Skip to main content
Erschienen in: Obesity Surgery 10/2020

17.06.2020 | Original Contributions

Laparoscopic Sleeve Gastrectomy Affects Coagulation System of Obese Patients

verfasst von: Chen Liu, Ziliang Han, Nengwei Zhang, Jirun Peng, Bin Zhu, Buhe Amin, Dexiao Du, Wei Yan, Dongdong Zhang, Ke Gong

Erschienen in: Obesity Surgery | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is nowadays the most popular bariatric procedure for obesity. However, whether LSG increases the risk of thrombosis remains unclear. The aim of this study was to investigate potential effects of LSG on coagulation system.

Methods

Fifty-five obese patients underwent LSG between 2016 and 2018. The LSG was performed with pneumoperitoneum pressure maintained at 13 mmHg. Venous blood specimens were collected from each patient before surgery, at the end of pneumoperitoneum (i.e., 0 h after surgery), and at 24 h after surgery to determine prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), platelet count (PLT), D-dimer (D-D), red blood cell count (RBC), hematocrit (HCT), plateletcrit (PCT), cholesterol (CHOL), triglyceride (TRIG), and serum calcium (Ca). All patients were examined on the veins of the lower limbs by color Duplex sonography (CDS) before surgery and at 24 h after surgery, respectively.

Results

All patients successfully underwent LSG. No severe surgery-related complications were observed during 1-month follow-up after operation. Preoperative BMI was 43.6 ± 8.3 kg/m2. The levels of coagulation factors were within the normal range before surgery, except a relatively higher PLT. The PT and D-D were increased at 0 h and 24 h after surgery (P < 0.05), whereas APTT was decreased (P < 0.05). The postoperative FIB remained similar to the preoperative one (P > 0.05). The CDS identified no thrombus in the veins of the lower limbs, either before surgery or at 24 h after surgery.

