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Title: Evaluation of selected factors affecting the reusults of primary and revision bariatric procedures, with particular emphasis on aspects related to the surgical technique
Abstract:
Introduction Morbid obesity is a disease affecting an increasing part of the world's population. The most effective treatment method, which allows for satisfactory results both in weight loss and improvement in the treatment of comorbidities is bariatrie surgery. Numerous studies and increasing annual number of performed surgeries lead to modification of patient preparation process, perioperative care and the evolution of indications for the treatment. The surgical technique is constantly changing and it may vary both between surgical centers and between operators within the same center. It is essential to standardize and unify the surgical technique due to the possibility of affecting the postoperative course, the number of complications and the effectiveness of bariatrie treatment. Despite extensive knowledge and years of experience, complications following bariatrie surgery persist, significantly diminishing patients' quality of life and exposing them to potentia! health risks, including loss of life .. However, there is lack of elear data regarding how the course of bariatrie surgery, the choice of surgical technique, and variations in surgical procedures impact treatment outcomes. Aim The main aim of the study was to assess potentia! factors influencing the results of primary and revision surgical treatment of obesity. The analysis focused particularly on the impact of asp ; ects related to surgical technique on postoperative results of bariatrie procedures. Materiał and methods The materiał and data collection for analysis were conducted in two stages. Initially, a meta-analysis was devised to explore various techniques of sleeve gastrectomy. Subsequently, data were gathered during the execution of a nationwide, multicenter study focusing on revision surgeries. Retrospective data on operated patients were compiled in an online database established for the multicenter study. Following the evaluation of the collected data, several articles were published, with four of them forming part of the series that underpins the doctoral dissertation. Summary of results Sleeve gastrectomy with omentopexy emerges as a procedure that mitigates perioperative complications and stapler line leaks, potentially lowering the occurrence of gastroesophageal reflux in comparison to sleeve gastrectomy without omentopexy. Notably, sleeve gastrectomy and adjustable gastric banding stand out as the most prevalent bariatrie procedures requiring revision surgery in Poland. The main indication for revision is the weight regain, and the most common procedures are one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB). It is worth noting that over-suturing of the stapler line during primary sleeve gastrectomy was more frequent among patients undergoing revision ; surgery due to insufficient weight loss or management of comorbidities. Those undergoing revision surgery due to weight regain typically had a smaller calibration bougie size used during their primary sleeve gastrectomy. Compared to the group ofyounger patients, revision bariatrie procedures in the group_ of surgical patients over 60 years of age do not increase the risk of perioperative complications and do not prolong the length of stay in the hospital in the postoperative period. Revision bariatrie procedures in the group of patients over 60 years of age yield lesser improvement in terms of comorbidities alleviation (arteria! hypertension and type II diabetes).
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Rada Dyscypliny Nauki medyczne
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Last modified:
Dec 30, 2024
In our library since:
Dec 30, 2024
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http://dl.cm-uj.krakow.pl:8080/publication/5181
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| Edition name | Date |
|---|---|
| ZB-141624 | Dec 30, 2024 |
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