The Effect of Increased Intraabdominal Pressure on Mean Platelet Volume During Laparoscopic Sleeve Gastrectomy Surgery
Öz
Objective: Obesity is defined as abnormal or excessive fat accumulation in adipose tissue, at a level that impairs health. Surgical procedures in the treatment of obesity have begun to be applied frequently in recent years. However, in such surgical procedures, increased intraoperative intra-abdominal pressure may be a matter of concern. In this study, we aimed to investigate the effects of the increase in intra-abdominal pressure in laparoscopic sleeve gastrectomy surgery on mean platelet volume (MPV), which is an indicator of platelet activity.
Material and Methods: 60 patients aged between 18 and 65 were included in the study. All patients underwent elective laparoscopic sleeve gastrectomy by adjusting the intra-abdominal pressure between 13-15 mm/Hg. Preoperative, intraoperative and postoperative MPV values were measured and it was evaluated whether there was a statistically significant difference between these values.
Results: The average body mass index of the patients was 44.46±4.18. The mean MPV values of the patients were measured as MPV preoperative 10.03±0.95 fl, MPV intraoperative 10.17±0.95 fl, MPV postoperative 10.32±0.81 fl. While there was no significant difference between preoperative and intraoperative MPV values, it was observed that there was a statistically significant difference between preoperative and postoperative, intraoperative and postoperative MPV values.
Conclusion: We think that monitoring the MPV value, which is an indicator of platelet size in terms of coagulation disorders due to platelet functions, in laparoscopic operations performed under intra-abdominal pressure, will be appropriate for monitoring acute thrombotic events after surgery.
Anahtar Kelimeler
Laparoscopic sleeve gastrectomy increased intraabdominal pressure mean platelet volume
Kaynakça
- Frühbeck G, Toplak H, Woodward E et al. Obesity: The gate way to ill health an EASO position statement on a rising public health, clinical and scientific challenge in Europe. Obes Facts. 2013;6(2):117-120.
- The International Classification of adult underweight, overweight and obesity according to BMI. Erişim tarihi: 08 Şubat 2020: http://apps.who.int/bmi/index.jsp? introPage=intro_3.html
- The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Erişim tarihi: 08 Şubat 2020: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf
- Laparoscopic Surgery - What is it? Erişim tarihi 08 Şubat 2020: https://fascrs.org/patients/diseases-and-conditions/ a-z/laparoscopic-surgery-what-is-it
- Gülleroğlu A, Turgut N, Vatansever Ş ve ark. Laparoskopik kolesistektomi operasyonlarında karın içi basınç artışının solunum mekaniği, hemodinami ve metabolizma üzerindeki etkileri. Okmeydanı Tıp Dergisi. 2015;31(3):134-143.
- Abdominal compartment syndrome in adults. Erişim tarihi: 08 Şubat 2020: https://www.uptodate.com/contents/ abdominal-compartment-syndrome-in-adults?search= abdominal%20compartment%20syndrome&source=searc h_result&selectedTitle=1~69&usage_type=default&displ ay_rank=1
- Çoban E, Özdoğan M, Yazıcıoğlu G et al. The mean platelet volume in patients with obesity. Int J Clin Pract. 2005;59(8):981-982.
- Automated hematology instrumentation. Erişim tarihi: 08 Şubat 2020: https://www.uptodate.com/contents/ automated-hematology-instrumentation?search= mean%20platelet%20volume§ionRank=1&usage_ty pe=default&anchor=H8&source=machineLearning&sele ctedTitle=1~49&display_rank=1#H8
- Chu H, Wang Y, Sun Y, et al. Accuracy of pleth variability index to predict fluid responsiveness in mechanically ventilated patients: A systematic review and meta-analysis Clin Monit Comput. 2016;30(30):265-274.
- Celep RB, Kahramanca S, Özsoy M, et al. Effects of intraabdominal pressure on mean platelet volume during laparoscopic cholecystectomy. Turk J Med Sci. 2014;44(3):360-364.
- Beyazit Y, Sayilir A, Torun S, et al.. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol. 2012;36(2): 162-168.
- Kılınçalp S, Ekiz F, Başar Ö, et al. Mean platelet volume could be possible biomarker in early diagnosis and monitoring of gastric cancer. Platelets. 2014;25(8):592- 594.
- Kiliçli-Çamur N, Demirtunç R,Konuralp C, et al. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit, 2005;11(8):387- 392.
- Arslantas R, Arslantas MK, Altun GT. The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery. Marmara Med. Jour. 2020;33(2):54-60.
- Koivusalo AM, Lindgren L. Effects of carbon dioxide pneumoperitoneum for laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2000;44(7):834-841.
- Wajima Z, Shiga T, Imanaga K. Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia? Biosci Trends. 2018;11(6):667-674.
- Lehavi A, Livshits B, Katz Y. Effect of position and pneumoperitoneum on respiratory mechanics and transpulmonary pressure during laparoscopic surgery. Laparosc Surg. 2018;2:60.
LAPAROSKOPİK SLEEVE GASTREKTOMİ AMELİYATLARINDA KARIN İÇİ BASINÇ ARTIŞININ ORTALAMA TROMBOSİT HACMİ ÜZERİNE ETKİSİNİN ARAŞTIRILMASI
Öz
Amaç: Obezite, adipoz dokuda, sağlığı bozacak düzeyde anormal ya da aşırı yağ birikimi olarak tanımlanmaktadır. Obezite tedavisinde cerrahi uygulamalar, son yıllarda sıklıkla uygulanmaya başlanmıştır. Ancak bu tür cerrahi uygulamalarda intraoperatif karın içi basınç artışı endişe konusu olabilir. Bu çalışmada laparoskopik sleeve gastrektomi operasyonundaki intraabdominal basınç artışının, trombosit aktivitesinin bir göstergesi olan ortalama trombosit hacmine (MPV) etkilerini araştırmayı amaçladık.