Conclusions

LSG may cause postoperative hypercoagulability of patients with obesity.
Literatur
1.
Zurück zum Zitat Rottenstreich A, Elazary R, Yuval JB, et al. Assessment of the procoagulant potential after laparoscopic sleeve gastrectomy: a potential role for extended thromboprophylaxis. Surg Obes Relat Dis. 2018;14:1–7.PubMed Rottenstreich A, Elazary R, Yuval JB, et al. Assessment of the procoagulant potential after laparoscopic sleeve gastrectomy: a potential role for extended thromboprophylaxis. Surg Obes Relat Dis. 2018;14:1–7.PubMed
2.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004;292:1724–37.PubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004;292:1724–37.PubMed
3.
Zurück zum Zitat Terranova L, Busetto L, Vestri A, et al. Bariatric Surgery: cost-effectiveness and budget impact. Obes Surg. 2012;22:646–53.PubMed Terranova L, Busetto L, Vestri A, et al. Bariatric Surgery: cost-effectiveness and budget impact. Obes Surg. 2012;22:646–53.PubMed
4.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.PubMed Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.PubMed
5.
Zurück zum Zitat Liu J. The status quo and changes of metabolic and bariatric surgery in China. Chinese Journal of Gastrointestinal Surgery. 2017;20(4):378–82.PubMed Liu J. The status quo and changes of metabolic and bariatric surgery in China. Chinese Journal of Gastrointestinal Surgery. 2017;20(4):378–82.PubMed
6.
Zurück zum Zitat Abuoglu HH, Müftüoğlu MAT, Odabaşı M. A new protocol for venous thromboembolism prophylaxis in bariatric surgery. Obes Surg. 2019;29(2):729–34.PubMed Abuoglu HH, Müftüoğlu MAT, Odabaşı M. A new protocol for venous thromboembolism prophylaxis in bariatric surgery. Obes Surg. 2019;29(2):729–34.PubMed
7.
Zurück zum Zitat Davies HO, Popplewell M, Singhal R, et al. Obesity and lower limb venous disease—the epidemic of phlebesity. Phlebology. 2017;32(4):227–33.PubMed Davies HO, Popplewell M, Singhal R, et al. Obesity and lower limb venous disease—the epidemic of phlebesity. Phlebology. 2017;32(4):227–33.PubMed
8.
Zurück zum Zitat Cheung ZB, Vig KS, White SJW, et al. Impact of obesity on surgical outcomes following laminectomy for spinal metastases. Global Spine J. 2019;9(3):254–9.PubMed Cheung ZB, Vig KS, White SJW, et al. Impact of obesity on surgical outcomes following laminectomy for spinal metastases. Global Spine J. 2019;9(3):254–9.PubMed
9.
Zurück zum Zitat Kimura Y, Oki E, Ando K, et al. Incidence of venous thromboembolism following laparoscopic surgery for gastrointestinal cancer: a single-center. Prospective Cohort Study World J Surg. 2016;40(2):309–14.PubMed Kimura Y, Oki E, Ando K, et al. Incidence of venous thromboembolism following laparoscopic surgery for gastrointestinal cancer: a single-center. Prospective Cohort Study World J Surg. 2016;40(2):309–14.PubMed
10.
Zurück zum Zitat Nimeri AA, Bautista J, Ibrahim M, et al. Mandatory risk assessment reduces venous thromboembolism in bariatric surgery patients. Obes Surg. 2018;28(2):541–7.PubMed Nimeri AA, Bautista J, Ibrahim M, et al. Mandatory risk assessment reduces venous thromboembolism in bariatric surgery patients. Obes Surg. 2018;28(2):541–7.PubMed
11.
Zurück zum Zitat Kahn SR, Morrison DR, Cohen JM, Emed J, Tagalakis V, Roussin A, et al. Interventions for implementation of thromboprophylaxis in hospitalized medical and surgical patients at risk for venous thromboembolism. Cochrane Database Syst Rev (7):2013:CD008201. Kahn SR, Morrison DR, Cohen JM, Emed J, Tagalakis V, Roussin A, et al. Interventions for implementation of thromboprophylaxis in hospitalized medical and surgical patients at risk for venous thromboembolism. Cochrane Database Syst Rev (7):2013:CD008201.
12.
Zurück zum Zitat Spyropoulos AC, Lin J. Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative claims analysis from 30 managed care organizations. J Manag Care Pharm. 2007;13:475–86.PubMed Spyropoulos AC, Lin J. Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative claims analysis from 30 managed care organizations. J Manag Care Pharm. 2007;13:475–86.PubMed
13.
