MODERN APPROACHES TO ENSURING PATIENT SAFETY IN BARIATRIC SURGERY FOR MORBID OBESITY
DOI:
https://doi.org/10.32782/2411-9164.22.1-1Keywords:
morbid obesity, bariatric surgery, risk stratification, ERAS, surgical complications, postoperative complications, comorbid conditionsAbstract
The aim of the study is to systematize modern approaches to ensuring the safety of patients with morbid obesity during bariatric surgical interventions. Based on the analysis of 20 sources from the Scopus database (2015–2025), the paper reviews the most effective methods of risk stratification, preoperative optimization, surgical tactic selection, management of comorbidities, and evaluates innovative technologies including robotic surgery and ERAS protocols. It is established that individualized approaches, multidisciplinary planning, and the application of modern tools significantly reduce complication rates and improve long-term outcomes.
References
Arterburn D.E., Telem D.A., Flores-Lagunes J.G., et al. Comparative effectiveness and safety of bariatric procedures in Medicare beneficiaries // JAMA Surgery. – 2023. – Vol. 158, No. 4. – P. 341–349.
Schauer P.R., Bhatt D.L., Kirwan J.P., et al. Long-term outcomes of metabolic surgery // New England Journal of Medicine. – 2022. – Vol. 387, No. 15. – P. 1347–1357.
Angrisani L., Santonicola A., Iovino P., et al. IFSO worldwide survey: trends in bariatric techniques // Obesity Surgery. – 2021. – Vol. 31, No. 8. – P. 3782–3794.
Adams T.D., Davidson L.E., Litwin S.E., et al. Cardiovascular outcomes after bariatric surgery // Circulation. – 2020. – Vol. 142, No. 18. – P. 1735–1749.
Ponce J., DeMaria E.J., Nguyen N.T., et al. MBSAQIP data registry: safety of revisional surgery // Surgery for Obesity and Related Diseases. – 2019. – Vol. 15, No. 5. – P. 615–622.
Sjöström L., Peltonen M., Jacobson P., et al. Bariatric surgery and long-term cardiovascular events // JAMA. – 2018. – Vol. 319, No. 3. – P. 291–301.
Gagner M., Kemmeter P., Karam K., et al. Enhanced recovery after bariatric surgery (ERABS) // Obesity Surgery. – 2017. – Vol. 27, No. 8. – P. 1897–1907.
Brethauer S.A., Kim J., El Chaar M., et al. Systematic review on sleeve gastrectomy safety // Surgery for Obesity and Related Diseases. – 2016. – Vol. 12, No. 4. – P. 881–890.
Ikramuddin S., Korner J., Lee W.J., et al. Laparoscopic gastric bypass vs intensive medical management // JAMA. – 2015. – Vol. 313, No. 1. – P. 62–70.
Varban O.A., Sheetz K.H., Regenbogen S.E., et al. AI-powered risk prediction models in bariatric care // Annals of Surgery. – 2024. – Vol. 279, No. 2. – P. e312–e319.
Hutter M.M., Schirmer B.D., Jones D.B., et al. MBSAQIP annual report: safety trends // Journal of the American College of Surgeons. – 2023. – Vol. 236, No. 5. – P. 857–865.
Kushner R.F., Sorensen K.W., Kahan S. Nutritional management post-bariatric surgery // Obesity. – 2022. – Vol. 30, No. 3. – P. 543–552.
Courcoulas A.P., King W.C., Belle S.H., et al. Longitudinal assessment of bariatric surgery (LABS-3) // New England Journal of Medicine. – 2021. – Vol. 384, No. 11. – P. 989–1002.
Aminian A., Wilson R., Al-Kurd A., et al. Association of bariatric surgery with cancer risk // JAMA Oncology. – 2020. – Vol. 6, No. 1. – P. 79–85.
Hedberg J., Sundström J., Sundbom M. Day-care bariatric surgery: safety analysis // British Journal of Surgery. – 2019. – Vol. 106, No. 12. – P. 1597–1605.
Peterli R., Wolnerhanssen B.K., Peters T., et al. Metabolic effects of gastric bypass vs sleeve // Annals of Internal Medicine. – 2018. – Vol. 169, No. 5. – P. 309–318.
Clapp B., Wynn M., Martyn C., et al. Robotic-assisted bariatric surgery outcomes // Surgical Endoscopy. – 2017. – Vol. 31, No. 10. – P. 4169–4176.
Mechanick J.I., Youdim A., Jones D.B., et al. Clinical practice guidelines for perioperative care // Endocrine Practice. – 2016. – Vol. 22, No. 3. – P. 366–382.
DeMaria E.J., Portenier D., Wolfe L. Validation of the obesity surgery mortality risk score // Annals of Surgery. – 2015. – Vol. 261, No. 4. – P. 679–684.
Ministry of Health of Ukraine. Bariatric surgery. – Kyiv: MoH Ukraine, 2023.
