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Role of Preoperative Upper Gastrointestinal Endoscopy in Preventing postoperative Upper Gastrointestinal Bleed in

A K Setya1, Y Mehta, M Kshatriya

  • 1Department of Gastroenterology, Anaesthesiology and Cardiac Surgery, Escorts Heart Institute and Research Centre, New Delhi, India.

Annals of Cardiac Anaesthesia
|September 12, 2007
PubMed

Insights

Preoperative upper gastro-intestinal endoscopy significantly reduces postoperative bleeding in coronary artery bypass graft patients. Screening identified and treated lesions, preventing complications and shortening hospital stays.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Surgical Outcomes

Background:

  • Postoperative upper gastro-intestinal (UGI) bleeding is a significant risk following coronary artery bypass graft (CABG) surgery.
  • Pre-existing UGI mucosal lesions may contribute to postoperative bleeding events.

Purpose of the Study:

  • To evaluate the efficacy of preoperative upper gastro-intestinal endoscopy in preventing postoperative UGI bleeding in CABG patients.
  • To compare the incidence of postoperative UGI bleeding and hospital stay between patients screened preoperatively and a historical control group.

Main Methods:

  • A prospective study (Group A) of 103 CABG patients undergoing preoperative UGI endoscopy.
  • Identification and treatment of significant UGI lesions with Omeprazole, followed by check endoscopy.
  • Retrospective analysis of 1274 patients (Group B) for postoperative UGI bleed incidence.

Main Results:

  • 51.5% of Group A patients had significant UGI lesions; 20.4% had severe lesions requiring treatment.
  • No postoperative UGI bleeds occurred in Group A (n=103) versus 42 bleeds in Group B (n=1274).
  • Group A showed a statistically significant lower incidence of postoperative UGI bleed and a shorter hospital stay for bleeding patients compared to Group B.

Conclusions:

  • Preoperative UGI endoscopy is a valuable tool for identifying and managing pre-existing UGI lesions before CABG surgery.
  • Screening and treatment significantly reduce the risk of postoperative UGI bleeding and associated hospital stay.
  • This proactive approach enhances patient safety and optimizes surgical outcomes in CABG patients.

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