БАРИАТРИЧЕСКИЕ ОПЕРАЦИИ ПРИ МОРБИДНОМ ОЖИРЕНИИ

Abstract

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 meanoperative 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 preventionofcomplications permits increasing significantly bariatric surgery safety. What this paper adds The structure of postoperative complications of bariatric surgical interventions performed in a multidisciplinary hospital has been determined. Staplelinefailure withgastricleak are the most common early complications after the operations related to resection or gastric bypass and account for more than 47% of all complications. Prevention of complications to improve outcome significantly increases the safety of the performed bariatric interventions.