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Rhabdomyolysis after bariatric surgery by Roux-en-Y gastric bypass: a prospective study.

Abstract：

BACKGROUND:Obesity is a worldwide epidemic associated to comorbidities and increased mortality. Because it is chronic and recurrent and has little response to clinical measures, surgical treatment (bariatric surgery) is a therapeutic option frequently used. Different surgical complications have been associated with this type of procedure, but there is little knowledge about neuromuscular complications. Among the latter, rhabdomyolysis (RML), described a few years ago, has not been well characterized to date. METHODS:We have studied 22 consecutive patients who underwent surgical treatment with open Roux-en-Y gastric bypass (RYGBP) for morbid obesity in a university hospital. A database was created including the following information of each patient: gender, age, body mass index (BMI), comorbidities, surgical time, pre- and postoperative creatine phosphokinase (CPK) dosages, and neuromuscular symptoms after surgery. The main outcome measure was the frequency of RML using CPK dosage after 24 h of surgery. RML was diagnosed as an increase of more than five times the superior limit of normal range of CPK. RESULTS:Fourteen women and eight men were evaluated, with median age of 39.9+/-11.2 years, median BMI of 52.4+/-8.0 kg/m2 and mean surgical time of 253.2+/-51.9 min. The mean value of postoperative CPK was 7,467.7+/-12,177.1 IU/L, being greater than 5,000 IU/L in 40.9% of the patients. RML was diagnosed in 17 (77.3%) patients. No patient had renal failure caused by RML, but there was one death (4.5%) related to abdominal infectious complications. Clinical neuromuscular symptoms occurred in 45% of patients, and muscular pain was the most common one, especially in gluteus region. Comparative analyzes between patients without and with RML diagnosis showed that longer surgical time (p=0.005), and occurrence of neuromuscular symptoms (p=0.04) were more common in the latter. CONCLUSION:The results of this study are similar to few other investigations and confirm that RML in open bariatric surgery with RYGBP (Capella) is a common complication. A longer surgical time can be involved in RML pathogenesis, and muscular pain is suggestive of RML occurrence.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

de Oliveira LD,Diniz MT,de Fátima H S Diniz M,Savassi-Rocha AL,Camargos ST,Cardoso F

doi

10.1007/s11695-008-9780-8

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

1102-7

issue

eissn

0960-8923

issn

1708-0428

journal_volume

pub_type

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Rhabdomyolysis after bariatric surgery by Roux-en-Y gastric bypass: a prospective study.