Вестник хирургии имени И.И. Грекова (Sep 2022)
Modern principles of prevention of early postoperative complications in bariatric surgery (review of literature)
Abstract
The article presents the problem of the development of complications of bariatric surgery in the early postoperative period. After the start of the use of endovideosurgical technologies in bariatric surgery, the incidence of general surgical complications in the early postoperative period dropped sharply to 2-6 %. Nevertheless, serious complications still arise, the frequency and type of which largely depends on the patient's comorbidity and the complexity of the operation. The most formidable and difficult complication in treatment is the failure of the sutures of the stomach stump (stapler line), which is more often characteristic of longitudinal resection of the stomach and occurs in 1.5-2.4 % of cases. Deep vein thrombosis is another serious complication in bariatric surgery - the incidence ranges from 2.4 to 4.5 %. Bleeding is no less serious complication of obesity surgery. The frequency of repeated interventions associated with bleeding in the early postoperative period is 11 %. Moreover, in 85 % of cases, conservative methods of stopping bleeding are successful. Considering that the permissible operational lethality of bariatric operations should not exceed 0.1 %, the issues of developing a unified concept of prevention methods to reduce the incidence of complications in patients with morbid obesity remain relevant.
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