BACKGROUND: Rhabdomyolysis is a potential threat after bariatric surgey. The severity ranges from asymptomatic elevations of serum muscle enzyme levels to life-threatening cases associated with muscle necrosis, compartment syndrome, acute renal failure and cardiac arrest. METHODS: We studied 98 consecutive obese patients who underwent primary uncomplicated bariatric surgery during a 1-year period. A database was created for all patients (sex, age, BMI, duration of the operation); serum creatinine phosphokinase (CPK) was systematically measured before surgery and on the first and second postoperative day. RESULTS: The study sample consisted of 35 males (35.7%) and 63 females (64.3%) with preoperative CPK level 156.6 +/- 41.1 U/L (40 to 220), 24 hours postoperatively 1,075.2 +/- 596.5 U/L, (85 to 2,790 U/L) and 48 hours postoperatively 967.3 +/- 545.3 U/L (79 to 2,630). There was no difference in mean BMI (P=0.1) and mean duration of operation (P=0.5) between males and females. However, a statistically significant difference in mean elevation of CPK between males and females (P=0.003) was found. The variables sex, age, weight and duration of surgery were analyzed by multivariate logistic regression, but did not show a statistically significant difference. CONCLUSION: Rhabdomyolysis is a potentially fatal complication of surgical procedures in obese patients, and can be minimized with simple measures such as additional padding, aggressive hydration and urine alkalinization. Diagnosis requires a high level of physician awareness.
BACKGROUND: Rhabdomyolysis is a potential threat after bariatric surgey. The severity ranges from asymptomatic elevations of serum muscle enzyme levels to life-threatening cases associated with muscle necrosis, compartment syndrome, acute renal failure and cardiac arrest. METHODS: We studied 98 consecutive obesepatients who underwent primary uncomplicated bariatric surgery during a 1-year period. A database was created for all patients (sex, age, BMI, duration of the operation); serum creatinine phosphokinase (CPK) was systematically measured before surgery and on the first and second postoperative day. RESULTS: The study sample consisted of 35 males (35.7%) and 63 females (64.3%) with preoperative CPK level 156.6 +/- 41.1 U/L (40 to 220), 24 hours postoperatively 1,075.2 +/- 596.5 U/L, (85 to 2,790 U/L) and 48 hours postoperatively 967.3 +/- 545.3 U/L (79 to 2,630). There was no difference in mean BMI (P=0.1) and mean duration of operation (P=0.5) between males and females. However, a statistically significant difference in mean elevation of CPK between males and females (P=0.003) was found. The variables sex, age, weight and duration of surgery were analyzed by multivariate logistic regression, but did not show a statistically significant difference. CONCLUSION: Rhabdomyolysis is a potentially fatal complication of surgical procedures in obesepatients, and can be minimized with simple measures such as additional padding, aggressive hydration and urine alkalinization. Diagnosis requires a high level of physician awareness.
Authors: João E M T M Ettinger; Carlos A Marcílio de Souza; Paulo V Santos-Filho; Euler Azaro; Carlos A B Mello; Edvaldo Fahel; Paulo B P Batista Journal: Obes Surg Date: 2007-04 Impact factor: 4.129
Authors: Leonardo Dornas de Oliveira; Marco Túlio C Diniz; Maria de Fátima H S Diniz; Alexandre L Savassi-Rocha; Sarah T Camargos; Francisco Cardoso Journal: Obes Surg Date: 2008-12-19 Impact factor: 4.129
Authors: João E M T M Ettinger; Carlos A Marcílio de Souza; Euler Azaro; Carlos A B Mello; Paulo V Santos-Filho; Juliana Orrico; Rodolfo C Santana; Paulo Amaral; Edvaldo Fahel; Paulo Benigno P Batista Journal: Obes Surg Date: 2008-03-29 Impact factor: 4.129