Vanessa S Falk, MD1, David Pace, MD2, Chris Smith, MD2, Darrell Boone, MD2, Raleen Murphy, NP2, Deborah Gregory, PhD2, Laurie Twells, PhD2. 1Memorial University of Newfoundland, University of Alberta, 2Memorial University of Newfoundland
Bariatric surgery is effective for weight loss and reduction of obesity-related comorbidities. While it has tremendous benefits for patients, weight loss surgery is also associated with significant complications and approximately 0.2% mortality rate. Although guidelines exist as to who qualifies for bariatric surgery, patient risk stratification systems for surgery are lacking. A recent German study suggested that not body mass index (BMI), but rather obesity-related comorbidities influence the rate of post-operative complications. This study reviews the effect of pre-operative obesity-related comorbidities on post-operative 30-day complication rate.
Methods: Data was prospectively collected on patients undergoing laparoscopic sleeve gastrectomy (LSG) between May 2011 and February 2014 at a single bariatric surgery center. These charts were reviewed for patient demographics (age, gender, BMI), obesity-related comorbidities (hypertension, obstructive sleep apnea, diabetes, dyslipidemia, gastroesophageal reflux, cardiovascular disease, osteoarthritis), and 30-day complication and mortality rates. Minor complications were defined as Clavien-Dindo class 2 or less, and major complications as Clavien-Dindo class 3 or higher. Patients were divided into two groups based on number of pre-operative comorbidities. Group A included patients with ≤ 2 obesity-related comorbidities. Group B included patients with ≥3 comorbidities. An independent student t-test for continuous and chi-square test for categorical values were performed to compare patient demographics and 30-day complication rates between these groups. Statistical analysis was performed using SPSS (Version 21).
Results: A total of 209 patients underwent LSG. Group A had 101 patients, 91 females and 10 males with a mean BMI of 49.5 kg/m2 (range 37.7 to 67.4 kg/m2) and mean age 40.7years (range 26-70 years). Group B had a total of 108 patients, 78 females and 30 males, with a mean BMI of 48.9 kg/m2 (range 35.0 to 67.2 kg/m2) and mean age 47years (range 22-67 years). While both groups did not differ in mean BMI, Group B had a higher number of males (30 males, p=0.001) and was older (47.0 years, p<0.001). The 30-day overall complication rate for Group A was 8.1% with 5.1% being minor and 3.0% major (2 leaks, 1 gastric fistula) complications. The overall complication rate for Group B was slightly lower at 7.2% with 6.3% minor and 0.9% major (1 leak) complications (p>0.05). No mortality occurred.
Conclusion: The data shows that males and older patients had greater number of obesity-related comorbidities. The number of preoperative comorbidities did not impact the rate of early post-operative complications following LSG.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78925
Program Number: P511
Presentation Session: Poster (Non CME)
Presentation Type: Poster
