Outcomes of same-day discharge sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review and meta-analysis

Vanetta, Carolina; Dreifuss, Nicolás H; Angeramo, Cristian A.; Baz, Carolina; Cubisino, Antonio; Schlottmann, Francisco; Masrur, Mario

doi:10.1016/j.soard.2022.09.004

Cited by 23 publications

(7 citation statements)

References 45 publications

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“…The success rate of our study is comparable with results of this study (93% vs 88–98%). Our overall morbidity was higher (9.9 vs. 2.5–4%), but our reoperation rates were lower (1.3% vs 1.9–2.5%) [ 18 ]. This is most likely to our low threshold for readmission, where all readmitted patients were registered as morbidity.…”

Section: Discussionmentioning

confidence: 99%

Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass: a Cohort of 500 Consecutive Patients

et al. 2023

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Introduction There is an increasing demand on hospital capacity worldwide due to the COVID-19 pandemic and local staff shortages. Novel care pathways have to be developed in order to keep bariatric and metabolic surgery maintainable. Same-day discharge (SDD) after laparoscopic Roux-en-Y gastric bypass (RYGB) is proved to be feasible and could potentially solve this challenge. The aim of this study was to investigate whether SDD after RYGB is safe for a selected group of patients. Methods In this single-center cohort study, low-risk patients were selected for primary RYGB with intended same-day discharge with remote monitoring. All patients were operated according to ERAS protocol. There were strict criteria on approval upon same-day discharge. It was demanded that patients should contact the hospital in case of any signs of complications. Primary outcome was the rate of successful same-day discharge without readmission within 48 h. Secondary outcomes included short-term complications, emergency department visits, readmissions, and mortality. Results Five hundred patients underwent RYGB with intended SDD, of whom 465 (93.0%) were successfully discharged. Twenty-one patients (4.5%) were readmitted in the first 48 h postoperatively. None of these patients had a severe bleeding. This results in a success rate of 88.8% of SDD without readmission within 48 h. Conclusions Same-day discharge after RYGB is safe, provided that patients are carefully selected and strict discharge criteria are used. It is an effective care pathway to reduce the burden on hospital capacity. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass: a Cohort of 500 Consecutive Patients

et al. 2023

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“…The reasons for such are likely multifactorial. Increasing utilization and data to support same-day discharge SG and RYGB continue to add confidence for safely performing day-surgery for comparatively healthier patients [21,22]. This offers substantial cost and resource savings, both of which have remained limited in the COVID-19 era [23].…”

Section: Discussionmentioning

confidence: 99%

Lasting Impact of COVID-19 on Bariatric Surgery Delivery in North America: A Retrospective International Cohort Study of 349,209 Patients in 902 Centers

et al. 2023

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COVID-19 resulted in dramatic changes to the delivery of bariatric surgery; however, the lasting effect on current and future delivery remains uncharacterized. We sought to characterize differences and trends in bariatric surgery care and outcomes between 2020 and 2021. The Metabolic and Bariatric Accreditation and Quality Improvement Program (MBSAQIP) collects data from 902 centers in North America. The MBSAQIP database was evaluated, including patients undergoing sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) with two cohorts described: those receiving surgery in 2020 and those in 2021. Patient selection, operative techniques, and outcomes were compared using bivariate analysis. Multivariable modelling evaluated factors including operative year, independently associated with serious complications and mortality. We evaluated 349,209 patients, with 154,960 (44.4% undergoing bariatric surgery during 2020 compared to 194,249 (55.6%) in 2021. This represents a 20.2% year-to-year increase in total cases, and a 20.7% increase in cases per center (178.5 cases/center in 2020 vs. 215.4 cases/center in 2021). Patients receiving bariatric surgery during 2021 were statistically younger with fewer comorbidities compared to 2020; however, differences were small and groups appeared clinically similar. Length of stay continued to decrease (1.4 ± 1.1 days 2020 vs. 1.3 ± 1.2 days 2021, p < 0.001), yet post-operative outcomes remained similar. Bariatric surgical volumes have increased but may still remain inadequate to meet demand, while trends towards selecting younger, healthier patients for bariatric surgery continue. Efforts to recover from the effects of COVID-19 are ongoing, and long-term evaluation of outcomes following these changes will remain important.

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“…Otro estudio canadiense basado en una serie de 914 pacientes intervenidos en régimen ambulatorio (60 GV y 854 BPG) demostró que sólo el 3% de los pacientes requirió ser readmitido en un centro hospitalario, en especial por sangrado postoperatorio, pudiendo ser los pacientes rescatados en todos los casos sin ningún caso de mortalidad [24] . En 2023 se ha publicado una revisión sistemática y meta-análisis de estudios observacionales, con 5.000 pacientes incluidos, mostrando una tasa de éxito del programa de GV ambulatoria del 99%, con un 4% de readmisiones, una morbilidad global del 4%, un 1% de reintervenciones y un 0% de mortalidad, resultados equiparables a los programas con hospitalización [25] . Además de estos satisfactorios resultados de seguridad, un estudio prospectivo francés mostro que el 82% de los pacientes operados de cirugía bariátrica sin ingreso se mostraban satisfechos con el circuito perioperatorio [26] .…”

Section: Discusión: ¿Por Qué Sin Ingreso?unclassified

Cirugía Bariátrica en Régimen Ambulatorio: Evidencias de viabilidad y propuestas de implementación

Osorio Aguilar,

Lazzara,

Sobrino Roncero

et al. 2024

BMI Journal

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Outcomes of same-day discharge sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review and meta-analysis

Cited by 23 publications

References 45 publications

Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass: a Cohort of 500 Consecutive Patients

Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass: a Cohort of 500 Consecutive Patients

Lasting Impact of COVID-19 on Bariatric Surgery Delivery in North America: A Retrospective International Cohort Study of 349,209 Patients in 902 Centers

Cirugía Bariátrica en Régimen Ambulatorio: Evidencias de viabilidad y propuestas de implementación

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