Laparoskopik sleeve gastrektomi hastalarımızın erken ve geç komplikasyonlarına yaklaşımımız

Abstract

Aim: Laparoscopic Sleeve Gastrectomy (LSG) is used as an effective surgical method in the treatment of morbid obesity. In our study, we investigated the early and late complications and treatment methods of our patients who underwent LSG.Material and method: 390 patients between the ages of 18-70 who were operated between January 2016 and December 2020 were included in the study. Patient records were retrospectively scanned electronically and the results were recorded.Results: Laparoscopic sleeve gastrectomy surgery was performed on 390 morbidly obese patients. Of the patients, 310 (78.1%) were female, 80 (21.9%) were male, with a mean age of 42.1 years (22-65) and 42.9 years (24-70) patients. Complications were observed in 22 (5.64%) patients with LSG. Ten (2.56%) of the patients developed complications in the early period, 9 (2.33%) developed complications in the late period, and 3 (0.75%) of them developed both early and late complications.Early complications; Postoperative early anastomosis leakage in 4 (1%) patients, atelectasis in 2 (0.5%) patients, bleeding in 1 (0.25%) patient, dehydration in 1 (0.25%) patient, intra-abdominal collection in 1 (0.25%) patient, pleurosis in 1 (0.25%) patient was detected. Stent was applied to the patients with leakage, and the patient with bleeding was operated. Other patients received medical treatment.Late complications; Minimal stenosis causing reflux in the incisura angularis was found in 5 (1.25%) patients, and trocar port hernia was found in 4 (1%) patients.Early and late complication; Late complications were also observed in 3 (0.75%) patients who underwent stenting due to early leakage. Late pyloric stenosis was detected in 1 (0.25%) of these patients, gastric ulcers in 1 (0.25%) and esophagocardial stenosis in 1 (0.25%) patient. Patients with trocar port hernia and patients with severe symptomatic incisura angularis stenosis were treated surgically, while other patients were treated medically. No mortality was observed.Conclusion: Laparoscopic sleeve gastrectomy, which is an effective method in the treatment of morbid obesity, can have serious early and late complications. For this reason, we believe that it will be safer to operate them in centers where necessary intensive care conditions and endoscopic interventions such as stenting can be performed quickly and reliably.