LAPAROSKOPİK SLEEVE GASTREKTOMİ AMELİYATLARINDA KARIN İÇİ BASINÇ ARTIŞININ ORTALAMA TROMBOSİT HACMİ ÜZERİNE ETKİSİNİN ARAŞTIRILMASI

Abstract

Amaç: Obezite, adipoz dokuda, sağlığı bozacak düzeyde anormal ya da aşırı yağ birikimi olarak tanımlanmaktadır. Obezite tedavisinde cerrahi uygulamalar, son yıllarda sıklıkla uygulanmaya başlanmıştır. Ancak bu tür cerrahi uygulamalarda intraoperatif karın içi basınç artışı endişe konusu olabilir. Bu çalışmada laparoskopik sleeve gastrektomi operasyonundaki intraabdominal basınç artışının, trombosit aktivitesinin bir göstergesi olan ortalama trombosit hacmine (MPV) etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya yaşları 18 ile 65 arasında olan 60 hasta dahil edildi. Tüm hastalara intraabdominal basınç 13-15 mm/Hg aralığında ayarlanarak, elektif laparoskopik sleeve gastrektomi operasyonu yapıldı. Preoperatif, intraoperatif ve postoperatif MPV değerleri ölçülerek bu değerler arasında istatistiksel olarak anlamlı fark olup olmadığı değerlendirildi. Bulgular: Hastaların vücut kitle indeksi ortalamaları 44.46±4.18 idi. Hastaların MPV ortalama değerleri MPV preoperatif 10.03±0.95 fl, MPV intraoperatif 10.17±0.95 fl, MPV postoperatif 10.32±0.81 fl olarak ölçüldü. Preoperatif ve intraoperatif MPV değerleri arasında anlamlı fark oluşmaz iken, preoperatif ve postoperatif, intraoperatif ve postoperatif MPV değerine arasında istatistiksel anlamlı fark oluştuğu gözlendi. Sonuç: İntraabdominal basınç altında yapılan laparoskopik operasyonlarda, trombosit fonksiyonlarına bağlı koagulasyon bozuklukları açısından trombosit büyüklüğünün bir göstergesi olan MPV değerinin izlenmesinin, cerrahi sonrası akut trombotik hadiselerin takibi açısından uygun olacağını düşünmekteyiz.

Keywords

• Laparoskopik sleeve gastrektomi
• karın içi basınç artışı
• ortalama trombosit hacmi

The Effect of Increased Intraabdominal Pressure on Mean Platelet Volume During Laparoscopic Sleeve Gastrectomy Surgery

Abstract

Objective: Obesity is defined as abnormal or excessive fat accumulation in adipose tissue, at a level that impairs health. Surgical procedures in the treatment of obesity have begun to be applied frequently in recent years. However, in such surgical procedures, increased intraoperative intra-abdominal pressure may be a matter of concern. In this study, we aimed to investigate the effects of the increase in intra-abdominal pressure in laparoscopic sleeve gastrectomy surgery on mean platelet volume (MPV), which is an indicator of platelet activity. Material and Methods: 60 patients aged between 18 and 65 were included in the study. All patients underwent elective laparoscopic sleeve gastrectomy by adjusting the intra-abdominal pressure between 13-15 mm/Hg. Preoperative, intraoperative and postoperative MPV values were measured and it was evaluated whether there was a statistically significant difference between these values. Results: The average body mass index of the patients was 44.46±4.18. The mean MPV values of the patients were measured as MPV preoperative 10.03±0.95 fl, MPV intraoperative 10.17±0.95 fl, MPV postoperative 10.32±0.81 fl. While there was no significant difference between preoperative and intraoperative MPV values, it was observed that there was a statistically significant difference between preoperative and postoperative, intraoperative and postoperative MPV values. Conclusion: We think that monitoring the MPV value, which is an indicator of platelet size in terms of coagulation disorders due to platelet functions, in laparoscopic operations performed under intra-abdominal pressure, will be appropriate for monitoring acute thrombotic events after surgery.

Keywords

• Laparoscopic sleeve gastrectomy
• increased intraabdominal pressure
• mean platelet volume

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