Determinants of resource utilization and outcomes in laparoscopic Roux-en-Y gastric bypass: a multicenter analysis of 14,251 patients

Abstract

Age, sex, race, obesity, and some medical comorbidities affect outcomes and increase resource utilization. Optimization of modifiable factors and careful patient selection are needed to facilitate further improvement in outcomes and resource utilization.

Early Outcomes of Roux-en-Y Gastric Bypass in a Publically Funded Obesity Program

“…The mean operating time to perform laparoscopic RYGB in our series was similar to that previously reported in the literature [13, 19, 20, 22, 23]; however, considerable variability exists between studies [18, 24, 25]. Furthermore, a number of studies have suggested that a learning curve exists and influences operating times [13, 25, 26].…”

Bariatric Surgery and Renal Disease

“…Meier-Kriesche et al analyzed the database of over 50,000 renal transplant recipients (1988e1997) from the United States Renal Data System (USRDS) and showed that the relative risk ratio for graft loss was 1.4 times higher in patients with a BMI >36 kg/m 2 , [77]. Preoperative dependence on dialysis has been shown to be one of the strongest predictors of postoperative complications after bariatric surgery [80]. Due to this most transplant centers have set body mass index limits over which patients are not considered eligible for transplant (35 kg/m 2 ).…”

Treating the Obese Dialysis Patient: Challenges and Paradoxes

“…The growing experience with LRYGB has been accompanied by improved outcomes for patients as more cases are treated with this method. However, relevant to this discussion, preoperative dialysis dependence was found to be the biggest risk factor associated with postoperative complications (odds ratio [OR], 8.5; 95% confidence interval [CI], 2.3–32.3) (97). Analysis of complications from National Surgical Quality Improvement Program (NSQIP) revealed that 4 of 12 (33%) patients on dialysis had complications; half of the complications required a return to the operating room within 30 days.…”

“…Analysis of complications from National Surgical Quality Improvement Program (NSQIP) revealed that 4 of 12 (33%) patients on dialysis had complications; half of the complications required a return to the operating room within 30 days. The reasons for renal comorbidities that affect outcomes are unclear, and further studies are needed to confirm these findings (97).…”