Zurück zum Zitat Sczepaniak JP, Owens ML, Shukla H, et al. Comparability of weight loss reporting after gastric bypass and sleeve gastrectomy using BOLD data 2008-2011. Obes Surg. 2015;25(5):788–95.PubMed Sczepaniak JP, Owens ML, Shukla H, et al. Comparability of weight loss reporting after gastric bypass and sleeve gastrectomy using BOLD data 2008-2011. Obes Surg. 2015;25(5):788–95.PubMed
14.
Zurück zum Zitat Carlin AM, Zeni TM, English WJ, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg. 2013;257(5):791–7.PubMed Carlin AM, Zeni TM, English WJ, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg. 2013;257(5):791–7.PubMed
15.
Zurück zum Zitat Ching SS, Cheng AKS, Kong LWC, et al. Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asia in cohort. Surg Obes Relat Dis. 2015;12(2):335–7. Ching SS, Cheng AKS, Kong LWC, et al. Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asia in cohort. Surg Obes Relat Dis. 2015;12(2):335–7.
16.
Zurück zum Zitat Alvarenga ES, Menzo EL, Szomstein S, et al. Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from metabolic and bariatric surgical accreditation quality and improvement program. Surg Endosc. 2016;30(7):2673–8.PubMed Alvarenga ES, Menzo EL, Szomstein S, et al. Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from metabolic and bariatric surgical accreditation quality and improvement program. Surg Endosc. 2016;30(7):2673–8.PubMed
17.
Zurück zum Zitat Berger R, Clements RH, Morton JM, et al. The impact of different surgical techniques on outcomes in laparoscopic sleeve gastrectomies: the first report from the metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP). Ann Surg. 2016;264(3):464–73.PubMed Berger R, Clements RH, Morton JM, et al. The impact of different surgical techniques on outcomes in laparoscopic sleeve gastrectomies: the first report from the metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP). Ann Surg. 2016;264(3):464–73.PubMed
18.
Zurück zum Zitat Ponce J, Nguyen NT, Hutter M, et al. American Society for Metabolic and Bariatric Surgery estimation of surgery procedures in the United States, 2011–2014. Surg Obes Relat Dis. 2015;11:1199–200.PubMed Ponce J, Nguyen NT, Hutter M, et al. American Society for Metabolic and Bariatric Surgery estimation of surgery procedures in the United States, 2011–2014. Surg Obes Relat Dis. 2015;11:1199–200.PubMed
19.
Zurück zum Zitat Bariatric Surgical Group, Shanghai Surgical Association, Shanghai Quality Control Center of General Surgery. Bariatric/metabolic surgery annual research and trend analysis 2012–2016 in Shanghai. Chinese Journal of Practical Surgery. 2018;36:94–6. Bariatric Surgical Group, Shanghai Surgical Association, Shanghai Quality Control Center of General Surgery. Bariatric/metabolic surgery annual research and trend analysis 2012–2016 in Shanghai. Chinese Journal of Practical Surgery. 2018;36:94–6.
20.
Zurück zum Zitat Jingang Liu. Current situation of surgical treatment of patients with obesity and type 2 diabetes. Chinese Journal of Practical Surgery 2014;34: 1021–1022,1025 Jingang Liu. Current situation of surgical treatment of patients with obesity and type 2 diabetes. Chinese Journal of Practical Surgery 2014;34: 1021–1022,1025
21.
Zurück zum Zitat Mastoraki A, Mastoraki S, Schizas D, et al. Facing the challenge of venous thromboembolism prevention in patients undergoing major abdominal surgical procedures for gastrointestinal cancer. World J Gastrointest Oncol. 2018;10(10):328–35.PubMedPubMedCentral Mastoraki A, Mastoraki S, Schizas D, et al. Facing the challenge of venous thromboembolism prevention in patients undergoing major abdominal surgical procedures for gastrointestinal cancer. World J Gastrointest Oncol. 2018;10(10):328–35.PubMedPubMedCentral
22.
Zurück zum Zitat Yang C, Zhu L. Coagulation and deep vein flow changes following laparoscopic total extraperitoneal inguinal hernia repair: a single-center, prospective cohort study. Surg Endosc. 2019; Feb 11. [Epub aehead of print] Yang C, Zhu L. Coagulation and deep vein flow changes following laparoscopic total extraperitoneal inguinal hernia repair: a single-center, prospective cohort study. Surg Endosc. 2019; Feb 11. [Epub aehead of print]