Gereç ve Yöntemler: Çalışmaya yaşları 18 ile 65 arasında olan 60 hasta dahil edildi. Tüm hastalara intraabdominal basınç 13-15 mm/Hg aralığında ayarlanarak, elektif laparoskopik sleeve gastrektomi operasyonu yapıldı. Preoperatif, intraoperatif ve postoperatif MPV değerleri ölçülerek bu değerler arasında istatistiksel olarak anlamlı fark olup olmadığı değerlendirildi.
Bulgular: Hastaların vücut kitle indeksi ortalamaları 44.46±4.18 idi. Hastaların MPV ortalama değerleri MPV preoperatif 10.03±0.95 fl, MPV intraoperatif 10.17±0.95 fl, MPV postoperatif 10.32±0.81 fl olarak ölçüldü. Preoperatif ve intraoperatif MPV değerleri arasında anlamlı fark oluşmaz iken, preoperatif ve postoperatif, intraoperatif ve postoperatif MPV değerine arasında istatistiksel anlamlı fark oluştuğu gözlendi.
Sonuç: İntraabdominal basınç altında yapılan laparoskopik operasyonlarda, trombosit fonksiyonlarına bağlı koagulasyon bozuklukları açısından trombosit büyüklüğünün bir göstergesi olan MPV değerinin izlenmesinin, cerrahi sonrası akut trombotik hadiselerin takibi açısından uygun olacağını düşünmekteyiz.
Anahtar Kelimeler
Laparoskopik sleeve gastrektomi karın içi basınç artışı ortalama trombosit hacmi
Kaynakça
- Frühbeck G, Toplak H, Woodward E et al. Obesity: The gate way to ill health an EASO position statement on a rising public health, clinical and scientific challenge in Europe. Obes Facts. 2013;6(2):117-120.
- The International Classification of adult underweight, overweight and obesity according to BMI. Erişim tarihi: 08 Şubat 2020: http://apps.who.int/bmi/index.jsp? introPage=intro_3.html
- The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Erişim tarihi: 08 Şubat 2020: http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf
- Laparoscopic Surgery - What is it? Erişim tarihi 08 Şubat 2020: https://fascrs.org/patients/diseases-and-conditions/ a-z/laparoscopic-surgery-what-is-it
- Gülleroğlu A, Turgut N, Vatansever Ş ve ark. Laparoskopik kolesistektomi operasyonlarında karın içi basınç artışının solunum mekaniği, hemodinami ve metabolizma üzerindeki etkileri. Okmeydanı Tıp Dergisi. 2015;31(3):134-143.
- Abdominal compartment syndrome in adults. Erişim tarihi: 08 Şubat 2020: https://www.uptodate.com/contents/ abdominal-compartment-syndrome-in-adults?search= abdominal%20compartment%20syndrome&source=searc h_result&selectedTitle=1~69&usage_type=default&displ ay_rank=1
- Çoban E, Özdoğan M, Yazıcıoğlu G et al. The mean platelet volume in patients with obesity. Int J Clin Pract. 2005;59(8):981-982.
- Automated hematology instrumentation. Erişim tarihi: 08 Şubat 2020: https://www.uptodate.com/contents/ automated-hematology-instrumentation?search= mean%20platelet%20volume§ionRank=1&usage_ty pe=default&anchor=H8&source=machineLearning&sele ctedTitle=1~49&display_rank=1#H8
- Chu H, Wang Y, Sun Y, et al. Accuracy of pleth variability index to predict fluid responsiveness in mechanically ventilated patients: A systematic review and meta-analysis Clin Monit Comput. 2016;30(30):265-274.
- Celep RB, Kahramanca S, Özsoy M, et al. Effects of intraabdominal pressure on mean platelet volume during laparoscopic cholecystectomy. Turk J Med Sci. 2014;44(3):360-364.
- Beyazit Y, Sayilir A, Torun S, et al.. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol. 2012;36(2): 162-168.
- Kılınçalp S, Ekiz F, Başar Ö, et al. Mean platelet volume could be possible biomarker in early diagnosis and monitoring of gastric cancer. Platelets. 2014;25(8):592- 594.
- Kiliçli-Çamur N, Demirtunç R,Konuralp C, et al. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit, 2005;11(8):387- 392.
- Arslantas R, Arslantas MK, Altun GT. The effects of pneumoperitoneum and patient position on the perfusion index and pleth variability index during laparoscopic bariatric surgery. Marmara Med. Jour. 2020;33(2):54-60.
- Koivusalo AM, Lindgren L. Effects of carbon dioxide pneumoperitoneum for laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2000;44(7):834-841.
- Wajima Z, Shiga T, Imanaga K. Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia? Biosci Trends. 2018;11(6):667-674.
- Lehavi A, Livshits B, Katz Y. Effect of position and pneumoperitoneum on respiratory mechanics and transpulmonary pressure during laparoscopic surgery. Laparosc Surg. 2018;2:60.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Hizmetleri ve Sistemleri (Diğer) |
| Bölüm | Özgün Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Nisan 2024 |
| Gönderilme Tarihi | 7 Kasım 2023 |
| Kabul Tarihi | 5 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 26 Sayı: 1 |
Kaynak Göster
Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.