Artur Kacprzyk1, Magdalena Pisarska, MD2, Tomasz Stefura1, Piotr Malczak, MD2, Marcin Dembinski, MD, PhD2, Jakub Dros1, Katarzyna Chlopas1, Michal Wysocki, MD2, Michal Pedziwiatr, MD, PhD2, Andrzej Budzynski, MD, PhD2, Piotr Major, MD, PhD2. 1Students’ Scientific Group at 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland, 22nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
Introduction: Laparoscopic Sleeve Gastrectomy (LSG) is one of the most frequently performed bariatric procedures worldwide. Preoperative knowledge concerning risk factors of potential intraoperative difficulties may help to predict outcomes and influence the operative approach.
Aim of the study: Our purpose was to identify potential risk factors of intraoperative difficulties during LSG.
Material and methods: The analysis included consecutive patients who underwent LSG between December 2009 and April 2017. Patients with intraoperative difficulties were submitted to Group 1, patients without intraoperative difficulties to Group 2. Demographic parameters were assessed for potential risk factors of intraoperative difficulties. Length of stay (LOS) and complication rate were also analysed.
Results: Group 1 consisted of 37 (11.71%) and Group 2 of 279 (88.29%) patients. Besides rates of diabetes, pulmonary disease and sleep apnea, which were higher in group 1, there were no statistical differences between the groups based on demographic parameters. Univariate logistic regression found that risk factors affecting intraoperative difficulties included BMI >45 kg/m2 (OR 2.15, 95% CI 1.05-4.39, p=0.0362), experience of operating surgeon (OR 9.22, 95% CI 4.31-19.72, p=0.0058), incidence of diabetes (OR 2.44, 95% CI 1.19-4.98, p=0.0146) or pulmonary disease (OR 12.22, 95% CI 1.97-75.75, p<0.0001). In the multivariate logistic regression model only experience of operating surgeon (OR 8.61, 95% CI 3.75-19.72, p<0.0001) remained significant factor affecting intraoperative difficulties.
Conclusions: The only significant factor contributing to the incidence of intraoperative difficulties is the experience of the surgeon.
Keywords: sleeve gastrectomy, intraoperative difficulties, risk factors, postoperative complications
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94656
Program Number: P113
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster