Defining Global Benchmarks in Bariatric Surgery

Gerö, Dániel; Raptis, Dimitri A.; Vleeschouwers, Wouter; Veldhuisen, Sophie L. van; Martin, Andrés; Xiao, Yao; Galvao, Manoela; Giorgi, Marcoandrea; Benois, Marine; Espinoza, Felipe Sandoval; Hollyman, Marianne; Lloyd, Aaron; Hosa, Hanna; Schmidt, Henner; Garcia-Galocha, José Luis; Vrande, Simon van de; Chiappetta, Sonja; Menzo, Emanuele Lo; Aboud, Cristina Mamédio; Lüthy, Sandra Gagliardo; Orchard, Philippa; Rothe, S.; Prager, Gerhard; Pournaras, Dimitri J.; Cohen, Ricardo; Rosenthal, Raúl J.; Weiner, Rudolf A.; Himpens, Jacques; Torres, Antonio; Higa, Kelvin; Welbourn, Richard; Berry, Marcos; Boza, Camilo; Iannelli, Antonio; Vithiananthan, Sivamainthan; Ramos, Almino Cardoso; Olbers, Torsten; Sepúlveda, Matías; Hazebroek, Eric J.; Dillemans, Bruno; Staiger, Roxane D; Puhan, Milo A.; Peterli, Ralph; Bueter, Marco

doi:10.1097/sla.0000000000003512

Cited by 110 publications

(16 citation statements)

References 50 publications

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“… ** ***** Dallal, 2008 [ 27 ] ** ** *** ******* Garg, 2016 [ 40 ] *** . ** ***** Gero, 2019 [ 41 ] *** . *** ****** Gribsholt, 2016 [ 32 ] *** ** *** ******** Inabnet, 2011 [ 33 ] *** ** ** ******* Kellogg, 2009 [ 26 ] *** .…”

Section: Resultsmentioning

confidence: 99%

“…The indications for readmissions and number of readmissions are presented in Table 6 . Four studies showed indications for readmissions [ 26 , 32 , 40 , 41 ]. The different timepoints of FU have shown similar reasons for readmissions in which abdominal pains, intestinal obstruction, gastrointestinal complaints including nausea and vomiting, and dietary complaints were most common.…”

Section: Resultsmentioning

confidence: 99%

“…The FU for the included studies with data on readmissions was up to 4.2 years post-surgery. Up to one in five patients was readmitted at least once within the first 90 days after surgery [ 23 , 24 , 26 , 28 , 30 , 33 , 34 , 36 , 38 – 41 ]. One-year readmission rate was up to 16.6%, 2-year readmission rate was 29%, and the percentage after 4.2 years of FU was 23.9% [ 29 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…One-year readmission rate was up to 16.6%, 2-year readmission rate was 29%, and the percentage after 4.2 years of FU was 23.9% [ 29 , 31 , 32 ]. Five studies provided an overview of indications for ED visits and readmissions of which abdominal pain, intestinal obstruction, gastrointestinal complaints including nausea and vomiting, and dietary complaints were most common [ 25 , 26 , 32 , 40 , 41 ]. Open surgery, unemployment, being disabled, retirement, Medicaid status, or undergoing surgery at an academic hospital were risk factors for ED visits and readmissions [ 23 , 24 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Long-term Emergency Department Visits and Readmissions After Laparoscopic Roux-en-Y Gastric Bypass: a Systematic Review

et al. 2021

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Purpose There is considerable evidence on short-term outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB), but data on long-term outcome is scarce, especially on postoperative emergency department (ED) visits and readmissions. We aim to systematically review evidence on the incidence, indications, and risk factors of ED visits and readmissions beyond 30 days after LRYGB. Materials and Methods A systematic search in PubMed, Scopus, Embase.com, Cochrane Library, and PsycINFO was performed. All studies reporting ED visits and readmissions > 30 days after LRYGB, with ≥ 50 patients, were included. PRISMA statement was used and the Newcastle-Ottawa Scale for quality assessment. Results Twenty articles were included. Six studies reported on ED visits (n = 2818) and 19 on readmissions (n = 276,543). The rate of patients with an ED visit within 90 days after surgery ranged from 3.9 to 32.6%. ED visits at 1, 2, and 3 years occurred in 25.6%, 30.0%, and 31.1% of patients. Readmissions within 90 days and at 1-year follow-up ranged from 4.1 to 20.5% and 4.75 to 16.6%, respectively. Readmission was 29% at 2 years and 23.9% at 4.2 years of follow-up. The most common reason for ED visits and readmissions was abdominal pain. Conclusion Emergency department visits and readmissions have been reported in up to almost one in three patients on the long-term after LRYGB. Both are mainly indicated for abdominal pain. The report on indications and risk factors is very concise. A better understanding of ED visits and readmissions after LRYGB is warranted to improve long-term care, in particular for patients with abdominal pains.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-term Emergency Department Visits and Readmissions After Laparoscopic Roux-en-Y Gastric Bypass: a Systematic Review

