Management of surgical complications of previous bariatric surgery in pregnant women. A systematic review from the BARIA-MAT Study Group

Petrucciani, Niccolò; Ciangura, C.; Debs, Tarek; Ducarme, Guillaume; Calabrese, Daniela; Gugenheim, Jean

doi:10.1016/j.soard.2019.10.022

Cited by 27 publications

(24 citation statements)

References 93 publications

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“…Our patients are instructed about potentially dangerous symptoms and are encouraged to directly consult the bariatric surgical unit, which guarantees rapid and expert management. The referral of patients to centers lacking experience in bariatric surgery may be responsible for diagnostic and treatment delay [ 11 ]. Furthermore, in our opinion, the experience of the center and the number of bariatric surgeries per year is a second important factor.…”

Section: Discussionmentioning

confidence: 99%

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Internal Hernia After One Anastomosis Gastric Bypass (OAGB): Lessons Learned from a Retrospective Series of 3368 Consecutive Patients Undergoing OAGB with a Biliopancreatic Limb of 150 cm

et al. 2021

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Background Internal hernia (IH) represents a relatively common and well-known complication after Roux-en-Y gastric bypass. IH after one anastomosis gastric bypass (OAGB) is less frequent and rarely reported in the literature. This study presents a series of IH after OAGB observed in a high-volume bariatric center. Methods Data of patients who underwent OAGB with an afferent limb of 150 cm between May 2010 and September 2019 were prospectively collected and retrospectively analyzed. Data of patients undergoing surgery for IH during follow-up were collected and analyzed. Results Ninety-six patients out of 3368 with a history of OAGB had intestinal incarceration in the Petersen’s orifice (2.8%). Specificity and sensitivity of computed tomography scans in the diagnosis of IH were 59% and 76%, respectively. The mean timeframe between OAGB and surgery for IH was 21.9±18.3 months. Mean body mass index at the time of IH surgery was 24.7 ± 3.6. Surgery was completed laparoscopically in 96.8% of cases. Nine patients (9.3%) had signs of bowel hypovascularization. In all patients, the herniated bowel was repositioned, and the Petersen’s orifice was closed, without the need for bowel resection. Mean hospital stay was 1.9 ± 4.8 days. The postoperative morbidity rate was 8.3%. Long-term IH relapse was observed in 14 patients; signs of bowel hypovascularization due to incarceration in a small orifice was observed in eight of these patients (57%). Conclusions Incidence of IH after OAGB is 2.8%. IH is associated with a low rate of bowel ischemia and the need for intestinal resection.

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Section: Discussionmentioning

confidence: 99%

“…In mild cases, the IH may also cause chronic digestive symptoms, including pain, discomfort, and nausea [2]. IH is especially dangerous in pregnant women, with reported cases of maternal and fetal death due to bowel ischemia consequent to IH with late diagnosis and treatment [11,12].…”

Section: Introductionmentioning

confidence: 99%

Internal Hernia After One Anastomosis Gastric Bypass (OAGB): Lessons Learned from a Retrospective Series of 3368 Consecutive Patients Undergoing OAGB with a Biliopancreatic Limb of 150 cm

et al. 2021

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“…A considerable number of patients undergoing BS are females in their childbearing age, and most likely, they will become pregnant in the future. Thus, BS may have a serious impact on these patients during the subsequent pregnancy [29]. Our review of studies demonstrated that BS has positive effects on metabolic diseases and fertility; however, it may carry medical and surgical complications for mothers and babies, such as IH, bowel intussusception, bowel obstruction, gastric band slippage, bowel volvulus, gastro-jejunal bleeding, cholelithiasis, and maternal or fetal death [28].…”

Section: Internal Herniation After Bariatric Surgerymentioning

confidence: 97%

“…Postoperatively, the patients usually experience an uneventful pregnancy and delivery course [33]. Maternal and fetal mortality for this patient group was estimated at 2.5% and 7.5%, respectively [29]. Based on these studies, a high suspicion of IH should be maintained when managing pregnant patients complaining of abdominal pain with a surgical history of LRYGB.…”

Section: Internal Herniation After Bariatric Surgerymentioning

confidence: 99%

“…They found that LRYGB was the most common procedure and IH the most common complication. The surgical complications of a previous BS during pregnancy probably have critical consequences [29]. Stuart et al also conducted a cohort study on a large number of patients to compare the risk of abdominal surgery during pregnancy between women who have undergone BS and obese women with BMIs of >35 without previous BS.…”

Section: Internal Herniation After Bariatric Surgerymentioning

confidence: 99%

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How to Treat Hernias in Pregnant Women?

Danawar

Mekaiel

Raut

et al. 2020

Cureus

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A hernia is a common surgical problem. Although hernias during pregnancy are uncommon, they can be challenging for both the surgeon and the patient if present. To date, there is no consensus in the medical community regarding the elective repair of hernias in pregnant women. The debate mainly concerns three areas: the timing, the approach, and the surgical technique. This study aims to offer a clear pathway in this field based on the best available data. In this study, we collected reviews written in English and published in PubMed from 2010 to 2020 (the exception being three articles that were published before 2010, which we retained since they contained relevant information). We used regular and Medical Subject Headings (MeSH) keywords. Two of the authors screened the collected studies to select the best articles that would fit our inclusion criteria for the review. The articles considered for this review can be classified into retrospective studies, case reports, and reviews. No randomized controlled trials were found.

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