Abstract：
OBJECTIVE: Aim: To improve the management of morbidly obese patients who undergo gastric bypass surgery to reduce the number of postoperative complications, in particular, bleeding.
METHODS: Materials and Methods: From 2011 to 2022, a total of 348 patients with morbid obesity (MO) underwent laparoscopic gastric bypass treatment at the clinical base of the Department of General Surgery №2 of Bogomolets National Medical University. The retrospective group included 178 patients who received treatment between 2011 and 2019. 170 patients were enrolled in the prospective group for the period from 2019 to 2022.
RESULTS: Results: Retrospective group had 8 episodes of postoperative bleeding, representing a rate of 4.49%, prospective group - 3 episodes of postoperative bleeding, representing a rate of 1.76% Four factor characteristics associated with the probability of bleeding were identified: \"number of comorbid conditions\", \"arterial hypertension\", \"chronic liver diseases\" and \"chronic obstructive pulmonary disease\".
CONCLUSIONS: Conclusions: The factors responsible for the occurrence of postoperative bleeding in morbidly obese patients after laparoscopic gastric bypass surgery were the number of comorbid conditions, the presence of arterial hypertension, the presence of chronic liver diseases, and chronic obstructive pulmonary disease. A new strategy for the management of morbidly obese patients after laparoscopic gastric bypass was developed. This strategy involves changing cassettes to create gastroentero- and enteroenteroanastomoses, reducing the period of use of the nasogastric tube, drains, and urinary catheter from 3-4 days to 1 day, and resuming the drinking regimen 6 hours after extubation.
METHODS: Materials and Methods: From 2011 to 2022, a total of 348 patients with morbid obesity (MO) underwent laparoscopic gastric bypass treatment at the clinical base of the Department of General Surgery №2 of Bogomolets National Medical University. The retrospective group included 178 patients who received treatment between 2011 and 2019. 170 patients were enrolled in the prospective group for the period from 2019 to 2022.
RESULTS: Results: Retrospective group had 8 episodes of postoperative bleeding, representing a rate of 4.49%, prospective group - 3 episodes of postoperative bleeding, representing a rate of 1.76% Four factor characteristics associated with the probability of bleeding were identified: \"number of comorbid conditions\", \"arterial hypertension\", \"chronic liver diseases\" and \"chronic obstructive pulmonary disease\".
CONCLUSIONS: Conclusions: The factors responsible for the occurrence of postoperative bleeding in morbidly obese patients after laparoscopic gastric bypass surgery were the number of comorbid conditions, the presence of arterial hypertension, the presence of chronic liver diseases, and chronic obstructive pulmonary disease. A new strategy for the management of morbidly obese patients after laparoscopic gastric bypass was developed. This strategy involves changing cassettes to create gastroentero- and enteroenteroanastomoses, reducing the period of use of the nasogastric tube, drains, and urinary catheter from 3-4 days to 1 day, and resuming the drinking regimen 6 hours after extubation.
摘要：
目的：目的：改善对病态肥胖患者进行胃旁路手术的管理，以减少术后并发症的发生。特别是,出血。
方法：材料与方法：2011年至2022年，在Bogomolets国立医科大学普通外科第2部临床基地对348例病态肥胖（MO）患者进行腹腔镜胃旁路术治疗。回顾性组包括2011年至2019年接受治疗的178例患者。从2019年到2022年，170名患者被纳入前瞻性组。
结果：结果：回顾性组有8次术后出血，占4.49%，前瞻性组-术后出血3次，代表1.76%的比率确定了与出血概率相关的四个因素特征：“共病条件的数量”，“动脉高血压”，“慢性肝病”和“慢性阻塞性肺疾病”。
结论：结论：腹腔镜胃旁路手术后病态肥胖患者发生术后出血的因素是共病条件的数量，动脉高血压的存在，慢性肝病的存在，和慢性阻塞性肺疾病。开发了一种用于腹腔镜胃旁路术后病态肥胖患者管理的新策略。该策略涉及更换卡带以创建胃肠和肠肠吻合，减少鼻胃管的使用时间，排水沟,导尿管从3-4天到1天，拔管后6小时恢复饮酒方案。
方法：材料与方法：2011年至2022年，在Bogomolets国立医科大学普通外科第2部临床基地对348例病态肥胖（MO）患者进行腹腔镜胃旁路术治疗。回顾性组包括2011年至2019年接受治疗的178例患者。从2019年到2022年，170名患者被纳入前瞻性组。
结果：结果：回顾性组有8次术后出血，占4.49%，前瞻性组-术后出血3次，代表1.76%的比率确定了与出血概率相关的四个因素特征：“共病条件的数量”，“动脉高血压”，“慢性肝病”和“慢性阻塞性肺疾病”。
结论：结论：腹腔镜胃旁路手术后病态肥胖患者发生术后出血的因素是共病条件的数量，动脉高血压的存在，慢性肝病的存在，和慢性阻塞性肺疾病。开发了一种用于腹腔镜胃旁路术后病态肥胖患者管理的新策略。该策略涉及更换卡带以创建胃肠和肠肠吻合，减少鼻胃管的使用时间，排水沟,导尿管从3-4天到1天，拔管后6小时恢复饮酒方案。