et al. 2021

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“…Etwa 4 % der operierten Patienten werden aufgrund eines postoperativen Problems (Wundinfekt, Thrombose, Lungenembolie, Darmpassageproblematik etc.) innerhalb von 30 Tagen erneut hospitalisiert, die 30-Tage-Letalität beträgt 0,05-0,2 % [8]. Unter Berücksichtigung des anästhesiologischen und chirurgischen Risikoprofils dieser Patientenklientel sind diese Zahlen auch im Vergleich zu anderen viszeralchirurgischen Eingriffen insgesamt sehr niedrig.…”

Section: Komplikationenunclassified

Adipositaschirurgie: Update 2020

Widmer

Büter

Thalheimer

2020

Schweiz. Gastroenterol.

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Zusammenfassung Die Anzahl übergewichtiger und adipöser Patienten steigt weltweit epidemisch an. Neben massiven sozioökonomischen Folgen sehen wir uns mit einer Vielzahl von adipositasassoziierten Begleiterkrankungen konfrontiert, die zum Teil eine massive Belastung für die betroffenen Patienten darstellen. Die Therapie sollte idealerweise so früh wie möglich durch ein interdisziplinäres Team begonnen werden und stufenweise erfolgen. Der konservative Therapieansatz ist jedoch weiterhin längerfristig kaum erfolgreich. Auch wenn in den letzten Jahren einige vielversprechende Medikamente zur Behandlung der Adipositas entwickelt wurden, ist die konservative Therapie für Patienten und Ärzte häufig frustran. Die langfristig erfolgreichste Therapie bleibt daher die bariatrische Chirurgie (operative Eingriffe, die zu einer Reduktion des Körpergewichts führen). In diesem Artikel werden die aktuellen operativen Verfahren der bariatrischen Chirurgie, die postoperativen Ergebnisse sowie die bisher bekannten Wirkungsmechanismen dargestellt.

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Comparison of Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass

Hedberg,

Thorell,

Österberg

et al. 2024

JAMA Netw Open

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ImportanceLaparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) are widely used bariatric procedures for which comparative efficacy and safety remain unclear.ObjectiveTo compare perioperative outcomes in SG and RYGB.Design, Setting, and ParticipantsIn this registry-based, multicenter randomized clinical trial (Bypass Equipoise Sleeve Trial), baseline and perioperative data for patients undergoing bariatric surgery from October 6, 2015, to March 31, 2022, were analyzed. Patients were from university, regional, county, and private hospitals in Sweden (n = 20) and Norway (n = 3). Adults (aged ≥18 years) eligible for bariatric surgery with body mass indexes (BMIs; calculated as weight in kilograms divided by height in meters squared) of 35 to 50 were studied.InterventionsLaparoscopic SG or RYGB.Main Outcomes and MeasuresPerioperative complications were analyzed as all adverse events and serious adverse events (Clavien-Dindo grade &gt;IIIb). Ninety-day mortality was also assessed.ResultsA total of 1735 of 14 182 eligible patients (12%; 1282 [73.9%] female; mean (SD) age, 42.9 [11.1] years; mean [SD] BMI, 40.8 [3.7]) were included in the study. Patients were randomized and underwent SG (n = 878) or RYGB (n = 857). The mean (SD) operating time was shorter in those undergoing SG vs RYGB (47 [18] vs 68 [25] minutes; P &lt; .001). The median (IQR) postoperative hospital stay was 1 (1-1) day in both groups. The 30-day readmission rate was 3.1% after SG and 4.0% after RYGB (P = .33). There was no 90-day mortality. The 30-day incidence of any adverse event was 40 (4.6%) and 54 (6.3%) in the SG and RYGB groups, respectively (odds ratio, 0.71; 95% CI, 0.47-1.08; P = .11). Corresponding figures for serious adverse events were 15 (1.7%) for the SG group and 23 (2.7%) for the RYGB group (odds ratio, 0.63; 95% CI, 0.33-1.22; P = .19).Conclusions and RelevanceThis randomized clinical trial of 1735 patients undergoing primary bariatric surgery found that both SG and RYGB were performed with a low perioperative risk without clinically significant differences between groups.Trial RegistrationClinicalTrials.gov Identifier: NCT02767505

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Defining Global Benchmarks in Bariatric Surgery

Cited by 110 publications

References 50 publications

Long-term Emergency Department Visits and Readmissions After Laparoscopic Roux-en-Y Gastric Bypass: a Systematic Review

Long-term Emergency Department Visits and Readmissions After Laparoscopic Roux-en-Y Gastric Bypass: a Systematic Review

Adipositaschirurgie: Update 2020

Comparison of Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass

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