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Master Thesis

Recommandations de bonnes pratiques en préopératoire et postopératoire de la chirurgie bariatrique en France : évaluation des pratiques à partir des données de l’Assurance Maladie

Abstract : Obesity is a major public health problem. Its most effective treatment, bariatric surgery, is more and more frequent. Our retrospective descriptive study looked for the elements within the recommendations of good practices by the High Authority of Health of 2009 for the preoperative and postoperative management of bariatric surgery in France. These data came from reimbursements from the Health Insurance. Our goal was to evaluate the current state of practices in France for the implementation of these recommendations. 11,824 patients were hospitalized for bariatric surgery between January 1st and March 31, 2014: 9,565 women (80.9%) were operated on compared to 2,259 men (19.1%). The average age of intervention was 40.29 years (± 11.81 years). There were 1,249 adjustable gastric bandings, 3,410 gastric bypasses, 24 biliopancreatic diversions and 7,141 sleeve gastrectomies. Before surgery, 75.3% of patients saw a gastroenterologist, 70.2% a cardiologist, 67.7% a pulmonologist and 91.4% performed a biology report of comorbidities. A large majority had a nutritional biology report in pre (94.3%) and postoperative (92.3%) and 83.4% of patients of malabsorptive surgery were supplemented with vitamins in the year of intervention. Upper gastrointestinal endoscopy was reimbursed for 80.6% of patients, a dental assessment for 52.2%. A preoperative beta-HCG assay was found for 7.3% of women of childbearing age. 43.2% of patients used anti-inflammatory drugs after the intervention. Postoperative psychiatric follow-up involved 8.7% of patients while 25% of patients remained on psychotropic treatment. Despite an overall improvement of the practices, the respect of the recommendations still remains perfectible on certain elements. The growing number of operated patients will require appropriatetraining and greater involvement of general practitioners.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01892722
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, October 10, 2018 - 6:50:08 PM
Last modification on : Tuesday, October 23, 2018 - 1:13:39 AM

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Coralie Duffillot. Recommandations de bonnes pratiques en préopératoire et postopératoire de la chirurgie bariatrique en France : évaluation des pratiques à partir des données de l’Assurance Maladie. Médecine humaine et pathologie. 2018. ⟨dumas-01892722⟩

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