23.
Zurück zum Zitat Kopec AK, Abrahams SR, Thornton S, et al. Thrombin promotes diet-induced obesity through fibrin-driven inflammation. J Clin Invest. 2017;127(8):3152–66.PubMedPubMedCentral Kopec AK, Abrahams SR, Thornton S, et al. Thrombin promotes diet-induced obesity through fibrin-driven inflammation. J Clin Invest. 2017;127(8):3152–66.PubMedPubMedCentral
24.
Zurück zum Zitat Forestieri P, Quarto G, De Caterina M, et al. Prophylaxis of thromboembolism in bariatric surgery with parnaparin. Obes Surg. 2007;17:1558–62.PubMed Forestieri P, Quarto G, De Caterina M, et al. Prophylaxis of thromboembolism in bariatric surgery with parnaparin. Obes Surg. 2007;17:1558–62.PubMed
25.
Zurück zum Zitat Sharma A, Dahiya D, Kaman L, et al. Effect of various pneumoperitoneum pressures on femoral vein hemodynamics during laparoscopic cholecystectomy. Updates Surg. 2016;68(2):163–9.PubMed Sharma A, Dahiya D, Kaman L, et al. Effect of various pneumoperitoneum pressures on femoral vein hemodynamics during laparoscopic cholecystectomy. Updates Surg. 2016;68(2):163–9.PubMed
26.
Zurück zum Zitat Ntourakis D, Sergentanis TN, Geergiopoulos I, et al. Subclinical activation of coagulation and fibrinolysis in laparoscopic cholecystectomy: do risk factors exist? Int J Surg 2011; 9(5):374–377. Ntourakis D, Sergentanis TN, Geergiopoulos I, et al. Subclinical activation of coagulation and fibrinolysis in laparoscopic cholecystectomy: do risk factors exist? Int J Surg 2011; 9(5):374–377.
27.
Zurück zum Zitat Tripodi A. Liver disease and hemostatic (dys) function. Semin Thromb Hemost. 2015;41:462–7.PubMed Tripodi A. Liver disease and hemostatic (dys) function. Semin Thromb Hemost. 2015;41:462–7.PubMed
28.
Zurück zum Zitat Duxbury MB, Poller L. The oral anticoagulant saga: past, present, and future. Clin Appl Thromb Hemost. 2001;7:269–75.PubMed Duxbury MB, Poller L. The oral anticoagulant saga: past, present, and future. Clin Appl Thromb Hemost. 2001;7:269–75.PubMed
29.
Zurück zum Zitat Kim B, Jang S, Lee YJ, et al. Determination of the cut-off prothrombin time to estimate plasma rivaroxaban overdose status. Journal of Thrombosis and Thrombolysis. Published online:10 September 2019 Kim B, Jang S, Lee YJ, et al. Determination of the cut-off prothrombin time to estimate plasma rivaroxaban overdose status. Journal of Thrombosis and Thrombolysis. Published online:10 September 2019
30.
Zurück zum Zitat Stroh C, Michel N, Luderer D, et al. Risk of thrombosis and thromboembolic prophylaxis in obesity surgery: data analysis from the German Bariatric Surgery registry. Obes Surg. 2016;26(11):2562–71.PubMed Stroh C, Michel N, Luderer D, et al. Risk of thrombosis and thromboembolic prophylaxis in obesity surgery: data analysis from the German Bariatric Surgery registry. Obes Surg. 2016;26(11):2562–71.PubMed
31.
Zurück zum Zitat Yu W, Yanting W, Zhongdong Z, et al. Effect of different position and CO2 pneumoperitoneum pressure of femoral venous hemodynamics. Chinese Journal of General Surgery. 2009;18:609–11. Yu W, Yanting W, Zhongdong Z, et al. Effect of different position and CO2 pneumoperitoneum pressure of femoral venous hemodynamics. Chinese Journal of General Surgery. 2009;18:609–11.
32.
Zurück zum Zitat Sobolewski AP, Deshmukh RM, Brunson BL, et al. Venous hemodynamic changes during laparoscopic cholecystectomy. J Laparoendosc Surg. 1995;5:363–9.PubMed Sobolewski AP, Deshmukh RM, Brunson BL, et al. Venous hemodynamic changes during laparoscopic cholecystectomy. J Laparoendosc Surg. 1995;5:363–9.PubMed
33.
Zurück zum Zitat Schwenk W, Bohm B, Junghans T, et al. Intermittent sequential compression of the lower limbs prevents venous stasis in laparoscopy and conventional colorectal surgery. Dis Colon Rectum. 1997;40:1056–62.PubMed Schwenk W, Bohm B, Junghans T, et al. Intermittent sequential compression of the lower limbs prevents venous stasis in laparoscopy and conventional colorectal surgery. Dis Colon Rectum. 1997;40:1056–62.PubMed
34.
