Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
Hemşirelik Bakımında Güncel Bir Yaklaşım: Bariyatrik Cerrahi Komplikasyonları
A Current Approach to Nursing Care: Complications of Bariatric Surgery
Pınar YILMAZa, Ayşe TOPAL HANÇERa
aHemşirelik Bölümü, Cerrahi Hastalıkları Hemşireliği AD, Sivas Cumhuriyet Üniversitesi
Sağlık Bilimleri Fakültesi, Sivas, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2019;11(1):68-73
doi: 10.5336/nurses.2018-61888
Article Language: TR
Full Text
ÖZET
 Obezite; alınan enerjinin, harcanan enerjiden fazla olması sonucu vücuttaki lipit oranının artması ile ortaya çıkan kronik ve global bir hastalıktır. Obezite daha çok beden kitle indeksi parametresi ile tanımlanmaktadır. Beden kitle indeksinin 40 kg/m2 ve üzerinde olması morbid obezite olarak da tanımlanmaktadır. Obezitenin tedavisinde diyet, egzersiz, medikal tedavi ve cerrahi tedavi gibi birçok yöntem kullanılmaktadır. Morbid obezitenin tedavisinde en etkili yöntem ise bariatrik cerrahidir. Bariatrik cerrahinin farklı türleri bulunmaktadır. Bariyatrik cerrahinin son zamanlarda popüler hâle gelmesi bariyatri hastalarına bakım veren hemşirelere de oldukça önemli sorumluluklar yüklemektedir. Bariyatrik cerrahi diğer cerrahi işlemler sonrası verilmesi gereken bakıma ek olarak, oluşabilecek komplikasyonlara yönelik de özel bir bakım gerektirmektedir. Bu nedenle hemşirelerin bariyatrik cerrahi sonrası oluşabilecek komplikasyonları bilmeleri ve bu komplikasyonları önlemek için doğru girişimlerde bulunmaları oldukça önemlidir. Bu komplikasyonlar cerrahi işlem sonrası oluşum süresine göre erken ve geç dönemde meydana gelmektedir. Erken dönem komplikasyonları anostomoz kaçağı, intra-abdominal enfeksiyonlar, bulantıkusma ve dumping sendromudur. Bariyatrik cerrahinin geç dönem komplikasyonları ise emilim bozuklukları, insizyonel herni, kolelitiyazis ve renal hastalıklardır. Bu komplikasyonlar çoğu zaman yaşamsal önem taşımaktadr. Kaliteli bir hemşirelik bakımı ile bu komplikasyonların neredeyse tamamı önlenebilmektedir. Bu çalışmada, bariyatrik cerrahi sonrası erken ve geç dönem oluşabilecek komplikasyonların ve bu komplikasyonları önlenmesinde hemşirenin görevlerinin incelenmesi amaçlanmıştır.

Anahtar Kelimeler: Bariyatrik cerrahi; komplikasyonlar; hemşirelik bakımı
ABSTRACT
 Obesity; is a chronic and global disease that is caused by an increase in the amount of energy consumed and an increase in the proportion of the lipid in the resultant body. Obesity is mostly defined by the body mass index parameter. The body mass index of 40 kg/m2 and above is also defined as morbid obesity. Obesity is treated by many methods such as diet, exercise, medical treatment, and surgical treatment. The most effective method for the treatment of morbid obesity is bariatric surgery. There are different types of bariatric surgery. With the recent popularity of bariatric surgery, nurses who care for bariatric patients also have considerable responsibilities. Bariatric surgery requires special care for the complications that may occur in addition to the need to be given after other surgical procedures. For this reason it is very important that the nurses know the complications that may occur after bariatric surgery and make the right attempts to prevent these complications. These complications occur in the early and late period according to the duration of the postoperative period. Early complications include anastomotic leakage, intra-abdominal infections, nausea and vomiting, and dumping syndrome. Late complications of bariatric surgery are impairment disorders, incisional hernia, cholelithiasis, and renal diseases. Although these complications are often vital, almost all of them can be prevented with quality nursing care. This review includes the complications that may occur early and late after bariatric surgery and the tasks of the nurse to prevent these complications.

