Role of Preoperative Upper Gastrointestinal Endoscopy in Preventing postoperative Upper Gastrointestinal Bleed in Patients Undergoing CABG.
One hundred and three patients (Group A), mean age 55.81 +/- 8.54 years, 94 males and 9 females, scheduled for coronary artery bypass graft (CABG) surgery were subjected to preoperative upper gastro-intestinal (UGI) endoscopy. 51.5% of these were found to have significant mucosal lesions in the UGI tract. Twenty one (20.4%) had severe lesions which could have bled, warranting postponement of their surgery. All of these 21 were treated with Omeprezole 20 mg / day for a mean of 35.87 +/- 4.64 days and subjected to check endoscopy after the treatment. 16 of these 21 patients were taken up for CABG after the lesions had healed. Five deferred surgery. None of the 103 patients had a postoperative UGI bleed. A retrospective analysis of 1274 patients (group B) was carried out for number of patients (42) having postoperative UGI bleed. The results of group A and group B were then compared. Patients in group A had significant lower incidence of postoperative UGI bleed than those in group B. Postoperative hospital stay in patients of UGI bleed in group B was 24.71 +/- 20.88 (range 8 days - 129 days). In group A it was 14.34 +/- 12.44 days (range 7 days - 88 days). The difference is statistically highly significant. It appears that patients who have postoperative UGI bleed probably bleed from pre existing lesions. We conclude that preoperative UGI endoscopy is a valuable tool in preventing postoperative UGI bleed.
Setya
A K
AK
Department of Gastroenterology, Anaesthesiology and Cardiac Surgery, Escorts Heart Institute and Research Centre, New Delhi, India.
Mehta
Y
Y
Kshatriya
M
M
Trehan
N
N