Laparoskopik sleeve gastrektomi de pulmoner tromboemboli riskinin padua skoru ile değerlendirilmesi: retrospektif bir çalışma
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Dosyalar
Tarih
2019
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Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Pulmoner tromboemboli bariatrik cerrahide postoperatif dönemde yeterli önlem alınmazsa morbidite ve mortalitenin yüksek olduğu ve bu nedenle hızlı tanı ve tedavi gerektiren bir kompikasyondur. Toplumdaki morbid obezite oranı arttıkça pulmoner tromboemboli’ningelişme potansiyeli daha da artış göstermektedir. Çalışmamızın amacı pulmoner tromboemboli tanısı konularak tedavi edilen olgularınklinik, laboratuvar ve radyolojik sonuçlarınıretrospektif olarak değerlendirmekti.Gereç ve Yöntem: Bariatrik cerrahi kliniğimizde Mart 2014 ile Ocak 2016 tarihleri arasında morbid obezite nedeniyle laparoskopik sleevegastrektomi geçiren hastaların dosyaları retrospektif olarak incelendi. Olguların klinik, radyolojik, laboratuar, demografik özellikleri ilePadua skorları değerlendirildi. Hastaların postoperatif dönemdeki verileri ve komplikasyonları istatistiksel olarak değerlendirildi. Postoperatif pulmoner tromboemboli riskini etkileyebilecek faktörler tek değişkenli regresyon analizi ile değerlendirildi.Bulgular: Hastaların 146’sı (%55) kadın ,124’u (%45) erkekti. Ortalama yaş 44.7 4.3 (22-72) olarak belirlendi. Ayrıca ortalama operasyon sonrası hastanede kalış süresi 5.7 2.3(2-25) gündü. Hastalardan çok-yüksek-riskli(VHR) ve yüksek-riskli (HR) gruplara postoperatifdönemde pnömotik cihazı uygulanırken, orta-riskli(MR) ve düşük-riskli (LR) gruplara varis çorabı uygulandı. Uygulanan koruyucu işlemlere rağmen 3 hastada derin ven trombozu ve 2 hastada pulmoner tromboemboli görüldü (p0.05), herhangi bir mortalite saptanmadı.Hastalardaki postoperatif dönemde görülen gerileme ve postoperatif pulmoner tromboemboli riskini etkileyebilecek faktörler (vücut kitleindeksi, geçirilmiş venöz emboli öyküsü, immobilite ve komplikasyonlar ) istatistiksel olarak anlamlı olarak saptandı (p0.05).Sonuç: Bariatrik cerrahide pulmoner tromboemboli profilaksisi için öncelikle önerilen ilaç daima düşük molekül ağırlıklı heparindir. Hastalara bu koruyucu tedaviye ek olarak pnömotik cihaz ve/veya varis çorabı uygulaması gerekmektedir. Bariatrik cerrahide olası komplikasyonları önlemede pnömotik cihaz varis çorabı uygulamasına göre daha efektiftir.
Background: Pulmonary thromboembolism in bariatric surgery is a complication that has higher rates of postoperative morbidity andmortality, requiring rapid diagnosis and treatment. As morbid obesity rates increase in society, the development potential of pulmonarythromboemboli further increases. The aim of our study was to evalute clinical, laboratory and radiological outcomes of patients who havebeen diagnosed with pulmonary tromboembolism and treated retrospectively.Material and methods: The clinical follow up cards were collected of patients who had undergone Laparoscopic sleeve gastrectomyfor morbid obesity between March 2014 to January 2016 retrospectively. Clinical, radiological, laboratory, demographic characteristicsoutcomes and Padua scores were evaluated. Postoperative data and complications of the patients were evaluated statistically. Factors thatmight affect postoperative pulmonary thromboembolism were evaluated by univariate regression analysis.Results: The gender of patients were 146 (55%) female and 124 (45%) male. The mean age was 44.7 4.3 (22-72) years. Also meanpostoperative stay in hospital was 5.7 2.3 (2-25) days. Patients performed varicose vein socks in mid-high-risk (MR) and low-risk (LR)groups while the pneumothic device was applied to very high-risk (VHR) and high-risk groups. Despite the protective procedures, deepvein thrombosis was seen in 3 patients and pulmonary thromboembolism was seen in 2 patients (p0.05), no mortality was detected.Postoperative pulmonary comorbidities and the risk factors for postoperative pulmonary thromboembolism (Body mass index, history ofprevious venous emboli, immobility and complications) were statistically significant (p0.05).Conclusion: The recommended medication for pulmonary thromboembolism prophylaxis in bariatric surgery is always low-molecularweight heparin. In addition to this preventive treatment of the disease, the application of a pneumatic device and / or varicose veins socksare required. Pneumatic device is more effective than varicose vein application in preventing possible complications in bariatric surgery.
Background: Pulmonary thromboembolism in bariatric surgery is a complication that has higher rates of postoperative morbidity andmortality, requiring rapid diagnosis and treatment. As morbid obesity rates increase in society, the development potential of pulmonarythromboemboli further increases. The aim of our study was to evalute clinical, laboratory and radiological outcomes of patients who havebeen diagnosed with pulmonary tromboembolism and treated retrospectively.Material and methods: The clinical follow up cards were collected of patients who had undergone Laparoscopic sleeve gastrectomyfor morbid obesity between March 2014 to January 2016 retrospectively. Clinical, radiological, laboratory, demographic characteristicsoutcomes and Padua scores were evaluated. Postoperative data and complications of the patients were evaluated statistically. Factors thatmight affect postoperative pulmonary thromboembolism were evaluated by univariate regression analysis.Results: The gender of patients were 146 (55%) female and 124 (45%) male. The mean age was 44.7 4.3 (22-72) years. Also meanpostoperative stay in hospital was 5.7 2.3 (2-25) days. Patients performed varicose vein socks in mid-high-risk (MR) and low-risk (LR)groups while the pneumothic device was applied to very high-risk (VHR) and high-risk groups. Despite the protective procedures, deepvein thrombosis was seen in 3 patients and pulmonary thromboembolism was seen in 2 patients (p0.05), no mortality was detected.Postoperative pulmonary comorbidities and the risk factors for postoperative pulmonary thromboembolism (Body mass index, history ofprevious venous emboli, immobility and complications) were statistically significant (p0.05).Conclusion: The recommended medication for pulmonary thromboembolism prophylaxis in bariatric surgery is always low-molecularweight heparin. In addition to this preventive treatment of the disease, the application of a pneumatic device and / or varicose veins socksare required. Pneumatic device is more effective than varicose vein application in preventing possible complications in bariatric surgery.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Acıbadem Sağlık Bilimleri Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
1
Künye
Yormaz, S., Yılmaz, H., Alptekin, H., Acar, F., Ece, İ., Çolak, B., Yormaz, B., Kafali, M. E., Şahin, M. (2019). Laparoskopik Sleeve Gastrektomi De Pulmoner Tromboemboli Riskinin Padua Skoru ile Değerlendirilmesi: Retrospektif Bir Çalışma. Acıbadem Sağlık Bilimleri Dergisi, 10(1), 73-77.
