Effect of perioperative management on short-term outcomes after sleeve gastrectomy: a 600-patient single-center cohort study |
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| Affiliation: | 1. Department of Medicine, Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA;2. Sanford School of Public Policy, Duke University, Durham, NC, USA;3. University Hospitals Case Medical Center, Case Western Reserve University, Case Comprehensive Cancer Center, Cleveland, OH, USA;1. Department of Anaesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP-3, New Haven, CT 06510, USA;2. Yale Center for Analytical Sciences, Yale University School of Medicine, 333 Cedar Street, TMP-3, New Haven, CT 06510, USA;3. University of Connecticut, CT, USA;4. Harvey Cushing/John Hay Whitney Medical Library, Yale University School of Medicine, 333 Cedar Street, TMP-3, New Haven, CT 06510, USA;1. Institute of Physical and Organic Chemistry at Southern Federal University, 194/2 Stachka St., 344090 Rostov on Don, Russian Federation;2. Southern Scientific Center of the Russian Academy of Sciences, 41 Chehova Ave., 344006 Rostov on Don, Russian Federation;3. A.N. Nesmeyanov Institute of Organoelement Compounds, 28 Vavilov St., 119991 Moscow, Russian Federation;4. International Tomography Center, Siberian Branch of the Russian Academy of Sciences, 3a Institutskaya St., 630090 Novosibirsk, Russian Federation |
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| Abstract: | BackgroundReports on the postoperative outcomes of sleeve gastrectomy (SG) have only been from small, single-center series and meta-analyses of studies with variable SG management. The objective of this study was to evaluate post-SG outcomes in a specialized bariatric surgery center with a routinely performed standardized procedure.MethodsThe postoperative complication rate, operating times, and postoperative data were evaluated from all patients undergoing a primary SG between November 2004 and February 2012. Results were analyzed for 3 separate surgical periods, which differed with perioperative management.ResultsOf 600 patients (mean age: 41.8±11.3; mean body mass index [BMI]: 47.2±16 kg/m²; 80% were women who underwent primary SG), 26.8% had a BMI≥50 kg/m². The mean operating time was 84 minutes. The rate of conversion was 1%. There were no postoperative deaths. The overall complication rate was 8.5%; the major complication rate was 5.6%; the revisional surgery rate was 4.6% and the gastric leak rate was 2.5%. Over the course of the 3 study periods, the operating time fell from 91±32 to 79±22 minutes (P≤.001); the length of hospital stay decreased from 4.5±4.9 to 3.4±4.3 days (P = .02); the major complication rate fell from 6.4% to 5.5% (P = NS); and the gastric fistula rate decreased from 4.6% to 1.9% (P = NS).ConclusionIn a specialist bariatric surgery center, SG had an acceptable complication rate. Modifications in the perioperative management of SG were associated with a shorter mean operating time and hospital stay and did not increase the major complication or gastric fistula rates. |
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| Keywords: | Laparoscopic sleeve gastrectomy Gastric fistula Complications after sleeve gastrectomy Morbid obesity |
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