• 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
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • 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
      • 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
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • 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
    • COVID-19 Annoucements
    • 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
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The 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
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • 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
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

Volume and Outcome relationship in Bariatric Surgery in the Era of Laparoscopy

Mehraneh D Jafari, MD, Monica T Young, MD, Vinh Q Nguyen, PhD, Brian R Smith, MD, Michael J Stamos, Ninh T Nguyen, MD

University of California, Irvine

INTRODUCTION

The rapid adoption of the laparoscopic approach for bariatric operations over the past decade has been accompanied by an exponential growth in the number of procedures performed annually. Multiple studies have examined the effects of volume on surgical outcomes for bariatric surgery. However, these studies were analyzed in the era of open surgery and the absence of national accreditation centers. It has been shown that volume is an independent predictor of serious complications. Mortality associated with bariatric surgery has decreased tremendously over the past decade. The purpose of this study is to demonstrate the effect of volume on surgical outcomes in bariatric surgery within the era of laparoscopy and national accreditation.

METHODS AND PROCEDURES

Using the Nationwide Inpatient Sample, a retrospective review of elective admission of bariatric surgical cases was conducted between 2006-2010. Patient demographics, comorbidities, serious postoperative morbidity, and in-hospital mortality were reviewed. Outcomes were analyzed according to low volume (LVH, <50 cases), medium volume (MVH, 50-100 cases) and high volume hospitals (HVH, >100 cases). A multivariate analysis was conducted to estimate and test the association of volume on mortality and serious morbidity while controlling for age, gender, hospital factors (teaching, size, and location), comorbidities, and procedure type (stapling and non-stapling). Separate a priori specified models were fit to consider the effect of volume for stapling (gastric bypass and sleeve gastrectomy) and non-stapling procedures (gastric band).

RESULTS

Among the estimated 381,674 cases sampled, 74% of cases were performed in HVH. Gastric bypass and sleeve gastrectomy accounted for 72% of cases. Patient age, gender distribution, race, hospital type and comorbidity score were similar for all groups. Hospital charges were highest in the LVH, while length of stay and anastomotic leak were similar among the three groups. In-hospital mortality was higher in the LVH (0.14%) compared to HVH (0.06%). Using multivariate analysis and controlling for confounding variables, procedures performed in a LVH were associated with 2.9 fold increase in mortality rates (95% CI [1.5, 5.7]; p<0.02) and a 1.3 fold increase in serious morbidity (95% CI [1.2, 1.5]; p<0.01) compared to HVH. Stapling procedures performed in LVH were associated with a 2.9 fold increase in mortality rates (95% CI [1.4, 6.1]; p<0.04) and a 1.3 fold increase in serious morbidity (95% CI [1.1, 1.4]; p<0.01) compared to HVH. Non-stapling procedures performed in LVH are associated with a 1.6 fold increase in mortality rates (95% CI [1.2, 2.2]; p<0.01) compared to HVH.

CONCLUSION

In the era of laparoscopy, hospitals with high case volumes continue to have improved serious morbidity and mortality. We were unable to differentiate if the improved outcomes at high volume centers are related to their higher volume or their status of accreditation as centers of excellence.


Session: Podium Presentation

Program Number: S050

Post Views: 355

Share this:

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

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

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

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

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

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc