Skip to main content
Erschienen in: Obesity Surgery 12/2013

01.12.2013 | Original Contributions

Early Post-operative Complications: Incidence, Management, and Impact on Length of Hospital Stay. A Retrospective Comparison Between Laparoscopic Gastric Bypass and Sleeve Gastrectomy

verfasst von: Rudolf A. Weiner, Islam A. El-Sayes, Sophia Theodoridou, Sylvia R. Weiner, Oliver Scheffel

Erschienen in: Obesity Surgery | Ausgabe 12/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common obesity surgeries. Their early complications may prolong hospital stay (HS).

Methods

Data for patients who underwent LRYGB and LSG in our clinic from 2009 through August 2012 were collected. Early post-operative complications prolonging HS (>5 days) were retrospectively analyzed, highlighting their relative incidence, management, and impact on length of HS.

Results

Sixty-six patients (4.9 %) after 1,345 LRYGB operations vs. 49 patients (7.14 %) after 686 LSG operations developed early complications. This difference is statistically significant (p = 0.039). Male gender percentage was significantly higher in complicated LSG group vs. complicated LRYGB group [23 patients (46.9 %) vs. 16 patients (24.2 %)] (p = 0.042). Mean BMI was significantly higher in the complicated LSG group (54.2 ± 8.3) vs. complicated LRYGB group (46.8 ± 5.7; p = 0.004). Median length of HS was not longer after complicated LSG compared with complicated LRYGB (11 vs. 10 days; p = 0.287). Leakage and bleeding were the most common complications after either procedure. Leakage rate was not higher after LSG (12 patients, 1.7 %) compared with LRYGB (22 patients, 1.6 %; p = 0.304). Bleeding rate was significantly higher after LSG (19 patients, 2.7 %) than after LRYGB (10 patients, 0.7 %; p = 0.004). Prolonged elevation of inflammatory markers was the most common presentation for complications after LSG (18 patients, 36.7 %) and LRYGB (31 patients, 46.9 %).

