Chetna Bakshi, MD, Sara Siskind, MD, Christopher Taglia, MD, Larry Gellman, MD, Dominick Gadaleta, MD. Zucker School of Medicine at Hofstra/Northwell
Background: Laparoscopic sleeve gastrectomy has gained interest in the United States due to its efficacy and relative safety1. Many studies have been done comparing sleeve gastrectomies with other bariatric procedures. High volume centers have developed early recovery protocols to decrease hospital length of stay without increasing morbidity or post-operative re-admissions2. The aim of this study was to demonstrate superior outcomes and lower complication rates at a high volume center for sleeve gastrectomies, using a similar technique.
Methods: A retrospective chart review was undertaken, looking at outcomes after sleeve gastrectomies performed between 2012 and 2017 by three surgeons who utilize a similar technique at a single Bariatric Center of Excellence. All patients who had additional bariatric procedures listed, such as gastric band removal, were excluded. The primary end points were post-operative complications including ICU stay, mortality, and readmission rates.
Results: 812 patients were included in the study with a mean BMI of 45.59 +/- 7.36. Average hospital length of stay was 1.15 +/- 1.19 days for the index hospitalization. None of the patients experienced any intra-operative complications. Only four patients (0.49%) had an ICU admission within 30 days, and there was only one mortality (0.12%). Four patients (0.49%) required discharge to a rehabilitation facility, and four patients (0.49%) experienced dehydration requiring treatment. Twenty patients (2.46%) presented to the ED but only 16 (1.97%) required re-admission, and only 5 of these (0.62%) required an intervention.
Conclusions: The overall complication rate in this study is lower than that described in the literature. The re-admission rate was 1.97%, significantly lower than the 3.8% quoted in previous studies3. Re-admission complications in this study included venous thromboembolic events, wound infections, and dehydration. Notably, no leaks were seen. This study effectively demonstrates that high volume bariatric centers with standardized techniques and protocols can achieve lower complications rates, thus minimizing patient injury and preserving valuable healthcare resources.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95707
Program Number: P098
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster