Early Complications After Laparoscopic Gastric Bypass Surgery

Stenberg, Erik; Szabó, Éva; Ågren, Göran I.; Näslund, Erik; Boman, Lars; Bylund, Ami; Hedenbro, Jan; Laurenius, Anna; Lundegårdh, Göran; Lönroth, Hans; Möller, Peter; Sundbom, Magnus; Ottosson, Johan; Näslund, Ingmar

doi:10.1097/sla.0000000000000431

Cited by 145 publications

(50 citation statements)

References 24 publications

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“…Patients in the FT group were on average a few years older. Previous research has shown that patient with a higher age have an increased risk at postoperative complications [18]. Nonetheless, age turned out not to be a significant predictor after univariate analysis on postoperative complications in the current study.…”

Section: Discussioncontrasting

confidence: 70%

Conventional versus fast track anaesthesia in an unselected group of patients undergoing revisional bariatric surgery

Wezenbeek

Pouwels

Buise

et al. 2015

International Journal of Surgery Open

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Introduction:Fast track care has proven to be safe and effective in primary bariatric procedures. The number of more complex revisional procedures is expected to rise over the next years. The aim was to evaluate the potential benefits and safety of a fast-track protocol in an unselected group of patients undergoing Roux-en-Y Gastric Bypass (rRYGBP) as revision. Method: For this retrospective study, all patients undergoing rRYGBP between January 2005 and December 2013 were included and categorized between conventional care (CC) and fast track care (FT). Patient characteristics, operative details and intra-and early postoperative complications < 30 days were analysed. Results: A total of 407 patients were included for analysis. 303 patients (74.4%) received peri-and postoperative treatment according to the fast track protocol. Mean age of the study population was 44.0 ± 8.9 years; mean pre-primary procedure BMI was 45.7 ± 7.0 kg/m 2 . A total of 54 (13.3%) postoperative complications were registered (CC 19.2% vs FT 11.2%; p = 0.038). Both operative time (CC 135.3 ± 42.6 minutes vs FT 79.3 ± 29.3 minutes; p < 0.001) as well as hospital stay (CC 5.1 ± 6.3 days vs FT 3.1 ± 5.3 days; p < 0.001) were significantly shorter in the FT group. A multivariate analysis on postoperative complications showed that fast track was not predictive for the occurrence of complications (OR = 0.853; 95% CI [0.403-1.804]; p = 0.677). Conclusion:Fast track care appears to be safe and efficient for patients undergoing revisional Rouxen-Y gastric bypass, but postoperative outcome may be highly dependent on surgical experience.

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Section: Discussioncontrasting

confidence: 70%

Conventional versus fast track anaesthesia in an unselected group of patients undergoing revisional bariatric surgery

Wezenbeek

Pouwels

Buise

et al. 2015

International Journal of Surgery Open

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“…More women than men undergo laparoscopic gastric bypass surgery [22], and it is thus important to see if the increased risk for postoperative pain amongst women previously described [5] is, in fact, gender-associated or if there is another explanation. Even though further studies are needed to more fully clarify this matter, the results of the present study indicate that factors other than gender alone are of importance.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Increased Experience of Postoperative Pain after Laparoscopic Gastric Bypass Surgery

et al. 2017

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IntroductionPatients with high body mass index (BMI), pre-existing pain and young age and women seem to experience more postoperative pain. Few studies have, however, addressed these risk factors amongst obese patients undergoing bariatric surgery.The aim of the present study was to evaluate risk factors for postoperative pain following laparoscopic gastric bypass surgery.MethodsIn this cohort study, we used data from the PAIN OUT register for postoperative pain during the first 24 h after surgery. Primary outcome measure was severity of pain after surgery. Multivariate analyses were conducted to evaluate BMI, young age, gender and pre-existing pain as independent risk factors for postoperative pain.ResultsWe included 192 patients in this study. Younger age (B −0.08, 95%CI −0.11 to −0.05/year; p < 0.001), female gender (B 0.92, 95%CI 0.10–1.75; p = 0.029) and pre-existing pain (B 1.06, 95%CI 0.03–2.09; p = 0.044) were all associated with an increased risk for postoperative pain. In the multivariate analyses, only young age ((adjusted OR 0.95, 95%CI 0.92–0.97/year; p < 0.001) and pre-existing pain (adjusted OR 2.56, 95%CI 1.09–6.00; p = 0.031) remained as independent risk factors for severe postoperative pain.ConclusionYounger age and pre-existing pain are associated with severe postoperative pain during the first 24 h after laparoscopic gastric bypass surgery, whereas female gender and high BMI are not.

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“…Mortality related to bariatric surgeries remains below 1% and is approximately 0.3% in international studies. (9-11) Among early complications, the most important include surgical wound infections, anastomosis dehiscence, fistulas, bleeding, venous thromboembolism and incisional hernias. The prevalence of postoperative complications is low, including bleeding in 0.5%, thromboembolism in 0.8% and operative wound complications in 1.8% of cases.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of postoperative complications is low, including bleeding in 0.5%, thromboembolism in 0.8% and operative wound complications in 1.8% of cases. (9-11) …”

Section: Introductionmentioning

confidence: 99%

Immediate postoperative of bariatric surgery in the intensive care unit versus an inpatient unit. A retrospective study with 828 patients

Penna¹,

Vaz²,

Fonseca³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectiveTo compare the incidence of complications and the duration of hospitalization of patients undergoing bariatric surgery admitted to the intensive care unit or a post-surgical hospitalization unit.MethodsThis retrospective observational study included 828 patients admitted between January 2010 and February 2015 during the immediate postoperative period of bariatric surgery in a hospital. Data were collected via electronic medical records. The Mann-Whitney test was used to compare continuous variables, and the chi-square was used to compare categorical variables.ResultsPatients in both groups had similar demographic characteristics, with no significant differences in anthropometric data and comorbidities. There was no significant difference in the comparison of complications between the two groups. However, the group admitted to the intensive care unit had longer hospitalization times (median of 3 days versus 2 days, p < 0.05), and hospital costs were 8% higher.ConclusionThe present study found no benefit in the routine admittance of patients to the intensive care unit after undergoing bariatric surgery. This practice increased hospitalization time and hospital costs, which wasted resources. It is necessary to create objective criteria to identify patients requiring intensive care unit admission after bariatric surgery.

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Early Complications After Laparoscopic Gastric Bypass Surgery

Cited by 145 publications

References 24 publications

Conventional versus fast track anaesthesia in an unselected group of patients undergoing revisional bariatric surgery

Conventional versus fast track anaesthesia in an unselected group of patients undergoing revisional bariatric surgery

Factors Associated with Increased Experience of Postoperative Pain after Laparoscopic Gastric Bypass Surgery

Immediate postoperative of bariatric surgery in the intensive care unit versus an inpatient unit. A retrospective study with 828 patients

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