Justin D Poling, MD, Scott Cassie, MD, FRCPSC, Andrew Smith, MD, FRCPSC. NOSM
OBJECTIVE: To combat the obesity epidemic in Northwestern Ontario, the Ontario Bariatric Network has recently created a Bariatric Centre of Excellence in Thunder Bay, Ontario. This is a remote northern tertiary hospital housing two dedicated fellowship trained bariatric surgeons and is a unique practice model in Canada. Our aim was to complete a review of the first two years (251 cases) in this practice to analyze short term outcomes to determine whether it is safe and feasible to offer minimally invasive bariatric surgery in this setting so as to meet the standards of a Bariatric Centre of Excellence.
METHODS AND PROCEDURES: An observational case series examining the first two years of the bariatric surgery practice in Thunder Bay, Ontario was undertaken via retrospective chart review. All patients taken to the OR for a bariatric surgery procedure in the 2014 and 2015 calendar years were included. Primary outcomes measured were 30-day morbidity and mortality. Secondary outcomes included length of stay in hospital and operating time. A patient database was also collected to assess patient demographics and the presence of obesity related comorbidities.
RESULTS: During the study period a total of 251 patients were taken to the OR for bariatric procedures; 163 (64.9%) received gastric bypass with Roux-en-Y reconstruction while 84 (33.5%) received sleeve gastrectomy. There were no deaths, and 4 (1.6%) procedures were aborted without completion. There was a single readmission for an unrelated issue; this was promptly resolved. There were 4 (1.6%) patients taken back to the OR, 3 (1.2%) of which were for intra-abdominal bleed; all were ultimately discharged home without major complication. There were zero anastomotic leaks. Mean length of stay was 2.12 days. Mean OR times were 104 and 76 minutes for bypass and sleeve gastrectomy respectively. Patients were predominantly female (87.3%), mean patient age was 45.3 years and mean pre-operative BMI was 47.3kg/m2 (range 36.3-67.5). Obesity associated medical comorbidities included diabetes mellitus (25.5%), hypertension (43.8%), obstructive sleep apnea (35.1%), GERD (50.2%), coronary artery disease (2%), dyslipidemia (29.5%) and osteoarthritis (36.7%).
CONCLUSIONS: Based on our results we believe that high quality minimally invasive bariatric surgery can be offered in a remote northern setting to the standards of a Bariatric Centre of Excellence in a safe and effective manner. Further data will be required to assess long-term outcomes.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78941
Program Number: P572
Presentation Session: Poster (Non CME)
Presentation Type: Poster
