Laparoscopic Sleeve Gastrectomy: A Single Egyptian Center Experience with Anesthetic and Surgical Complications
Ahmed Hasanin
Department of Anesthesiology and Critical Care Medicine, Cairo University, Egypt.
Kareem Hussein
Department of Anesthesiology and Critical Care Medicine, Cairo University, Egypt.
Shereen Amin
Department of Anesthesiology and Critical Care Medicine, Cairo University, Egypt.
Gihan Obayah
Department of Anesthesiology and Critical Care Medicine, Cairo University, Egypt.
Ali Mokhtar *
Department of Anesthesiology and Critical Care Medicine, Cairo University, Egypt.
Sabah Abdelraouf
Department of Anesthesiology and Critical Care Medicine, Cairo University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Laparoscopic sleeve gastrectomy (LSG) as bariatric operation is gaining popularity nowadays. Many studies reported patient surgical outcome after LSG, however little is known about perioperative anesthesia-related complications. In this study we are reporting our experience in an university hospital with perioperative complications and adverse events in morbidly obese patients undergoing LSG.
Methods: A prospective cohort study was conducted in Cairo university hospitals. All patients scheduled for LSG during a period of seven months were included. Anesthesia-related complications were reported as well as surgical outcomes. Major anesthesia complications were defined as: intraoperative or postoperative cardiac arrest, failed intubation, postoperative ventilation, and postoperative inotropic support. Possible risk factors for developing perioperative complications were also analyzed using univariate and multivariate analysis.
Results: One hundred and fifty patients were included. Mean age was 33±6 years and mean Body mass index (BMI) was 48±6. No major anesthesia related complications were reported. We reported three cases (2%) of surgical anastomotic leakage and four cases (2.6%) of difficult intubation. Regarding minor complications, the most common were intraoperative and postoperative tachycardia (75%), increased plateau airway pressure (75%), and postoperative nausea and vomiting (60%). By multivariate analysis; independent risk factors for respiratory complications are BMI above 50 and STOP-BANG questionnaire score.
Conclusion: LSG is done in our center with a low rate of major anesthesia-related complications. Difficult intubation is not common in morbid obese patients. Risk factors for pulmonary complications in this population were BMI above 50 and STOP-BANG questionnaire.
Keywords: Laparoscope, sleeve gastrectomy, morbid obesity, perioperative complications.