Keywords: Bariatric surgery; complications; nursing care
REFERENCES:
  1. Bult MJ, van Dalen T, Muller AF. Surgical treatment of obesity. Eur J Endocrinol. 2008;158(2):135-45. [Crossref] [PubMed]
  2. Schirmer B, Schauer PR. The surgical management of obesity. In: Brunicardi F, Brandt M, Andersen D, Billiar T, Dunn D, Hunter JG, et al. Schwartz?s Principles of Surgery. 9th ed. McGraw Hill Professional; 2010. p.949-78.
  3. Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547-59. [Crossref] [PubMed]
  4. Barth MM, Jenson CE. Postoperative nursing care of gastric bypass patients. Am J Crit Care. 2006;15(4):378-87. [PubMed]
  5. Saber AA, Elgamal MH, McLeod MK. Bariatric surgery: the past, present, and future. Obes Surg. 2008;18(1):121-8. [Crossref] [PubMed]
  6. Sağlam F, Güven H. [Surgical treatment of obesity]. Okmeydanı Tıp Dergisi. 2014;30(Ek Sayı 1):60-5.
  7. Mechanick JI, Kushner RF, Sugerman HJ, Gonzalez-Campoy JM, Collazo-Clavell ML, Guven S, et al. American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4(5 Suppl):S109-84. [Crossref] [PubMed]
  8. Powell MS, Fernandez AZ Jr. Surgical treatment for morbid obesity: the laparoscopic Roux-en-Y gastric bypass. Surg Clin North Am. 2011;91(6):1203-24. [Crossref] [PubMed]
  9. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5(4):469-75. [Crossref] [PubMed]
  10. Brethauer SA, Harris JL, Kroh M, Schauer PR. Laparoscopic gastric aplication for treatment of severe obesity. Surg Obes Relat Dis. 2011;7(1):15-22. [Crossref] [PubMed]
  11. Tice JA, Karliner L, Walsh J, Petersen AJ, Feldman MD. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med. 2008;121(10):885-93. [Crossref] [PubMed]
  12. Suter M, Calmes JM, Paroz A, Giusti V. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16(7):829-35. [Crossref] [PubMed]
  13. Sudan R, Jacobs DO. Biliopancreatic diversion with duodenal switch. Surg Clin North Am. 2011;91(6): 1281-93. [Crossref] [PubMed]
  14. Tessier DJ, Eagon JC. Surgical management of morbid obesity. Curr Probl Surg. 2008;45(2):68-137. [Crossref] [PubMed]
  15. Harrington L. Postoperative care of patients undergoing bariatric surgery. Medsurg Nurs. 2006;15(6):357-63. [PubMed]
  16. Grindel ME, Grindel CG. Nursing care of the person having bariatric surgery. Medsurg Nurs. 2006;15(3):129-45. [PubMed]
  17. Wittmann DH. Staged abdominal repair: development and current practice of an advanced operative technique for diffuse suppurative peritonitis. Acta Chir Austriaca. 2000;32(4):171-8.
  18. Başoğlu ÖK, Bacakoğlu F, Ersin S, Erikoğlu M, Köse T. [The relationship of preoperative parameters with the risk of postoperative pulmonary complication in upper abdominal surgery]. Toraks Dergisi. 2000;2: 17-22.
  19. Sweis I, Yegiyants SS, Cohen MN. The management of postoperative nausea and vomiting: current thoughts and protocols. Aesthetic Plast Surg. 2013;37(3):625-33. [Crossref] [PubMed]
  20. Rüsch D, Eberhart LH, Wallenborn J, Kranke P. Nausea and vomiting after surgery under general anesthesia: an evidence-based review concerning risk assessment, prevention, and treatment. Dtsch Arztebl Int. 2010;107(42):733-41. [PubMed] [PMC]
  21. Aygin D. [Nausea and vomiting]. Yoğun Bakım Hemşireliği Dergisi. 2016;20(1):44-56.
  22. Shuster MH, Vázquez JA. Nutritional concerns related to Roux‐ en‐Y gastric bypass: what every cli nician needs to know. Crit Care Nurs Q. 2005;28(3):227-60. [Crossref] [PubMed]
  23. Elliot K. Nutritional considerations after bariatric surgery. Crit Care Nurs Q. 2003;26(2):133-8. [Crossref] [PubMed]
  24. Bloomberg RD, Fleishman A, Nalle JE, Herron DM, Kini S. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145-54. [Crossref] [PubMed]
  25. De Prisco C, Levine SN. Metabolic bone disease after gastric bypass surgery for obesity. J Med Sci. 2005;329(2):57-61. [Crossref]
  26. Aksoy E, Çakmak A, Orozakunov E, Gürel M. [Evaluation of mesh fixation strength after placement of polypropylene mesh secured using polypropylene suture, titanium stapler and nitinol anchors]. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2009;62(1):39-43. [Crossref]
  27. Kalan I, Yeşil Y. [Chronic diseases associated with obesity]. Diyabet ve Obezite. 2010;(23-24):78 81.
  28. Yüksel A. [Cholelithiasis nutritional relationship and diet principles]. Güncel Gastroentereloji. 2016;20(3): 327-30.
  29. Freeman JB, Meyer PD, Printen KJ, Mason EE, DenBesten L. Analysis of gallbladder bile in morbid obesity. Am J Surg. 1975;129(2):163-6. [Crossref]
  30. Sioka E, Zacharoulis D, Zachari E, Papamargaritis D, Pinaka O, Katsogridaki G, et al. Complicated gallstones after laparoscopic sleeve gastrectomy. J Obes. 2014;2014: 468203. [Crossref] [PubMed] [PMC]
  31. Stokes CS, Gluud LL, Casper M, Lammert F. Ursodeoxycholic acid and diets higher in fat prevent gallbladder stones during weight loss: a metaanalysis of randomized controlled trials. Clin Gastroenterol Hepatol. 2014;12(7):1090-100.e2. [Crossref] [PubMed]
  32. Lieske JC, Kumar R, Collazo-Clavell ML. Nephrolithiasis after bariatric surgery for obesity. Semin Nephrol. 2008;28(2):163-73. [Crossref] [PubMed] [PMC]
  33. Semins MJ, Asplin JR, Steele K, Assimos DG, Lingeman JE, Donahue S, et al. The effect of restrictive bariatric surgery on urinary stone risk factors. Urology. 2010;76(4):826-9.[Crossref] [PubMed]
  34. Özer C, Eğilmez T. [Bariatric surgery and urinary stone disease]. J Clin Anal Med. 2016;7(3):285-8.
  35. Puzziferri N, Blankenship J, Wolfe BM. Surgical treatment of obesity. Endocrine. 2006;29(1):11-9. [Crossref]

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com