Kendra L Young, Samaad Malik, MD, MSc, FRCSC. University of British Columbia
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed weight loss surgeries. Prolonged hospital admissions are associated with both increased morbidity and mortality and increased strain on the health care system; studies are now investigating the safety and feasibility of outpatient LSG. This study examined a single surgeon’s postoperative admission trends for patients who underwent LSG. The patients were divided into two cohorts based on the date of surgery, and we hypothesize institutional experience has a significant impact on postoperative stay and hospital readmission rate.
METHODS: This is a retrospective study on LSGs performed by a single surgeon in a tertiary center from 2012-2017. Inclusion criteria: patients >18 years old, BMI >35 with comorbidities or BMI >40, and patient approval by the Bariatric Surgical Program in Victoria, British Columbia. Patients with prior weight-loss surgery were excluded. Patients were discharged home on a care plan involving: nurse and surgeon telephone follow-ups within one week post-surgery.
Patients were divided into two cohorts: Cohort A (procedures between 2012-2014 inclusive) and Cohort B (procedures between 2015-2017 inclusive).
RESULTS: 323 patients were included in this study: 265 females (82.0%) and 58 males (18.0%). The mean preoperative age was 46.8 ± 10.5 years, and the mean preoperative BMI was 45.4 ± 5.72 kg/m2. The average postoperative discharge day for the population was day 1.69 ± 0.85 and the average OR time was 53.9 ± 20.6 minutes.
One patient in Cohort B was re-admitted POD8 with a diagnosis of postoperative edema managed conservatively and is included in the analysis as POD1. A second patient in Cohort B returned to hospital (POD21) for abdominal pain and was managed conservatively as outpatient.
CONCLUSION: There was a significant difference in the average postoperative discharge day between patients in Cohort A and Cohort B who underwent LSG with patients in Cohort B requiring a shorter average admission time. This study suggests that with increasing institutional experience and a postoperative discharge plan, patients undergoing LSG may be discharged on postoperative day one safely.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87279
Program Number: P674
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster