• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

RISKS OF SLEEVE GASTRECTOMY VERSUS GASTRIC BYPASS AMONG PATIENTS WITH KIDNEY DISEASE

John R Montgomery, MD1, Seth A Waits, MD1, Justin B Dimick, MD, MPH2, Dana A Telem2. 1University of Michigan, Dept Transplant Surgery, 2University of Michigan, Center for Healthcare Outcomes & Policy

Objective: Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) have similar long-term weight-loss and comorbidity-improvement among obese patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD). As such, the decision to proceed with RYGB versus LSG can be controversial and is often left to surgeon and/or patient preference. No published, generalizable data exists about the perioperative risks of these operations. To inform operative decision-making, we performed an analysis of perioperative safety of RYGB versus LSG in obese patients with CKD or ESRD using a national registry capturing >95% of bariatric operations.

Methods: Patients with CKD (creatinine ≥2 mg/dL, but not on dialysis) or dialysis-dependent ESRD who underwent primary, laparoscopic-RYGB or LSG between 2015-2016 were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program participant use file. The primary outcome was a composite variable of death and severe, life-threatening complications within 30-days of operation. Logistic regression was used to compare adverse outcomes between patients who underwent RYGB versus LSG. Subgroup analyses were then performed among CKD and ESRD patients.

Results: During the study period, 2,357 primary, laparoscopic bariatric operations were performed on obese patients with CKD (n=1521, 64.5%) or ESRD (n=836, 35.5%); of these, 1,704 (72.3%) were LSG and 653 (27.7%) were RYGB. After adjusting for patient age, smoking status, hypertension, diabetes, and functional status, there was a trend towards RYGB association with the primary outcome of death or severe, life-threatening complications (6.7vs4.9%), but this was not statistically significant (aOR 1.41[0.96-2.07], p=0.078). Major contributors to the composite primary outcome between RYGB and LSG patients were reoperation (4.0vs3.1%, p=0.3), major infection (1.8vs0.6%, p=0.005), transfusion ≥3 units (1.2vs0.5%, p=0.046), and leak (0.9vs0.4%, p=0.084). In the CKD subgroup, RYGB was associated with progression to renal failure requiring dialysis (2.8vs0.8%, p=0.002), and major infection (2.0vs0.5%, p=0.006). In the ESRD subgroup, RYGB was associated with myocardial infarction (0.7vs0.0%, p=0.033).

Conclusion: In a contemporary cohort of bariatric surgeries, nearly one-third of obese CKD and ESRD patients undergo RYGB. Our analysis shows increased risk of major infection and transfusion ≥3 units among RYGB patients when compared to LSG. Furthermore, CKD patients undergoing RYGB are three times more likely to experience progressive renal failure requiring dialysis. Given the clinical similarity of LSG and RYGB in terms of weight-loss and comorbidity-improvement among CKD and ESRD populations, we strongly recommend LSG as the preferred bariatric surgery unless otherwise contraindicated.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94562

Program Number: P084

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

219

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2019 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons