Novosti
Khirurgii

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Year 2021 Vol. 29 No 6

GENERAL & SPECIAL SURGERY

A.A. HLINNIK, S.D. AULAS, S.S. STEBOUNOV, O.O. RUMMO, V.I. HERMANOVICH

BARIATRIC SURGERY FOR MORBID OBESITY

Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology,
Belarusian Medical Academy of Post-Graduate Education, Minsk,
Republic of Belarus

Objective. To improve the results of surgical treatment of patients with morbid obesity.
Methods. The database of bariatric surgery (2014–2020 yrs) was created and analyzed in the center, retrospectively and prospectively. Total 292 operations, including 150 sleeve gastrectomy, 84 mini gastric bypass procedures, 37 adjustable gastric bandings, 12 Roux-en-Y gastric bypasses, 5 gastric plications and 4 gastric plications with gastric fundus resection have been included in this database. There were 215 females and 77 males. The mean age was 41 years. All surgeries were performed laparoscopically and mean operative time was 108 minutes.
Results. As the result of performed bariatric surgeries, 36 complications were registered. Total complication rate was 11,8% without any case of mortality. Staple line and anastomotic leakage rate after surgery, related to the stomach resection or bypass, was 3,4%. Staple line and anastomotic bleeding rate after the same procedures – 3,1%. The the aforementioned complications were the most frequent and accounted up to 47% of all bariatric surgery complications. Other complications occurred much less frequently with incidence rate 0,4% – 1,2%.
Conclusion. The bariatric surgery database allows analyzing the structure of performed operations and its complications as well as identifying the regularity of their development. That would help to develop methods of the most frequent complication prevention and their early diagnostics. Compatibility of the database format with IFSO Global Registry allows providing the collected data for further analysis at the international level. Data on the spectrum and frequency of postoperative complications in the center correlate with international experience. The most significant complications in the practice of the center are incompetence, anastomotic leakage and bleeding from the lines of sutures and anastomoses after operations associated with gastric resection or bypass. Therefore, the specific measures for improvement prevention of complications permits increasing significantly bariatric surgery safety.

Keywords: morbid obesity, bariatric surgery, postoperative complications, anastomotic leakage, surgical stapling, hemorrhage
p. 662-671 of the original issue
References
  1. Wolfe BM, Kvach E, Eckel RH. Treatment of Obesity: Weight Loss and Bariatric Surgery. Circ Res. 2016 May 27;118(11):1844-55. doi: 10.1161/CIRCRESAHA.116.307591
  2. Padwal R, Klarenbach S, Wiebe N, Birch D, Karmali S, Manns B, Hazel M, Sharma AM, Tonelli M. Bariatric surgery: a systematic review and network meta-analysis of randomized trials. Obes Rev. 2011 Aug;12(8):602-21. doi: 10.1111/j.1467-789X.2011.00866.x
  3. Tam CS, Berthoud HR, Bueter M, Chakravarthy MV, Geliebter A, Hajnal A, Holst J, Kaplan L, Pories W, Raybould H, Seeley R, Strader A, Ravussin E. Could the mechanisms of bariatric surgery hold the key for novel therapies? report from a Pennington Scientific Symposium. Obes Rev. 2011 Nov;12(11):984-94. doi: 10.1111/j.1467-789X.2011.00902.x
  4. Tian HL, Tian JH, Yang KH, Yi K, Li L. The effects of laparoscopic vs. open gastric bypass for morbid obesity: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2011 Apr;12(4):254-60. doi: 10.1111/j.1467-789X.2010.00757.x
  5. Himpens J, Ramos A, Welbourn R, Dixon J, Kinsman R, Walton P. IFSO Global Registry Report. 4th ed. Henley-on-Thames, United Kingdom; Dendrite Clinical Systems Ltd.; 2018. 84 p. https://www.ifso.com/pdf/4th-ifso-global-registry-report-last-2018.pdf
  6. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014 Mar;149(3):275-87. doi: 10.1001/jamasurg.2013.3654
  7. Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ. 2014 Aug 27;349:g3961. doi: 10.1136/bmj.g3961
  8. Montravers P, Augustin P, Zappella N, Dufour G, Arapis K, Chosidow D, Fournier P, Ribeiro-Parienti L, Marmuse JP, Desmard M. Diagnosis and management of the postoperative surgical and medical complications of bariatric surgery. Anaesth Crit Care Pain Med. 2015 Feb;34(1):45-52. doi: 10.1016/j.accpm.2014.06.002
  9. Sakran N, Goitein D, Raziel A, Keidar A, Beglaibter N, Grinbaum R, Matter I, Alfici R, Mahajna A, Waksman I, Shimonov M, Assalia A. Gastric leaks after sleeve gastrectomy: a multicenter experience with 2,834 patients. Surg Endosc. 2013 Jan;27(1):240-45. doi: 10.1007/s00464-012-2426-x
  10. Wölnerhanssen B, Peterli R. Management von komplikationen nach adipositaschirurgie. Der Chirurg. 2015 Dec;86(12):1114-20. doi: 10.1007/s00104-015-0098-5
  11. Noun R, Skaff J, Riachi E, Daher R, Antoun NA, Nasr M. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012 May;22(5):697-703. doi: 10.1007/s11695-012-0618-z
  12. Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007 Dec;17(6):793-98. doi: 10.1089/lap.2006.0128
  13. Talebpour M, Sadid D, Talebpour A, Sharifi A, Davari FV. Comparison of Short-Term Effectiveness and Postoperative Complications: Laparoscopic Gastric Plication vs Laparoscopic Sleeve Gastrectomy. Obes Surg. 2018 Apr;28(4):996-1001. doi: 10.1007/s11695-017-2951-8
  14. Yermilov I, McGory ML, Shekelle PW, Ko CY, Maggard MA. Appropriateness Criteria for Bariatric Surgery: Beyond the NIH Guidelines. Obesity. 2009 Aug;17(8):1521-27. doi: 10.1038/oby.2009.78
  15. Cummings DE, Cohen RV. Beyond BMI: the need for new guidelines governing the use of bariatric and metabolic surgery. Lancet Diabetes Endocrinol. 2014 Feb;2(2):175-81. doi: 10.1016/S2213-8587(13)70198-0
Address for correspondence:
220045, Republic of Belarus, Minsk,
Semashko Str., 8,
Minsk Scientific and Practical Center
of Surgery, Transplantology and Hematology,
the Surgical Unit.
tel. +375 29 123-86-21,
email:avlassergey@list.ru
Aulas Siarhei D.
Information about the authors:
Hlinnik Aliaksei A., PhD, Associate Professor of the Transplantology Department, Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus.
http://orcid.org/0000-0002-0530-1158
Aulas Siarhei D., Post-Graduate Student, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk ,Republic of Belarus.
http://orcid.org/0000-0003-3454-5298
Stebounov Sergei S., MD, Professor, Head of the Department of General, Plastic and Bariatric Surgery, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk , Republic of Belarus.
http://orcid.org/0000-0002-3795-6298
Rummo Oleg O., MD, Professor, Corresponding Member of National Academy of Sciences of Belarus, director, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk , Republic of Belarus.
http://orcid.org/0000-0001-7023-4767
Hermanovich Vitali I., Head of the Surgical Unit, Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology, Minsk, Republic of Belarus.
http://orcid.org/0000-0001-9396-5407
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