Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Abstract Background Bariatric surgery in super-super-obese (SSO) patients remains a continuous challenge due to intraabdominal fat masses, higher liver volume and existing comorbidities. A convenient procedure in SSO patients is one anastomosis gastric bypass (OAGB). The aim of this study was to compare the outcome of SSO patients undergoing OAGB in comparison to laparoscopic sleeve gastrectomy (LSG). Methods We retrospectively reviewed data from SSO patients who underwent OAGB and LSG in our institution between 2008 and 2020. Primary endpoints included percentage total body weight loss and percentage BMI loss at 12, 24, and 36 months after the operation. Secondary endpoints were perioperative complications, procedure length, length of hospital stay and outcome of comorbidities. Results 243 patients were included in this study. 93 patients underwent LSG and 150 underwent OAGB. At any of the time points evaluated, weight loss in patients after OAGB was greater than in LSG patients, while procedure length was significantly shorter for OAGB than LSG (81.4 vs. 92.1 min, p-value < 0.001). Additionally, mean length of hospital stay was shorter in the OAGB group (3.4 vs. 4.5 days, p-value < 0.001). There were more severe complications (Clavien-Dindo ≥ 3a) in the LSG group (11.8% vs 2.7%, p-value = 0.005). Conclusion In this retrospective analysis, OAGB was superior to LSG in terms of weight loss in SSO patients. Procedure length and hospital stay were shorter after OAGB in comparison to LSG and there were fewer severe complications. OAGB can therefore be regarded a safe and effective treatment modality for SSO patients.

Download Full-text

Risk factors for complications of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

International Journal of Surgery ◽

10.1016/j.ijsu.2016.12.012 ◽

2017 ◽

Vol 37 ◽

pp. 71-78 ◽

Cited By ~ 18

Author(s):

Piotr Major ◽

Michał Wysocki ◽

Michał Pędziwiatr ◽

Magdalena Pisarska ◽

Jadwiga Dworak ◽

...

Keyword(s):

Risk Factors ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy

Download Full-text

A prospective observational study investigating postoperative hemorrhage after laparoscopic sleeve gastrectomy using Bipolar Seal and Cut Caiman® (Aesculap AG)

International Surgery ◽

10.9738/intsurg-d-20-00013.1 ◽

2021 ◽

Author(s):

Clara Boeker ◽

Frank Brose ◽

Martina Mall ◽

Julian Mall ◽

Christian Reetz ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Hospital Stay ◽

Laparoscopic Sleeve Gastrectomy ◽

Revisional Surgery ◽

Length Of Hospital Stay ◽

Operation Time ◽

Postoperative Hemorrhage ◽

Bleeding Complications ◽

Average Hospital ◽

Vessel Sealing

Introduction Postoperative hemorrhage (POH) is the second most important acute complication following laparoscopic sleeve gastrectomy (LSG), with staple line leakage being the first. POH is reported in up to 5% of cases after LSG. Sufficient vessel sealing is crucial in avoiding later complications of POH during mobilization. This study investigated bleeding complications after LSG using the Advanced Bipolar Seal and Cut instrument Caiman 5 by Aesculap AG. Methods All LSG´s were performed using the Caiman 5 (Aesculap AG). Primary outcome was the incidence of POH, defined as the need for revisional surgery and/or blood transfusions. Secondary outcomes were hemoglobin levels preoperatively at the day of surgery (POD 0) and at postoperative days (POD) 1 and 2, volume and duration of drainage at POD 0-2, procedure time, and length of hospital stay. Results 100 patients who had undergone LSG from April 2016 to September 2017 were consecutively included in the study. Patients with contraindications to undergo LSG or were not able to give consent were excluded. Four patients needed treatment due to POH, in 3 of them surgery became necessary. Average operation time was 68.5 min, total volume of drainage was 186 ml. The drain stayed in situ for 2.2 days (mean). Average hospital stay was 3.6 days. Discussion/Conclusion In our study group of 100 LSG procedures POH was 4%. Operation time, volume and duration of drainage, length of hospital stay were not prolonged. LSG using Caiman is feasible and shows comparable results to other vessel sealing instruments at our center.

Download Full-text

Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Journal of Clinical Medicine ◽

10.3390/jcm11020436 ◽

2022 ◽

Vol 11 (2) ◽

pp. 436

Author(s):

Paulina Głuszyńska ◽

Inna Diemieszczyk ◽

Łukasz Szczerbiński ◽

Adam Krętowski ◽

Piotr Major ◽

...

