Bariatrik cerrahide rutin intraoperatif ve postoperatif kaçak testlerine ihtiyaç var mı?

Abstract

Aim: We aimed to evaluate the efficacy of the results of intraoperative methylene blue test and postoperative upper gastrointestinal contrast graphies for detecting leakage in both primary and revisional bariatric surgery. Methods: Two-hundred-eighty-seven patients, who underwent primary and revision bariatric surgery and routine intraoperative methylene blue test and upper gastrointestinal contrast studies postoperatively for leakage were included in the study. Patients’ demographic characteristics, comorbidities, length of hospital stay, operation time, intraoperative, and postoperative complications were analyzed retrospectively. Results: In our study, 256 of 287 (89.1%) patients underwent primary surgery, 221 (75.7%) patients were female, the mean patient age was 38.4 ± 11.9 years, and the mean body mass index was 44.3 ± 7.6 kg/m2. The number of patients who had previous abdominal surgery and comorbidity was 108 (37.6%) and 149 (51.9%), respectively. Leakage was detected by a methylene blue test in one (0.3%) patient who underwent one-anastomosis gastric bypass surgery. In one (3.2%) patient who underwent revisional surgery with negative results of methylene blue test, leakage was detected on the first postoperative day due to the clinical findings. There was no leakage detected in any patient with postoperative swallow graphies. There was no statistical difference in leakage between primary and revisional surgery groups (p = 0.23). There was no mortality. Conclusion: It could be unnecessary to use postoperative gastrointestinal contrast studies in both primary and revisional bariatric surgery, but the routine use of the intraoperative methylene blue test could be considered useful due to its positive results for the detection of leakage.