Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Obezite Cerrahisine Bağlı Ölümlerin Otopsi Bulgularının İncelenmesi: Retrospektif Özgün Araştırma
Investigation of Autopsy Findings of Obesity Surgery Related Deaths: Retrospective Original Research
Ferhat Turgut TUNÇEZa, Gülden ERSENa, Yusuf ATANb, Zafer KARADENİZc, Mehmet TOKDEMİRa
aİzmir Kâtip Çelebi Üniversitesi Tıp Fakültesi, Adli Tıp ABD, İzmir, Türkiye
bAdli Tıp Kurumu Çankırı Şube Müdürlüğü, Çankırı, Türkiye
cAdli Tıp Kurumu İzmir Grup Başkanlığı, İzmir, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2022;19(2):124-8
doi: 10.5336/forensic.2022-88888
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızda, obezite cerrahisi sonrası meydana gelen ölümleri ve otopsi bulgularını yapılan adli otopsiler üzerinden inceleyerek, bu veriler ışığında literatüre katkı sağlamayı amaçladık. Gereç ve Yöntemler: Çalışmamızda, Adli Tıp Kurumu İzmir Grup Başkanlığında 2010-2020 yılları arasında yapılan tüm otopsiler incelenerek, obezite cerrahisi sonrası otopsisi yapılan ölümler çalışmaya dâhil edildi. Elde edilen veriler SPSS 22 programıyla analiz edildi ve incelendi. Bulgular: Adli Tıp Kurumu İzmir Grup Başkanlığınca 2010-2020 yılları arasında yapılan toplam 25.349 otopsiden 7'sinin obezite cerrahisi sonrası otopsi yapıldığı, bunların 5'i sleeve gastrektomi, 1'i Roux-en-Y ve 1'i de total gastrektomi+Roux-en-Y bariyatrik cerrahi operasyonu geçirdiği tespit edildi. Olgularımızın ölüm sebepleri irdelendiğinde; 2 olgunun koroner arter hastalığı sonucunda öldüğü kanaatine varılırken, 1 olgunun bağırsak perforasyonu, 2 olgunun sepsis, 1 olgunun pulmoner emboli ve 1 olgunun superior mezenterik arter embolisi/superior mezenterik ven trombüsü ortak etkisi ile öldüğü tıbbi kanaatine varılmıştır. Sonuç: Postoperatif dönemde meydana gelen ölümler, tıbbi soruların yanı sıra hukuki olarak da malpraktis davaları açısından önemli soruları gündeme getirmektedir. Bu noktada detaylı ve cerrahi branşların da destek vereceği bir adli otopsi ile hukuki ve tıbbi açıdan olası sorular kolaylıkla yanıt bulacak ve uygulanan tıbbi-cerrahi tedavi yöntemlerinin halk sağlığı açısından sorgulanması, fayda-zararlarının tartışılmasıyla elde edilen sonuçlar literatüre katkı sağlayacaktır.

Anahtar Kelimeler: Obezite; bariyatrik cerrahi; otopsi
ABSTRACT
 Objective: In this study, it is aimed to contribute to the literature by examining the deaths and autopsy findings after obesity surgery through forensic autopsies executed. Material and Methods: In this study, all autopsies performed between 2010-2020 years at the Forensic Medicine Institute İzmir Group Presidency were examined and deaths autopsied after bariatric surgery were included in the study. The obtained data were analyzed with the SPSS 22 program. Results: 7 out of 25,349 cases performed in The Council of Forensic Medicine İzmir Group Presidency 2010-2020 were death cases after bariatric surgery in the last decade. The surgeries were 5 sleeve gastrectomy, 1 Roux-en-Y and 1 total gastrectomy+Roux-en-Y bariatric surgery. When the causes of death examined, it was concluded that 2 cases died as a result of coronary artery disease, 1 case died of intestinal perforation, 2 cases because of sepsis, 1 case result of pulmonary embolism and 1 case reasoned of mix effect of superior mesenteric artery embolism and superior mesenteric vein thrombus. Conclusion: Deaths occurring in the post operative period raise important questions in terms of legal malpractice cases, as well as medical questions. Forensic autopsies those will be supported surgical specialists and perfomed causiously, will answer possible legal and medical questions easier. The results obtained by examining the applied medical-surgical treatment methods, in concern of public health and discussing the benefits and harms of these surgeries will contribute to the literature.

Keywords: Obesity; bariatric surgery; autopsy
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