Keyword(s):

Risk Factors ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Length Of Hospital Stay ◽

Operation Time ◽

Late Complications ◽

P Value ◽

Early Complications ◽

Tertiary Institution ◽

Planning Optimization

Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.

Download Full-text

INCREASED HOSPITAL STAY;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.02.3109 ◽

2019 ◽

Vol 26 (02) ◽

Author(s):

Amir Memon

Keyword(s):

Risk Factors ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

University Hospital ◽

Medical Attention ◽

Prolonged Length ◽

Factors Associated ◽

Duration Of Hospital Stay ◽

Group A ◽

Group B

Objectives: This study aims to scientifically fill the gap and provide the scientific data regarding risk factors associated with prolonged length of hospital stay (PLOS) in children admitted at Isra University Hospital. Study Design: Descriptive case series study. Setting: Pediatric ward of Isra University Hospital Hyderabad. Period: 22 months from February 2016 till November 2017. Material and Methods: All the children having age ≥ one year and less than 10 years hospitalized due to any cause of either gender were enrolled under this study. A proforma was designed comprising of basic demographic variables like age and gender and relevant questions like cause of hospitalization, risk factors associated with PLOS, and duration of hospital stay. All the information was noted in proforma and analyzed using SPSS version 17.0. Results: In present study we collected data of 188 children. In group A (age >1 to 5 years) there were 109 children consisted of 57.97% and remaining group B (age >6 years to 10 years) there were 79 children consisted of 42.02%. The overall mean duration of hospital stay with SD was 12.21 ± 3.14. The mean age and SD of group A was 2.33 ± 1.09 years and group B was 7.01 ± 2.39 years. Children with Group A (age ≥1 year to 5 years), Females, late seeking of medical attention, children not responding on medical treatment, and those who get infected during hospitalization were significantly associated with prolonged length of hospital stay (p <0.05). Conclusion: Younger children with age less than 5 years having female predominance and delayed seeking of medical attention were the most significant risk factors associated with PLOS in our population.

Download Full-text

Abstract P160: Contributing Factors to Prolonged Length of Hospital Stay After Readmission Among Patients With Cardiovascular Diseases in Rural Appalachia

Circulation ◽

10.1161/circ.141.suppl_1.p160 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Hadii M Mamudu ◽

Sylvester Orimaye ◽

Manul Awasthi ◽

Arsham Alamian ◽

Liang Wang ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Prolonged Length ◽

Factors Associated ◽

Study Population ◽

Rural Appalachia

Introduction: The Appalachian region has a disproportionate rate of morbidity and mortality related to cardiovascular diseases (CVD), compared to other regions in the United States. Readmission after initial hospitalization for CVD is a major health and economic burden. However, little is known about the factors that contribute to a prolonged length of hospital stay (LOS) after readmission for CVD in rural Appalachia. This study aimed to identify factors associated with prolonged LOS after readmission of patients with CVD in rural Appalachian region. Hypothesis: It is hypothesized that certain demographic and CVD risk factors would be positively and significantly associated with prolonged LOS after readmission of patients with CVD. Methods: Study population consisted of 2,063 patients from Central Appalachia who were diagnosed with ≥1 CVD-related medical comorbidities (diabetes, hypertension, hypercholesterolemia, depressive symptoms, coronary artery disease, stroke, and heart failure) and readmitted between 2010 and 2016 to a large health system. The average LOS was assessed and the Cox Proportional Hazard Ratios (HR) were calculated to identify factors associated with prolonged LOS (defined as a LOS of six or more days) after readmission among CVD patients. The median LOS and probability of prolonged LOS for different sociodemographic risk groups in the study population were calculated. Results: The average LOS was 13.44±45.77 days. A one-year increase in the age of CVD patients tended to increase the risk of prolonged LOS by 0.6% (95% CI: 1.00-1.01; p=0.04). Additionally, being male was found to be associated with increased risk of prolonged LOS (HR: 1.20; 95% CI: 1.08-1.34; p<0.001). Similarly, having at least one CVD related comorbid condition increased the risk of prolonged LOS by 23.3% (95% CI: 1.03-1.47; p=0.02). Our findings also showed that both underweight and obese CVD patients were at 58.2% (95% CI: 0.52-0.65; p<0.0001) and 53.6% (95% CI: 0.50-0.56; p<0.0001) higher risk of having a prolonged LOS, respectively. Conclusions: In conclusion, increasing age, being male, having ≥1 comorbidities of CVD, and being underweight or obese were positively associated with prolonged LOS after hospital readmission in this rural population. These findings suggest that preventing and treating comorbid conditions and CVD risk factors may lower the likelihood of a prolonged LOS after readmission.

Download Full-text