Impact of a severe complication two years after laparoscopic Roux-en-Y gastric bypass: a cohort study from the Scandinavian Obesity Surgery Registry |
| |
| Affiliation: | 1. Stanford University School of Medicine, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Palo Alto, California;2. Stanford University School of Medicine, Department of General Surgery, Adolescent Bariatric Surgery, Palo Alto, California;1. Department of Anesthesiology, Critical Care and Pain Medicine, VA Boston Medical Center, West Roxbury, Massachusetts;2. Department of Anesthesiology, University of Central Florida, St. Augustine, Florida;3. Department of Anesthesiology, Macquarie University Hospital, Sydney, Australia;4. Department of Anesthesiology, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia;5. Department of Surgery, University of South Carolina School of Medicine–Prisma Health, Greenville, South Carolina;6. Department of Surgery, Tufts Medical Center, Boston, Massachusetts;7. Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas;1. Stanford University School of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Palo Alto, California;2. Falmouth, Maine;3. Harvard University Medical School, Massachusetts General Hospital, Department of Pediatric Surgery, Boston, Massachusetts;4. Nationwide Children’s Hospital and The Ohio State University, College of Medicine, Department of Pediatric Surgery, Columbus, Ohio;5. University of Colorado-Anschutz Medical Campus, Department of Surgery, Pediatric Minimally Invasive Bariatric Surgery, Aurora, Colorado;6. Morgan Stanley Children’s Hospital of NY Presbyterian and Columbia University Medical Center, New York, New York;7. Stanford University School of Medicine, Lucile Packard Children’s Hospital, Department of Surgery, Division of Pediatric Surgery, Stanford, California;1. Department of Pediatrics, Baylor College of Medicine, Waco, Texas;2. University of Texas Southwestern Medical School, Department of Pediatrics and Surgery, Dallas, Texas;1. Geisinger Obesity Institute, Danville, Pennsylvania;2. Department of Medical Genetics and Molecular Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania;3. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston. Massachusetts |
| |
| Abstract: | BackgroundAlthough severe complications (SCs) after laparoscopic Roux-en-Y gastric bypass (LRYGB) are rare, they can be devastating for the affected patient.ObjectiveTo access the impact of SCs (Clavien-Dindo ≥3b) 2 years after LRYGB by using a nationwide Swedish cohort of 48,201 primary cases between 2007 and June 2016.SettingUniversity hospital, Sweden.MethodsPatients with SC were matched 1:1 on age, sex, diabetic status, body mass index (BMI), and year of operation to patients without an SC. Weight loss, patient-scored quality of life (QoL), antidepressant use, proton pump inhibitors (PPI) and opioids, and in-hospital care were gathered from 3 national registers.ResultsA total of 1411 (2.9%) patients suffered an SC and 16 (.03%) died. In total, 1403 patients with SC (mean age, 42 yr; female, 75%; with diabetes, 15.7%; mean BMI, 41.9 kg/m2) could be matched. Both groups had a total body weight loss of 32% at 2 years. A lower physical QoL was observed in SCs throughout the study period. Antidepressant, PPI and opioid use was higher among patients with SC, even 2 years after surgery. At this time point, a doubling of oral morphine equivalents (7.3 to 17.0 mg/d) was found in patients with SC compared with prior to surgery. The SC group required more in-hospital care after the initial 30 days (3.8 versus .9 d in the remaining part of the first year).ConclusionAn SC resulted in higher antidepressant, PPI and opioid use as well as higher need for in-hospital care during the first 2 postoperative years. Affected patients should therefore receive special attention during follow up. |
| |
| Keywords: | Complications LRYGB Gastric bypass Co-morbidities Healthcare consumption Roux-en-Y gastric bypass SF-36 Quality of life |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