Zurück zum Zitat Schwenk W, Bohm B, Witt C, et al. Pulmonary function following laparoscopic or conventional colorectal resection: a randomized controlled evaluation. Arch Surg. 1999;134:6–13.PubMed Schwenk W, Bohm B, Witt C, et al. Pulmonary function following laparoscopic or conventional colorectal resection: a randomized controlled evaluation. Arch Surg. 1999;134:6–13.PubMed
35.
Zurück zum Zitat Yasui M, Ikeda M, Miyake M, et al. Comparison of bleeding risks related to venous thromboembolism prophylaxis in laparoscopic vs open colorectal cancer surgery: a multicenter study in Japanese patients. Am J Surg. 2017;213(1):43–9.PubMed Yasui M, Ikeda M, Miyake M, et al. Comparison of bleeding risks related to venous thromboembolism prophylaxis in laparoscopic vs open colorectal cancer surgery: a multicenter study in Japanese patients. Am J Surg. 2017;213(1):43–9.PubMed
36.
Zurück zum Zitat Casini A, Neerman-Arbez M, AriEns RA, et al. Dysfibrinogenemia: from molecular anomalies to clinical manifestations and management. J Thromb Haemost. 2015;13(6):909–19.PubMed Casini A, Neerman-Arbez M, AriEns RA, et al. Dysfibrinogenemia: from molecular anomalies to clinical manifestations and management. J Thromb Haemost. 2015;13(6):909–19.PubMed
37.
Zurück zum Zitat Amin B, Zhang C, Yan W, et al. Effects of pneumoperitoneum of laparoscopic cholecystectomy on the coagulation system of patients: a prospective observational study. Chin Med J. 2014;127(14):2599–604.PubMed Amin B, Zhang C, Yan W, et al. Effects of pneumoperitoneum of laparoscopic cholecystectomy on the coagulation system of patients: a prospective observational study. Chin Med J. 2014;127(14):2599–604.PubMed
38.
Zurück zum Zitat Linkins LA, Takach LS. Review of D-dimer testing: good, bad, and ugly. Int J Lab Hematol. 2017;39(Suppl 1):98–103.PubMed Linkins LA, Takach LS. Review of D-dimer testing: good, bad, and ugly. Int J Lab Hematol. 2017;39(Suppl 1):98–103.PubMed
39.
Zurück zum Zitat Chapina JC, Hajjar KA. Fibrinolysis and the control of blood coagulation. Blood Rev. 2015;29(1):17–24. Chapina JC, Hajjar KA. Fibrinolysis and the control of blood coagulation. Blood Rev. 2015;29(1):17–24.
40.
Zurück zum Zitat Kleinegris MC, ten Cate H, ten Cate-Hoek AJ. D-dimer as a marker for cardiovascular and arterial thrombotic events in patients with peripheral arterial diseases. A systematic review. Thromb Haemost. 2013;110(2):233–43.PubMed Kleinegris MC, ten Cate H, ten Cate-Hoek AJ. D-dimer as a marker for cardiovascular and arterial thrombotic events in patients with peripheral arterial diseases. A systematic review. Thromb Haemost. 2013;110(2):233–43.PubMed
41.
Zurück zum Zitat Trastulli S, Desiderio J, Guarino S, et al. Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis. 2013;9:816–30.PubMed Trastulli S, Desiderio J, Guarino S, et al. Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis. 2013;9:816–30.PubMed
42.
Zurück zum Zitat Haifu W, Ming Z, Di Z, et al. Prevention, diagnosis and treatment of perioperative complications of bariatric and metabolic surgery. Chin J Gastrointest Surg. 2017;21:393–7. Haifu W, Ming Z, Di Z, et al. Prevention, diagnosis and treatment of perioperative complications of bariatric and metabolic surgery. Chin J Gastrointest Surg. 2017;21:393–7.
43.
Zurück zum Zitat Chinese Society for Metabolic & Bariatric Surgery (CSMBS). Surgery guideline for Chinese obesity and type 2 diabetes (2014). Chinese Journal of Practical Surgery. 2014;34(11):1005–10. Chinese Society for Metabolic & Bariatric Surgery (CSMBS). Surgery guideline for Chinese obesity and type 2 diabetes (2014). Chinese Journal of Practical Surgery. 2014;34(11):1005–10.
44.
Zurück zum Zitat Chan MM, Hamza N, Ammori BJ. Duration of surgery independently influences risk of venous thromboembolism after laparoscopic bariatric surgery. Surg Obes Relat Dis. 2013;9(1):88–93.PubMed Chan MM, Hamza N, Ammori BJ. Duration of surgery independently influences risk of venous thromboembolism after laparoscopic bariatric surgery. Surg Obes Relat Dis. 2013;9(1):88–93.PubMed
45.
