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EVALUATION OF THE RISK OF PULMONARY THROMBOEMBOLISM USING A PADUA SCORE IN LAPAROSCOPIC SLEEVE GASTRECTOMY: A RETROSPECTIVE STUDY
Serdar Yormaz, Hüseyin Yılmaz, Hüsnü Alptekin, Fahrettin Acar, İlhan Ece, Bayram Çolak, Burcu Yormaz, Ertuğrul Kafalı, Mustafa Şahin
Selçuk Üniversitesi, Genel Cerrahi, Konya, Türkiye
Keywords: bariatric, tromboemboly, Padua

Background: Pulmonary thromboembolism in bariatric surgery is a complication that has higher rates of postoperative morbidity and mortality, requiring rapid diagnosis and treatment. As morbid obesity rates increase in society, the development potential of pulmonary thromboemboli further increases. The aim of our study was to evalute clinical, laboratory and radiological outcomes of patients who have been diagnosed with pulmonary tromboembolism and treated retrospectively.

Material and methods: The clinical follow up cards were collected of patients who had undergone Laparoscopic sleeve gastrectomy for morbid obesity between March 2014 to January 2016 retrospectively. Clinical, radiological, laboratory, demographic characteristics outcomes and Padua scores were evaluated. Postoperative data and complications of the patients were evaluated statistically. Factors that might affect postoperative pulmonary thromboembolism were evaluated by univariate regression analysis.

Results: The gender of patients were 146 (55%) female and 124 (45%) male. The mean age was 44.7 ± 4.3 (22-72) years. Also mean postoperative stay in hospital was 5.7 ± 2.3 (2-25) days. Patients performed varicose vein socks in mid-high-risk (MR) and low-risk (LR) groups while the pneumothic device was applied to very high-risk (VHR) and high-risk groups. Despite the protective procedures, deep vein thrombosis was seen in 3 patients and pulmonary thromboembolism was seen in 2 patients (p<0.05), no mortality was detected. Postoperative pulmonary comorbidities and the risk factors for postoperative pulmonary thromboembolism (Body mass index, history of previous venous emboli, immobility and complications) were statistically significant (p<0.05).

Conclusion: The recommended medication for pulmonary thromboembolism prophylaxis in bariatric surgery is always low-molecularweight heparin. In addition to this preventive treatment of the disease, the application of a pneumatic device and / or varicose veins socks are required. Pneumatic device is more effective than varicose vein application in preventing possible complications in bariatric surgery.