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KMID : 1155520120070010097
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Anesthesia and Pain Medicine
2012 Volume.7 No. 1 p.97 ~ p.102
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Blood coagulation changes in laparoscopic gastrectomy: morbid obese vs normal patients
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Kim Yong-Suk
Joo Jin
Ryu Keon-Hee
Lim Dae-Hwan
Park Chul-Soo
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Abstract
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Background: Patients with morbid obesity have higher risk of fatal thromboembolic episodes than non-obese patients. We aimed to identify perioperative changes in blood coagulation for the patients undergoing bariatric surgery and compare thromboelastography (TEG) findings with non-obese patients.
Methods: 24 patients with morbid obesity (group B) and 22 patients with stomach cancer (group S) who undergoing laparoscopic Roux- en-Y gastric bypass surgery were prospectively studied. Laboratory coagulation-related tests and TEG were conducted immediately after anesthetic induction (T0), at 2 hours after surgical incision (T1), and 2 hours after the end of surgery (T2).
Results: Group B had higher serum lactate, fibrinogen, maximum amplitude in TEG findings, and shorter activated partial thromboplastin time (aPTT) than group S at T0 (P ＜ 0.05). In group B, serum fibrinogen degradation products (FDP) at T2 and base deficit at T1 and T2 were higher, and aPTT was shorter than those at T0 (P ＜ 0.05). R-time and k-time showed gradual shortening toward T2. ?-angle at T1 and coagulation index at T2 increased significantly from those at T0 in the group B (P ＜ 0.05). However, group B failed to show any significant differences from the group S in TEG and coagulation-related laboratory findings except platelet count and serum fibrinogen level at T1 and T2.
Conslusions: Preoperatively, morbidly obese patients had more activated coagulation profiles than non-obese patients. However, remarkable perioperative changes in TEG findings could not be definitely observed between two groups.
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KEYWORD
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Bariatric surgery, Hypercoagulability, Thromboelastography
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