Bariatric surgery is as safe as other common operations: an analysis of the ACS-NSQIP

被引：19

作者：

Clapp, Benjamin

Mosleh, Kamal Abi ^{[1
]}

Glasgow, Amy E. ^{[2
]}

Habermann, Elizabeth B. ^{[1
,2
,3
]}

Dayyeh, Barham K. Abu ^{[4
]}

Spaniolas, Konstantinos ^{[5
]}

Aminian, Ali ^{[6
]}

Ghanem, Omar M. ^{[1
,7
,8
]}

机构：

[1] Texas Tech Univ Hlth Sci Ctr, Dept Surg, El Paso, TX USA

[2] Mayo Clin, Dept Surg, Rochester, MN USA

[3] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deliv, Rochester, MN USA

[4] Mayo Clin, Dept Hlth Sci Res, Div Hlth Care Policy & Res, Rochester, MN USA

[5] Mayo Clin, Div Gastroenterol & Hepatol, Rochester, MN USA

[6] Stony Brook Med, Dept Surg, Stony Brook, NY USA

[7] Cleveland Clin, Bariatr & Metab Inst, Dept Surg, Cleveland, OH USA

[8] Mayo Clin, Div Metab & Abdominal Wall Reconstruct Surg, 200 First St SW, Rochester, MN 55905 USA

来源：

SURGERY FOR OBESITY AND RELATED DISEASES | 2024年 / 20卷 / 06期

关键词：

Metabolic and bariatric surgery; Roux-en-Y gastric bypass; Safety and efficacy; Short-term outcomes; Sleeve gastrectomy; PHYSICIAN DECISION-MAKING; COLORECTAL SURGERY; HERNIA REPAIR; READMISSION; MORTALITY; COMPLICATIONS; ASSOCIATION; OUTCOMES;

D O I：

10.1016/j.soard.2023.11.017

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Metabolic and Bariatric Surgery (MBS) is the most effective management for patients with obesity and weight-related medical conditions. Nonetheless, some primary care physicians (PCPs) and surgeons from other specialties are reluctant to refer patients for MBS due to safety concerns. Objectives: To compare the outcomes of patients who underwent MBS with those who underwent other common operations. Setting: American College of Surgeons-National Surgical Quality Improvement Program Methods: Patients who underwent laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB), classified as MBS, were compared to nine frequently performed procedures including hip arthroplasty and laparoscopic cholecystectomy, appendectomy, colectomy, hysterectomy, and hernia repairs, among others. A multivariable logistic regression was constructed to compare outcomes including readmission, reoperation, extended length of stay (ELOS) (.75th percentile or >= 3 days) and mortality. Results: A total of 1.6 million patients were included, with 11.1% undergoing MBS. The odds of readmission were marginally lower in the cholecystectomy (adjusted odds ratio [aOR] = .88, 95% confidence interval (CI) [.85, .90]) and appendectomy (aOR = .88, 95% CI [.85, .90]) cohorts. Similarly, odds of ELOS were among the lowest, surpassed only by same-day procedures such as cholecystectomies and appendectomies. The MBS group had significantly low odds of mortality, comparable to safe anatomical procedures such as hernia repairs. Infectious and thrombotic complications were exceedingly rare and amongst the lowest after MBS. Conclusions: MBS demonstrates a remarkably promising safety profile and compares favorably to other common procedures in the short-term. PCPs and surgeons from other specialties can confidently refer patients for these low -risk, lifesaving operations. (Surg Obes Relat Dis 2024;20:515- 526.) (c) 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

引用

页数：11

共 44 条

[41] The Relationship Between Timing of Surgical Complications and Hospital Readmission [J].