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Khitaryan A.G.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Mezhunts A.V.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Voronova O.V.
Clinical Hospital “Russian Railway-Medicine”;
Pathological Anatomical Bureau
Orekhov A.A.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Melnikov D.A.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Pen O.S.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
The role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients
Journal: Pirogov Russian Journal of Surgery. 2025;(3): 76‑86
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To cite this article:
Khitaryan AG, Mezhunts AV, Voronova OV, et al. . The role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients. Pirogov Russian Journal of Surgery.
2025;(3):76‑86. (In Russ.)
https://doi.org/10.17116/hirurgia202503176
To study the role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients and to determine the indications for redo laparoscopy.
A single-center retrospective study enrolled 2011 patients who underwent surgery. All patients were categorized into two groups: group 1 (1983 patients) — standard postoperative period; group 2 (28 patients) — major inflammatory complications with redo laparoscopy.
We found no significant differences in BMI, weight and age between patients with and without complications. Conversely, high serum glucose, duration of type 2 DM over 5 years, tachycardia > 100 bpm and high VAS score of abdominal pain significantly increased the risk of complications. Contrast-enhanced CT of the abdomen has the greatest informative value. To ascertain critical value of each factor for between-group differentiation, we performed ROC analysis and demonstrated specificity of these indicators.
The challenge of early diagnosis of intra-abdominal inflammatory complications in bariatric patients is compounded by no typical symptoms and small informative value of laboratory and instrumental diagnostic methods. According to ROC analysis, combination of fever, hypotension, tachycardia and tachypnoea resulted AUC 0.80. Sensitivity 65% and specificity 82% indicated the need for immediate repeated surgery. However, availability of standardized surgical technique and clear algorithms for the entire team are essential for timely diagnosis and management of all potential complications in patients with serious postoperative bariatric complications.
Authors:
Khitaryan A.G.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Mezhunts A.V.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Voronova O.V.
Clinical Hospital “Russian Railway-Medicine”;
Pathological Anatomical Bureau
Orekhov A.A.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Melnikov D.A.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Pen O.S.
Rostov State Medical University;
Clinical Hospital “Russian Railway-Medicine”
Received:
28.10.2024
Accepted:
16.11.2024
List of references:
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