Unit:
Speciality New Technology and Minimal Invasive Techniques in Gastrointestival in Bariatric SurgeryLibrary of the School of Health Sciences
Author:
Varsos Panagiotis
Supervisors info:
Δημήτριος Θεοδώρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Θεοδωρόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Πρώιμη αναγνώριση μετεγχειρητικής διαφυγής σε βαριατρικούς ασθενείς : ανασκόπηση της τρέχουσας βιβλιογραφίας
Translated title:
Early detection of post-bariatric gastrointestinal leak: a review of current literature
Summary:
Bariatric surgery has been demonstrated to be the only procedure achieving long-term weight loss and decreased comorbidity rates in most patients presenting with morbid obesity.. Enhanced Recovery After Surgery (ERAS) programs integrate multimodal perioperative interventions that are designed to reduce physiologic stress, facilitate early return of bodily function, and reduce health care costs by decreasing length of hospital stay. These protocols were initially started in colorectal surgery, but there have been several studies reporting that applying an ERAS protocol was feasible and safe in bariatric surgery. The benefit of an early discharge also has some disadvantages. Some postoperative complications can appear after the patient has been discharged. In addition, obese patients often present with nonspecific symptoms, and Infections contribute to significant postoperative morbidity, increased mortality, prolonged hospital stay, and additional sanitary costs. An early diagnosis of complications after bariatric surgery remain a challenge for surgeons, and it is essential for better outcomes for the patient. This is especially important when early discharge is planned for the patient having minimally invasive surgery, as happens in ERAS programs. In these cases, providing a marker that can alert the surgeon to development of a septic complication before it is clinically evident would be essential to determine whether the patient can leave the hospital or should remains hospitalized for additional investigations to rule out a possible postoperative complication. This is crucial and could change the management for many patients. the best diagnostic method for septic complications remains clinical suspicion. The patient must be advised about the possible development of complications so that they can be referred for medical consultation sooner. There are still no ideal tests or markers for early prediction or identification of patients who are prone to septic complications. Several studies have investigated the relationship between acute-phase reactants and the appearance of postoperative septic complications after bariatric surgery
Main subject category:
Health Sciences
Keywords:
Bariatric surgery, Gastric leak, Postoperative complications, Clinical signs , Blood tests