Conclusions

LSG was associated with more early complications. This may be attributed to higher BMI and predominance of males in LSG group.
Literatur
1.
Zurück zum Zitat Abbatini F, Rizzello M, Casella G, et al. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes. Surg Endosc. 2010;24:1005–10.PubMedCrossRef Abbatini F, Rizzello M, Casella G, et al. Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes. Surg Endosc. 2010;24:1005–10.PubMedCrossRef
2.
Zurück zum Zitat Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122:248–56.PubMedCrossRef Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122:248–56.PubMedCrossRef
3.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
4.
Zurück zum Zitat Buchwald H, Oien D. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.PubMedCrossRef Buchwald H, Oien D. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.PubMedCrossRef
5.
Zurück zum Zitat Gagner M, Deitel M, Kalberer T, et al. The Second International Consensus Summit for Sleeve Gastrectomy, March 19–21, 2009. Surg Obes Relat Dis. 2009;5:476–85.PubMedCrossRef Gagner M, Deitel M, Kalberer T, et al. The Second International Consensus Summit for Sleeve Gastrectomy, March 19–21, 2009. Surg Obes Relat Dis. 2009;5:476–85.PubMedCrossRef
6.
Zurück zum Zitat Santry H, Gillen D, Lauderdale D. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.PubMedCrossRef Santry H, Gillen D, Lauderdale D. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17.PubMedCrossRef
7.
Zurück zum Zitat Griffith P, Birch D, Sharma A, et al. Managing complications associated with laparoscopic Roux-en-Y gastric bypass for morbid obesity. Can J Surg. 2012;55:329–36.PubMedCrossRef Griffith P, Birch D, Sharma A, et al. Managing complications associated with laparoscopic Roux-en-Y gastric bypass for morbid obesity. Can J Surg. 2012;55:329–36.PubMedCrossRef
8.
Zurück zum Zitat NIH Conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61.CrossRef NIH Conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61.CrossRef
9.
Zurück zum Zitat Runkel N, Colombo-Benkmann M, Hüttl T, et al. Evidence-based German guidelines for surgery for obesity. Int J Colorectal Dis. 2011;26:397–404.PubMedCrossRef Runkel N, Colombo-Benkmann M, Hüttl T, et al. Evidence-based German guidelines for surgery for obesity. Int J Colorectal Dis. 2011;26:397–404.PubMedCrossRef
10.
Zurück zum Zitat Stroh C, Luderer D, Weiner R, et al. Actual situation of thromboembolic prophylaxis in obesity surgery: data of quality assurance in bariatric surgery in Germany. Thrombosis. 2012. doi:10.1155/2012/209052. Stroh C, Luderer D, Weiner R, et al. Actual situation of thromboembolic prophylaxis in obesity surgery: data of quality assurance in bariatric surgery in Germany. Thrombosis. 2012. doi:10.​1155/​2012/​209052.
12.
Zurück zum Zitat Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257:231–7.PubMedCrossRef Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257:231–7.PubMedCrossRef
13.
Zurück zum Zitat Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.PubMedCrossRef Silecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.PubMedCrossRef
14.
Zurück zum Zitat Gagner M, Boza C. Laparoscopic duodenal switch for morbid obesity. Exp Rev Med Devices. 2006;3:105–12.CrossRef Gagner M, Boza C. Laparoscopic duodenal switch for morbid obesity. Exp Rev Med Devices. 2006;3:105–12.CrossRef
15.
Zurück zum Zitat Lancaster R, Hutter M. Bands and bypasses: 30-day morbidity and mortality of bariatric surgical procedures as assessed by prospective, multicenter, risk-adjusted ACS-NSQIP data. Surg Endosc. 2008;22:2554–63.PubMedCrossRef Lancaster R, Hutter M. Bands and bypasses: 30-day morbidity and mortality of bariatric surgical procedures as assessed by prospective, multicenter, risk-adjusted ACS-NSQIP data. Surg Endosc. 2008;22:2554–63.PubMedCrossRef
16.
Zurück zum Zitat Dallal R, Datta T, Braitman L. Medicare and Medicaid status predicts prolonged length of stay after bariatric surgery. Surg Obes Relat Dis. 2007;3:592–6.PubMedCrossRef Dallal R, Datta T, Braitman L. Medicare and Medicaid status predicts prolonged length of stay after bariatric surgery. Surg Obes Relat Dis. 2007;3:592–6.PubMedCrossRef
