The Effect of Laparoscopic Sleeve Gastrectomy Applications on Coagulation in Morbidly Obese Patients: Clinical Research

Abstract

Objective: Obese patients have an increased predisposition to thrombosis and are at a high risk for thrombotic complications associated with bariatric surgeries. This study aimed to evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on coagulation parameters in morbidly obese patients. Material and Methods: This prospective study was performed with 40 American Society of Anesthesiologists II-III morbidly obese patients with a body mass index of ≥40 kg/m² who underwent LSG. Anaesthesia was maintained with sevoflurane after anaesthesia induction. Haemoglobin, haematocrit, platelet, D-dimer and fibrinogen levels as well as prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalised ratio (INR) were compared in blood samples taken before the operation and at 1, 24 and 48 hours after the operation. In addition, duration of operation, length of hospital stay and the presence of symptomatic thromboembolic complications within 7 days after the operation were examined. Results: A significant increase was observed in PT and INR in all postoperative periods (p<0.001). Although a significant decrease was observed at the 1st hour, a significant increase was observed at the 24th and 48th hours in aPTT postoperatively (p<0.01). Postoperative fibrinogen and D-dimer levels were significantly higher than the preoperative levels (p<0.01). No symptomatic thromboembolic event was observed in any patient in the early postoperative period. Conclusion: In morbidly obese patients undergoing LSG, coagulation parameters are affected in line with the increased risk of thrombosis. Close monitoring of these patients for postoperative thromboembolic complications is important.