DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.
Department of Surgery, Sanatorio de la Mujer, Rosario, Argentina.
J Laparoendosc Adv Surg Tech A. 2021 Feb;31(2):146-151. doi: 10.1089/lap.2020.0696. Epub 2020 Sep 16.
Obesity treatment requires surgical procedures included in bariatric surgery. Bleeding complications are reported in 1%-4%. Image-guided surgery (IGS) includes minimally invasive procedures that have the advantage of less aggression to the patient, fewer complications, and a quick recovery. Endovascular therapy by interventional radiology (IR) is a minimally invasive image-guided procedure widely used in central, peripheral, and splanchnic vascular pathology. Treatment of postoperative bleeding in bariatric surgery can be aided by image-guided endovascular procedures. The aim of this study is to carry out an update on the application of IR in bariatric surgery bleeding complications. General rate of postoperative complications in bariatric surgery is 0%-10%. Postoperative bleeding (1%-4%) can be gastrointestinal (endoscopic treatment) or intra-abdominal (surgical treatment/relaparoscopy). In the case of arterial vascular lesions that cannot be resolved either endoscopically or surgically, the option of endovascular treatment with IR should be considered. Endovascular approach through IR and IGS in bleeding complications after bariatric surgery is presented as a valid minimally invasive therapy option in this group of patients.
肥胖症的治疗需要包括减重手术在内的外科手术。有报道称,此类手术会出现 1%-4%的出血并发症。影像引导手术(IGS)包括微创程序,其优点是对患者的侵袭性更小、并发症更少且恢复更快。介入放射学(IR)的血管内治疗是一种广泛应用于中央、外周和内脏血管病变的微创影像引导程序。影像引导血管内程序可辅助治疗减重手术后的出血。本研究旨在对 IR 在减重手术出血并发症中的应用进行更新。减重手术后的一般并发症发生率为 0%-10%。术后出血(1%-4%)可能是胃肠道(内镜治疗)或腹腔内(手术治疗/再次腹腔镜检查)。对于无法通过内镜或手术解决的动脉血管病变,应考虑采用 IR 的血管内治疗。对于减重手术后出血并发症,通过 IR 和 IGS 的血管内方法被提出作为该组患者的一种有效微创治疗选择。