17.
Zurück zum Zitat McCarty T, Arnold D, Lamont J, et al. Optimizing outcomes in bariatric surgery: outpatient laparoscopic gastric bypass. Ann Surg. 2005;242:494–501.PubMed McCarty T, Arnold D, Lamont J, et al. Optimizing outcomes in bariatric surgery: outpatient laparoscopic gastric bypass. Ann Surg. 2005;242:494–501.PubMed
19.
Zurück zum Zitat Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142:621–35.PubMedCrossRef Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142:621–35.PubMedCrossRef
20.
Zurück zum Zitat Morais A, Faintuch J, Leal A, et al. Inflammation and biochemical features of bariatric candidates: does gender matter? Obes Surg. 2011;21:71–7.PubMedCrossRef Morais A, Faintuch J, Leal A, et al. Inflammation and biochemical features of bariatric candidates: does gender matter? Obes Surg. 2011;21:71–7.PubMedCrossRef
21.
Zurück zum Zitat Stroh C, Köckerling F, Weiner R, et al. Are there gender-specific aspects of sleeve gastrectomy—data analysis from the quality assurance study of surgical treatment of obesity in Germany. Obes Surg. 2012;22:1214–9.PubMedCrossRef Stroh C, Köckerling F, Weiner R, et al. Are there gender-specific aspects of sleeve gastrectomy—data analysis from the quality assurance study of surgical treatment of obesity in Germany. Obes Surg. 2012;22:1214–9.PubMedCrossRef
22.
Zurück zum Zitat Inabnet W, Belle S, Bessler M, et al. Comparison of 30-day outcomes after non-LapBand primary and revisional surgical procedures from the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2010;6:22–30.PubMedCrossRef Inabnet W, Belle S, Bessler M, et al. Comparison of 30-day outcomes after non-LapBand primary and revisional surgical procedures from the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2010;6:22–30.PubMedCrossRef
23.
Zurück zum Zitat LABS Consortium Writing Group. Perioperative safety in the Longitudinal Assessment of Bariatric Surgery. New Engl J Med. 2009;361:445–54.CrossRef LABS Consortium Writing Group. Perioperative safety in the Longitudinal Assessment of Bariatric Surgery. New Engl J Med. 2009;361:445–54.CrossRef
24.
Zurück zum Zitat Skroubis G, Karamanakos S, Sakellaropoulos G, et al. Comparison of early and late complications after various bariatric procedures: incidence and treatment during 15 years at a single institution. World J Surg. 2011;35:93–101.PubMedCrossRef Skroubis G, Karamanakos S, Sakellaropoulos G, et al. Comparison of early and late complications after various bariatric procedures: incidence and treatment during 15 years at a single institution. World J Surg. 2011;35:93–101.PubMedCrossRef
25.
Zurück zum Zitat Fernandez A, DeMaria E, Tichansky D, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18:193–7.PubMedCrossRef Fernandez A, DeMaria E, Tichansky D, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18:193–7.PubMedCrossRef
26.
Zurück zum Zitat Marshall J, Srivastava A, Gupta SK, et al. Roux-en-Y gastric bypass leak complications. Arch Surg. 2003;138:520–3.PubMedCrossRef Marshall J, Srivastava A, Gupta SK, et al. Roux-en-Y gastric bypass leak complications. Arch Surg. 2003;138:520–3.PubMedCrossRef
27.
Zurück zum Zitat Bellorin O, Abdemur A, Sucandy I, et al. Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity. Obes Surg. 2011;21:707–13.PubMedCrossRef Bellorin O, Abdemur A, Sucandy I, et al. Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity. Obes Surg. 2011;21:707–13.PubMedCrossRef
28.
Zurück zum Zitat Fullum T, Aluka K, Turner P. Decreasing anastomotic and staple line leaks after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2009;23:1403–8.PubMedCrossRef Fullum T, Aluka K, Turner P. Decreasing anastomotic and staple line leaks after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2009;23:1403–8.PubMedCrossRef
29.
Zurück zum Zitat Madan A, Martinez J, Menzo E, et al. Omental reinforcement for intraoperative leak repairs during laparoscopic Roux-en-Y gastric bypass. Am Surg. 2009;75:839–42.PubMed Madan A, Martinez J, Menzo E, et al. Omental reinforcement for intraoperative leak repairs during laparoscopic Roux-en-Y gastric bypass. Am Surg. 2009;75:839–42.PubMed