Zurück zum Zitat Shida N, Kurasawa R, Maki Y, et al. Study of plasma coagulation induced by contact with calcium chloride solution. Soft Matter. 2016;12(47):9471–6.PubMed Shida N, Kurasawa R, Maki Y, et al. Study of plasma coagulation induced by contact with calcium chloride solution. Soft Matter. 2016;12(47):9471–6.PubMed
46.
Zurück zum Zitat Finks JF, English WJ, Carlin AM, et al. Predicting risk for venous thromboembolism with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2012;255(6):1100–4.PubMed Finks JF, English WJ, Carlin AM, et al. Predicting risk for venous thromboembolism with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2012;255(6):1100–4.PubMed
47.
Zurück zum Zitat Cao B, Wang J. Factors for hypercoagulable state formation after laparoscopic cholecystectomy: a prospective cohort study. Chinese Journal of General Surgery. 2017;26(8):1036–41. Cao B, Wang J. Factors for hypercoagulable state formation after laparoscopic cholecystectomy: a prospective cohort study. Chinese Journal of General Surgery. 2017;26(8):1036–41.
48.
Zurück zum Zitat Raftopoulos I, Martindale C, Cronin A, et al. The effect of extended post-discharge chemical thromboprophylaxis on venous thromboembolism rates after bariatric surgery: a prospective comparison trial. Surg Endosc. 2008;22(11):2384–91.PubMed Raftopoulos I, Martindale C, Cronin A, et al. The effect of extended post-discharge chemical thromboprophylaxis on venous thromboembolism rates after bariatric surgery: a prospective comparison trial. Surg Endosc. 2008;22(11):2384–91.PubMed
49.
Zurück zum Zitat Altieri MS, Yang J, Hajagos J, et al. Evaluation of VTE prophylaxis and the impact of alternate regimens on post-operative bleeding and thrombotic complications following bariatric procedures. Surg Endosc. 2018;32:4805–12.PubMed Altieri MS, Yang J, Hajagos J, et al. Evaluation of VTE prophylaxis and the impact of alternate regimens on post-operative bleeding and thrombotic complications following bariatric procedures. Surg Endosc. 2018;32:4805–12.PubMed
50.
Zurück zum Zitat Venclauskas L, Maleckas A, Arcelus JI, et al. European guidelines on perioperative venous thromboembolism prophylaxis: surgery in the obese patient. Eu J Anaestesiol. 2018;35(2):147–53. Venclauskas L, Maleckas A, Arcelus JI, et al. European guidelines on perioperative venous thromboembolism prophylaxis: surgery in the obese patient. Eu J Anaestesiol. 2018;35(2):147–53.
51.
Zurück zum Zitat Bhattacharya S, Kumar SS, Swamy PDK, et al. Deep vein thrombosis prophylaxis: are we overdoing? An Asian survey on trends in bariatric surgery with a systematic review of literature. Journal of minimal access surgery. 2018;14(4):285–90.PubMedPubMedCentral Bhattacharya S, Kumar SS, Swamy PDK, et al. Deep vein thrombosis prophylaxis: are we overdoing? An Asian survey on trends in bariatric surgery with a systematic review of literature. Journal of minimal access surgery. 2018;14(4):285–90.PubMedPubMedCentral
52.
Zurück zum Zitat Blanchet MC, Gignoux B, Matussiere Y, et al. Experience with an enhanced recovery after surgery (ERAS) program for bariatric surgery: comparison of MGB and LSG in 374 patients. Obes Surg. 2017;27(7):1896–900.PubMed Blanchet MC, Gignoux B, Matussiere Y, et al. Experience with an enhanced recovery after surgery (ERAS) program for bariatric surgery: comparison of MGB and LSG in 374 patients. Obes Surg. 2017;27(7):1896–900.PubMed
Metadaten
Titel
Laparoscopic Sleeve Gastrectomy Affects Coagulation System of Obese Patients
verfasst von
Chen Liu
Ziliang Han
Nengwei Zhang
Jirun Peng
Bin Zhu
Buhe Amin
Dexiao Du
Wei Yan
Dongdong Zhang
Ke Gong
Publikationsdatum
17.06.2020
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 10/2020
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04769-w

Weitere Artikel der Ausgabe 10/2020

Obesity Surgery 10/2020 Zur Ausgabe

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis 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“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ 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“

CME: 2 Punkte

Dr. med. Mihailo Andric
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.