Postoperative complications.
pulmonary embolism, hemorrhagic, BMI loss, hernias, thromboembolism, stenosis
PULMONARY EMBOLISM, INTESTINAL OBSTRUCTIONS, DEEP VENOUS THROMBOSIS, POSTOPERATIVE COMPLICATIONS, DEHISCENCE, COMPLICATION, SURGICAL COMPLICATIONS, ABSCESSES, THROMBOEMBOLISM, STENOSIS, COMPLICATIONS
All patients in G1 received prophylaxis for deep venous thrombosis and pulmonary embolism with 40 mg of Enoxaparin once a day, in the morning. In G2, 42.5% received 40 mg and 57.5% received 60mg of the same drug, once a day. None of the patients received prophylaxis with Enoxaparin every 12 hours. Only one patient in G1 required rehospitalization due to thromboembolism, with good evolution.Neither of the groups reported any occurrence of aponeurotic dehiscence, fistulas, intestinal obstructions, abscesses, or infectious, electrolytic, hemorrhagic, cardiac, and renal complications. No patients included in the study needed reoperation or died during the follow up.Comparing the costs, the differences of the amounts spent between the procedures were basically the costs of the staplers. The stapler plus four loads cost about R$ 2,400.00 for the laparotomy (G1). For the laparoscopic procedure (G2), 8 loads plus the Regarding the costs associated with postoperative complications, G1 required 3 endoscopic dilations due to gastro-jejunal stenosis, adding R$ 2,814.00 (R$ 938,00 per procedure). Besides stenosis, G1 increased the costs with the treatment of incisional hernias, because 7 patients were submitted to herniorrhaphies (R$ 539.92 per surgical procedure plus R$ 400.00 for each prolene mesh 15x15 cm x 7), adding R$ 6,579.44.The only case of thromboembolism that required hospitalization was a patient of the G1, that raised the hospital costs in R$ 521.33. Therefore, the surgical complications of the patients of the G1 raised the hospital costs in R$ 9,914.77. In the G2, only 2 endoscopic dilations due to gastro-jejunal stenosis were required, raising the hospital costs in R$ 1,876.00.In G1, the average time for the discharge was 2.86 postoperative day, generating a cost of R$ 2,350.00 with hospital services, while in G2 it was 2.0 days and the costs, R$ 1,643.33.Comparing the time of absence from work activities, G1 remained on average 49.5 days apart, while G2 remained only 14.5 days. The social security costs supported by the SUS due to the time away from work presented a significant difference (p<0.05) between the groups; whereas G1 spent R$ 24,354.14, the G2 caused no expenses for the time away from activities.The G1 had a substantially higher social security and complication costs totalizing R$ 34,268.91, while G2 summed R$ 1,876.00. Surgical material costs were significantly higher in G2, resulting in a difference of R$ 260,000.00 over G1.About the follow-up of patients in 15-30 days, 2 months, 3 months, 4 months, 6 months, 9 months and 12 months, the result of BMI loss was very similar in both groups.