Panniculectomy Surgery For Morbidly Obese
A Clinical Study
In certain circumstances, panniculectomy
is not a cosmetic procedure, but medically necessary to perform indicated
major gynecologic intra-abdominal surgery.
Aims
To present our experience with panniculectomy in morbidly obese women
undergoing major intra-abdominal surgery on a gynecologic oncology service.
Methods
The medical records of 48 morbidly obese women with a large dependent
pannus who underwent major intra-abdominal surgery via a panniculectomy
between May 1990 and October 1999 were reviewed. Data regarding demographics,
concomitant medical conditions, operative indications and results, and
postoperative outcomes were abstracted for analysis.
Results
The mean age was 54.9 years, the mean body mass was 130.2 kg, the mean
height was 1.63 m and the mean Quetelet Index was 49.3 kg/m2. The mean
operating time was 188 min and the mean estimated blood loss was 615 ml.
Two patients suffered intraoperative urologic injuries which were repaired
without sequelae; there were no bowel, vascular or neurologic injuries.
Eighteen patients had a suprafascial wound breakdown (3 complete and 15
superficial) and 15 patients developed an infection. There were no documented
deep venous thromboses, pulmonary emboli or fascial dehiscences. Two patients
died in the postoperative period; one from a myocardial infarction on
Day 2 and one from overwhelming sepsis on Day 76.
Conclusions
Morbid obesity is associated with substantial operative and postoperative
risks. Panniculectomy provides operative exposure with acceptable risks
of complications.
Source:
Pearl ML, Valea FA, Disilvestro PA, Chalas E. Division of Gynecologic
Oncology, Department of Obstetrics, Gynecology and Reproductive Medicine,
Department of Surgery, State University of New York at Stony Brook, Stony
Brook, New York 11794-8091, USA.
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