was 0.2% (0.2–0.2%, respectively), and the mean reoperation rate was 0.6% (0.7% and 0.5%, respectively). No statistically significant differences were observed. Conclusion Omentopexy is a technique that is widely used to prevent staple line complications. According to our study, omentopexy applied to an imbricated stapler line increased the operation time but did not affect bleeding or leakage ratios. This is the first study to evaluate the effect of omentopexy on imbricated staple lines. The findings of the study indicate that omentopexy has no additional benefit on early complications when using staple-line imbrication. Graphical Abstract

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Section: Comparison Of the Omentopexy And Control Groupssupporting

confidence: 48%

Section: Introductionmentioning

confidence: 91%

Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy

Kara,

Ozel,

Yardimci

2024

OBES SURG

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“…The authors suggest that there is an association between dietary intake following each one of the procedures, which impacts the microbiota. However, there is a limitation of this study which is a small sample size [27]. Dong et al [28 ▪▪ ] examined a cohort of obese patients with NAFLD who underwent bariatric surgery and evaluated their microbiome, serum metabolites, and gastrointestinal hormones, observing a significant change in Bacteroides and lipid-related metabolites.…”

Section: Nutritional Management During Critical Illnessmentioning

confidence: 99%

Nutritional management during critical illness in those with previous obesity surgery

Correia,

Rosenfeld

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review The prevalence of overweight and obesity in our society is a pressing concern that has demanded immediate attention. Traditional treatments have proven ineffective for many individuals, leading to a surge in bariatric surgery as a last resort. While the rate of early and late postoperative complications may be low, when they occur, they place these patients at higher risk of requiring intensive care treatment. Therefore, it is our aim to discuss the nutritional care of these individuals. Recent findings Nutritional management of critically ill postbariatric surgical patients is related to the difficulty of providing an adequate nutritional assessment, calculating the macro and micronutrient requirements, choosing the right therapy, and defining the timely moment to initiate it. The anatomic changes related to the bariatric operation pose a high risk for a nonfunctional gastrointestinal tract both in the early postoperative and late postoperative. Therefore, the route of nutrition will greatly rely on the absorptive capacity, as well as on the nutritional status, with parenteral nutrition being an early option, especially for those with high critical care severity scores. Also, these patients are known to have an altered microbiota which may influence the absorptive capacity. Immunonutrition, prebiotics, probiotics, and symbiotics may represent potential options, but there is currently little support for ‘one size fits all’. Summary The nutritional care of critically ill patients postbariatric surgery is a complex and nuanced process requiring a multifaceted precision approach. The distinct nutritional challenges of early and late postoperative patients necessitate a thorough nutritional assessment and a highly individualized nutritional care plan.

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