30.
Zurück zum Zitat Ballesta C, Berindoague R, Cabrera M, et al. Management of anastomotic leaks after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18:623–30.PubMedCrossRef Ballesta C, Berindoague R, Cabrera M, et al. Management of anastomotic leaks after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18:623–30.PubMedCrossRef
31.
Zurück zum Zitat Attila Csendes A, Burgos A, Braghetto I. Classification and management of leaks after gastric bypass for patients with morbid obesity: a prospective study of 60 patients. Obes Surg. 2012;22:855–62.PubMedCrossRef Attila Csendes A, Burgos A, Braghetto I. Classification and management of leaks after gastric bypass for patients with morbid obesity: a prospective study of 60 patients. Obes Surg. 2012;22:855–62.PubMedCrossRef
32.
Zurück zum Zitat Deitel M, Gagner M, Erickson A, et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749–59.PubMedCrossRef Deitel M, Gagner M, Erickson A, et al. Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2011;7:749–59.PubMedCrossRef
33.
Zurück zum Zitat Herron D, Roohipour R. Complications of Roux-en-Y gastric bypass and sleeve gastrectomy. Abdom Imaging. 2012;37:712–8.PubMedCrossRef Herron D, Roohipour R. Complications of Roux-en-Y gastric bypass and sleeve gastrectomy. Abdom Imaging. 2012;37:712–8.PubMedCrossRef
34.
Zurück zum Zitat Warschkow R, Tarantino I, Folie P. C-Reactive protein 2 days after laparoscopic gastric bypass surgery reliably indicates leaks and moderately predicts morbidity. J Gastrointest Surg. 2012;16:1128–35.PubMedCrossRef Warschkow R, Tarantino I, Folie P. C-Reactive protein 2 days after laparoscopic gastric bypass surgery reliably indicates leaks and moderately predicts morbidity. J Gastrointest Surg. 2012;16:1128–35.PubMedCrossRef
35.
Zurück zum Zitat Kolakowski S, Kirkland M, Schuricht A. Routine postoperative upper gastrointestinal series after Roux-en-Y gastric by pass: determination of whether it is necessary. Arch Surg. 2007;142:930–4.PubMedCrossRef Kolakowski S, Kirkland M, Schuricht A. Routine postoperative upper gastrointestinal series after Roux-en-Y gastric by pass: determination of whether it is necessary. Arch Surg. 2007;142:930–4.PubMedCrossRef
36.
Zurück zum Zitat Yu J, Turner M, Cho S, et al. Normal anatomy and complications after gastric bypass surgery: helical CT findings. Radiology. 2004;231:753–60.PubMedCrossRef Yu J, Turner M, Cho S, et al. Normal anatomy and complications after gastric bypass surgery: helical CT findings. Radiology. 2004;231:753–60.PubMedCrossRef
37.
Zurück zum Zitat Blackmon S, Santora R, Schwarz P, et al. Utility of removable esophageal covered self-expanding metal stents for leak and fistula management. Ann Thorac Surg. 2010;89:931–6.PubMedCrossRef Blackmon S, Santora R, Schwarz P, et al. Utility of removable esophageal covered self-expanding metal stents for leak and fistula management. Ann Thorac Surg. 2010;89:931–6.PubMedCrossRef
38.
Zurück zum Zitat Tan J, Kariyawasam S, Wijeratne T, et al. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20:403–9.PubMedCrossRef Tan J, Kariyawasam S, Wijeratne T, et al. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20:403–9.PubMedCrossRef
39.
Zurück zum Zitat Sakran N, Goitein D, Raziel A, et al. Gastric leaks after sleeve gastrectomy: a multicenter experience with 2,834 patients. Surg Endosc. 2013;27:240–5.PubMedCrossRef Sakran N, Goitein D, Raziel A, et al. Gastric leaks after sleeve gastrectomy: a multicenter experience with 2,834 patients. Surg Endosc. 2013;27:240–5.PubMedCrossRef
40.
Zurück zum Zitat Bakhos C, Alkhoury F, Kyriakides T, et al. Early post-operative hemorrhage after open and laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2009;2:153–577.CrossRef Bakhos C, Alkhoury F, Kyriakides T, et al. Early post-operative hemorrhage after open and laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2009;2:153–577.CrossRef
41.
