Analysis of Bariatric Surgery in High-risk Patients

Öz

Objective: In this study, we evaluated high-risk patients who underwent bariatric surgery. Patients who underwent bariatric surgery by the same surgical team were investigated. All patients’ medical records were obtained by examining follow up form of anesthesia, patients files and nurse observation files. Material and Methods: In this study, high risk criteria were divided in two groups as; major and minor criteria. Major criteria were accepted as; Cardiovascular, respiratory, renal, hepatic diseas and diabetes. Minor criteria were accepted as; Age > 40 years , tobacco usage, alcohol usage, body mass index > 43 kg/ m² , sleep apnea syndrome, gastroesophageal reflux disease. Patients withone major and one minor criterion or with two major criteria or two major criteria were classified as high risk patient group. In aspect of 120 patients within this study we evaluated morbidity, mortality and postoperative intensive care unit requirement. Results: We enrolled 3.3 % mortality rates, 42.5% morbidity rates and 25% intensive care unit requirement. Most frequent complications were respiratory failure, band related complications and cardiovascular complications. Conclusion: In our study; Age over 40 years , body mass index > 43 kg/ m² , sleep apnea syndrome, cardiovascular system disease, diabetes, prolonged pneumoperitoneum time at laparoscopic surgery, open surgery, hypoalbuminemia and blood glucose level over 126 mg/ dL were accepted as factors increasing morbidity and postoperative intensive care unit requirement.

Anahtar Kelimeler

• Obesity
• anaesthesia
• surgery
• high risk

Yüksek Riskli Hastalarda Bariyatrik Cerrahi Analizi

Öz

Amaç: Bu retrospektif çalışmada, bariyatrik cerrahi geçiren yüksek riskli hastalar değerlendirildi. Aynı cerrahi ekip tarafından bariatrik cerrahi geçiren 120 hasta incelendi. Tüm hastaların tıbbi kayıtları, anestezi takip formu, hasta dosyaları ve hemşire gözlem dosyaları incelenerek elde edildi. Gereç ve Yöntem: Bu çalışmada, yüksek risk kriterleri iki gruba ayrıldı: majör ve minör kriterler. Majör kriterler; kardiyovasküler sistem, solunum sistemi, böbrek, karaciğer hastalıkları ve diyabet olarak kabul edildi. Minör kriterler; 40 yaş üstü, tütün kullanımı, alkol kullanımı, vücut kitle indeksi > 43 kg/m2, uyku apnesi sendromu, gastroözofageal reflü hastalığı olarak kabul edildi. Bir minör artı bir majör kriter veya iki majör kritere sahip hastalar yüksek riskli hasta grubu olarak sınıflandırıldı. Yüksek risk kriterlerine sahip olmayan hastalar çalışma dışında bırakıldı. Bu çalışmada 120 hastada morbidite, mortalite ve ameliyat sonrası yoğun bakım ünitesi ihtiyacını değerlendirdik ve ayrıca mortalite, morbidite ve yoğun bakım ünitesi ihtiyacını etkileyen faktörleri belirlemeyi amaçladık. Bulgular: %3,3 mortalite oranı, %42,5 morbidite oranı ve %25 yoğun bakım ünitesi ihtiyacı tespit ettik. En sık görülen komplikasyonlar solunum yetmezliği, bantla ilgili komplikasyonlar ve kardiyovasküler komplikasyonlardı. Sonuç: Çalışmamızda; 40 yaş üstü, vücut kitle indeksi > 43 kg/m2, uyku apnesi sendromu, kardiyovasküler sistem hastalıkları, diyabet, laparoskopik cerrahide uzun süreli pnömoperiton süresi, açık cerrahi işlemler, hipoalbüminemi ve 126 mg/dL’nin üzerinde kan şekeri seviyesi, morbiditeyi ve ameliyat sonrası yoğun bakım ünitesi ihtiyacını artıran faktörler olarak kabul edildi.

Anahtar Kelimeler

• Obezite
• anestezi
• cerrahi
• yüksek risk

Kaynakça

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