Prolonged Operation Time Adversely Affects Outcomes in Bariatric Surgery

AbstractMen have been historically considered to be higher-risk patients for bariatric surgery compared to women, the perception of which is suggested to be a barrier to bariatric surgery in men. The purpose of this study is to conduct a matched-pair analysis to evaluate sex disparities in laparoscopic bariatric surgery outcomes. Data on patients who underwent laparoscopic bariatric surgery from March 2013 to 2017 was collected prospectively. Then, 707 men and 707 women pair-matched for age, preoperative body mass index (BMI) and the procedure type (i.e., sleeve gastrectomy, Roux-en-Y, or one-anastomosis gastric bypass) were compared in terms of weight loss, remission of obesity-related comorbidities, and postoperative complications classified according to the Clavien–Dindo classification. There was no difference between the two sexes regarding the operation time, bleeding during surgery and length of postoperative hospital stay. We observed similar total weight loss, BMI loss, and percentage of excess BMI loss at 12, 24, and 36 months postoperatively between men and women, with no difference in remission of diabetes mellitus, hypertension and dyslipidemia at 12 months. The rate of in-hospital, 30-day and late complications according to Clavien–Dindo classification grades was similar between men and women. Our matched-pair cohort analysis demonstrated that bariatric surgery results in comparable short- and mid-term efficacy in men and women, and is associated with similar rate and severity of postoperative complications between sexes. These findings suggest bariatric surgeons not to consider sex for patient selection in bariatric surgery.

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Microendoscopic Discectomy for Lumbar Disc Herniation: Factors for Prolonged Operation Time

Orthopedics & Traumatology ◽

10.5035/nishiseisai.60.295 ◽

2011 ◽

Vol 60 (2) ◽

pp. 295-297

Author(s):

Kuniyoshi Tsuchiya ◽

Kenichi Kawaguchi ◽

Satoshi Kido ◽

Hideya Kawamura

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Operation Time ◽

Prolonged Operation ◽

Microendoscopic Discectomy

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Bile Leakage After Hepatectomy for Liver Tumors

International Surgery ◽

10.9738/intsurg-d-16-00023.1 ◽

2016 ◽

Vol 101 (7-8) ◽

pp. 338-346 ◽

Cited By ~ 2

Author(s):

Takaaki Osawa ◽

Tsuyoshi Sano ◽

Yoshiki Senda ◽

Seiji Natsume ◽

Yasuhiro Shimizu

Keyword(s):

Portal Vein ◽

Preoperative Chemotherapy ◽

Predictive Factors ◽

Liver Tumor ◽

Portal Vein Embolization ◽

Liver Tumors ◽

Operation Time ◽

Bile Leakage ◽

Prolonged Operation ◽

Significant Difference

This study aimed to clarify the predictive factors for bile leakage after hepatectomy for liver tumor in terms of the International Study Group of Liver Surgery (ISGLS) definition. Between August 2006 and July 2012, 242 patients with a diagnosis of liver tumor underwent hepatectomy in our department, and the total bilirubin level of peritoneal drainage fluid prior to removal of the abdominal drains was examined. The data on all of the patients were analyzed retrospectively to identify the factors that might significantly affect the postoperative bile leakage. There was no grade C bile leakage, and grade A was documented in 65 patients (26.9%) and grade B in 7 patients (2.9%) in terms of the ISGLS definition. Although there was no significant difference in postoperative hospital stay between grade A bile leakage only and those without bile leakage (P = 0.933), a significant difference was noted between grades A and B (median, 11.0 versus 21.0 days; P < 0.001). Multivariate analysis revealed 4 independent significant predictive factors: prolonged operation time (P = 0.040), cholecystectomy (P = 0.048), non–portal vein embolization (P = 0.010), and preoperative chemotherapy (P = 0.021). The ISGLS definition of bile leakage is clinically useful. Prolonged operation time, cholecystectomy, non–portal vein embolization, and preoperative chemotherapy were significant independent risk factors of bile leakage in this study.

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Is Prolonged Operation Time a Predictor for the Occurrence of Complications in Ureteroscopy?

Urologia Internationalis ◽

10.1159/000367811 ◽

2015 ◽

Vol 95 (1) ◽

pp. 33-37 ◽

Cited By ~ 7

Author(s):

Sophie Knipper ◽

Christian Tiburtius ◽

Andreas J. Gross ◽

Christopher Netsch

Keyword(s):

Retrospective Analysis ◽

Effect Size ◽

Operation Time ◽

Interquartile Range ◽

Complication Rates ◽

Prolonged Operation ◽

Cohen’S D ◽

Level Of Significance ◽

Cohen's D ◽

The Impact

Objective: To determine the impact of duration of ureteroscopy for urolithiasis on complication rates (CRs) of the procedure. Methods: A retrospective analysis of 2,010 patients, treated between 2006 and 2011, was done. The operation time (OT) and the occurrence of complications were compared. Results: The overall CR was 14.3% [298 complications, minor complications (Clavien I-II) 91.7%]. The median OT was 35 min [interquartile range (IQR) 20-61]. The OT differed significantly between those without complications [34 min (IQR 20-60)] and those with complications [45 min (IQR 25-76)] (p < 0.0001). The correlation between the OT and the occurrence of complications (r = -0.009648, p < 0.0001) was very weak and passed the level of significance (r = 0.2). The effect size was of minor relevance (Cohen's d = 0.27972). Conclusions: Longer OT correlates significantly with a higher CR. The effect is however shown to be minor and the overall rate of complications, especially severe ones, is low.

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