Georgios Orthopoulos, MD, PhD, Partha Bhurtel, MBBS, Christopher Worgul, MD, Megan Goulard, NP, Anthony McCluney, MD, FACS, FASMBS, Nicole Pecquex, MD, FASMBS. St. Elizabeth’s Medical Center
Introduction: Nausea and vomiting is a common complication after laparoscopic sleeve gastrectomy (LSG). We evaluated the potential benefit of performing an omentopexy to the greater curvature of the stomach as a method of reducing these symptoms postoperatively.
Methods: This is a retrospective cohort study of 132 patients that underwent LSG with and without omentopexy between 10/2014-8/2015 at a single hospital. Only patients that had follow up visits up to one year postoperatively were included in the final analysis (n=130). Of these, 57 patients underwent omentopexy (Group 1) and 73 didn't (Group 2). The two groups were compared in regards to postoperative nausea requiring medical attention and other nausea-related outcomes (anti-nausea medication doses, emergency room (ER) visits and hospital readmissions). Statistical methods included t-test and x2-test, used as appropriate. p<0.05 was considered statistically significant.
Results: Patients that underwent omentopexy at the time of LSG were comparable in age, pre- and post-operative BMI, intraoperative and major postoperative complications. Groups 1 and 2 did not differ in postoperative nausea rates (21.05% vs 19.18%, respectively;p=0.83). The groups required similar total amounts of ondansetron (21.71±17.40mg vs 17.86±16.58mg, respectively;p=0.20) and promethazine (9.87±12.49mg vs 10.00±14.00mg, respectively;p=0.96) during their immediate postoperative hospitalization. Postoperative nausea-related ER visits (17.54% vs 12.33%, respectively;p=0.46) and hospital re-admissions (7.02% vs 6.85%, respectively;p=1.00) within one year of the procedure were also similar between the 2 groups. The above findings persisted after further sub-analysis of only the patients with postoperative nausea requiring medical attention with 12 patients in the omentopexy group (Group 1a) and 14 in the group without omentopexy (Group 2a). Groups 1a and 2a had similar postoperative nausea-related ER visits and hospital readmissions after stratifying for the following postoperative follow-up time periods: <30 days, 30 days-6 months and 6 months-1 year from surgery. Interestingly, no hospital readmissions >30 days from surgery were identified in patients who had undergone omentopexy, although this wasn't statistically significant when compared to those who had not undergone omentopexy (p=0.10).
Conclusion: Our findings indicate that omentopexy at the time of LSG does not significantly reduce postoperative nausea and nausea-related complications. However, no hospital readmissions after 30 days from surgery were noted in patients that had undergone omentopexy at the time of LSG when compared to those who did not. Further studies may elucidate the potential long-term benefit of omentopexy during LSG on postoperative nausea.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79661
Program Number: P532
Presentation Session: Poster (Non CME)
Presentation Type: Poster