Zurück zum Zitat Schauer P, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–29.PubMedCrossRef Schauer P, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–29.PubMedCrossRef
42.
Zurück zum Zitat Triantafyllidis G, Lazoura O, Sioka E, et al. Anatomy and complications following laparoscopic sleeve gastrectomy: radiological evaluation and imaging pitfalls. Obes Surg. 2011;21:473–8.PubMedCrossRef Triantafyllidis G, Lazoura O, Sioka E, et al. Anatomy and complications following laparoscopic sleeve gastrectomy: radiological evaluation and imaging pitfalls. Obes Surg. 2011;21:473–8.PubMedCrossRef
43.
44.
Zurück zum Zitat Sajid M, Khatri K, Singh K, et al. Use of staple-line reinforcement in laparoscopic gastric bypass surgery: a meta-analysis. Surg Endosc. 2011;25:2884–91.PubMedCrossRef Sajid M, Khatri K, Singh K, et al. Use of staple-line reinforcement in laparoscopic gastric bypass surgery: a meta-analysis. Surg Endosc. 2011;25:2884–91.PubMedCrossRef
45.
Zurück zum Zitat Consten E, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14:1360–6.PubMedCrossRef Consten E, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14:1360–6.PubMedCrossRef
46.
Zurück zum Zitat Giannopoulos G, Tzanakis N, Rallis G, et al. Staple line reinforcement in laparoscopic bariatric surgery: does it actually make a difference? A systematic review and meta-analysis. Surg Endosc. 2010;24:2782–8.PubMedCrossRef Giannopoulos G, Tzanakis N, Rallis G, et al. Staple line reinforcement in laparoscopic bariatric surgery: does it actually make a difference? A systematic review and meta-analysis. Surg Endosc. 2010;24:2782–8.PubMedCrossRef
47.
Zurück zum Zitat Daskalakis M, Berdan Y, Theodoridou S, et al. Impact of surgeon experience and buttress material on postoperative complications after laparoscopic sleeve gastrectomy. Surg Endosc. 2011;25:88–97.PubMedCrossRef Daskalakis M, Berdan Y, Theodoridou S, et al. Impact of surgeon experience and buttress material on postoperative complications after laparoscopic sleeve gastrectomy. Surg Endosc. 2011;25:88–97.PubMedCrossRef
48.
Zurück zum Zitat Chiu C, Lee W, Wang W, et al. Prevention of trocar-wound hernia in laparoscopic bariatric operations. Obes Surg. 2006;16:913–8.PubMedCrossRef Chiu C, Lee W, Wang W, et al. Prevention of trocar-wound hernia in laparoscopic bariatric operations. Obes Surg. 2006;16:913–8.PubMedCrossRef
49.
Zurück zum Zitat Brethauer S, Schauer P. Risk–benefit analysis of laparoscopic bariatric procedures. In: Schauer P, Schirmer B, Brethauer S, editors. Minimally invasive bariatric surgery. New York: Springer; 2007. p. 371. Brethauer S, Schauer P. Risk–benefit analysis of laparoscopic bariatric procedures. In: Schauer P, Schirmer B, Brethauer S, editors. Minimally invasive bariatric surgery. New York: Springer; 2007. p. 371.
50.
Zurück zum Zitat Hutter M, Schirmer B, Jones D, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254:410–22.PubMedCrossRef Hutter M, Schirmer B, Jones D, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254:410–22.PubMedCrossRef
51.
Zurück zum Zitat Birkmeyer N, Dimick J, Share D, et al. Hospital complication rates with bariatric surgery in Michigan. JAMA. 2010;304:435–42.PubMedCrossRef Birkmeyer N, Dimick J, Share D, et al. Hospital complication rates with bariatric surgery in Michigan. JAMA. 2010;304:435–42.PubMedCrossRef
52.
Zurück zum Zitat DeMaria E, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2010;6:347–55.PubMedCrossRef DeMaria E, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2010;6:347–55.PubMedCrossRef
Metadaten
Titel
Early Post-operative Complications: Incidence, Management, and Impact on Length of Hospital Stay. A Retrospective Comparison Between Laparoscopic Gastric Bypass and Sleeve Gastrectomy
verfasst von
Rudolf A. Weiner
Islam A. El-Sayes
Sophia Theodoridou
Sylvia R. Weiner
Oliver Scheffel
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 12/2013
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-1022-z

Weitere Artikel der Ausgabe 12/2013

Obesity Surgery 12/2013 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.