Safety and efficacy of outpatient sleeve gastrectomy: 2534 cases performed in a single free-standing ambulatory surgical center

Billing, Peter; Billing, Josiah; Harris, Eric; Kaufman, Jedediah; Landerholm, Robert; Stewart, Kurt

doi:10.1016/j.soard.2019.03.003

Cited by 24 publications

(12 citation statements)

References 14 publications

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“…Higher readmission rates (8.5%) were found on the series of 328 ambulatory SG published by Garofalo et al Most of these readmissions were due to nausea/vomiting and abdominal pain [13]. We found similar readmission (2.9%), reoperation (0.7%), and mortality (0.1%) rates to those reported by Billing and Lelazari [14,16]. In our analysis, most readmission was also related to nausea/vomiting (36.6% of readmissions) and abdominal pain (10.2% of readmissions).…”

Section: Discussionsupporting

confidence: 72%

“…For instance, Billing et al analyzed the outcomes of 2,534 outpatient SG performed in a single ambulatory center. Readmission, reoperation, staple line leak, and mortality rates were 2.5%, 1.4%, 0.9%, and 0.1%, respectively [16]. Similarly, Lalezari and colleagues reported the outcomes of 821 ambulatory SG.…”

Section: Discussionmentioning

confidence: 93%

“…Multiple series (most retrospective and single-center) have shown the safety and feasibility of outpatient SG in selected patients [11][12][13][14][15][16]. For instance, Billing et al analyzed the outcomes of 2,534 outpatient SG performed in a single ambulatory center.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, due to the disruption in surgical care delivery due to the COVID-19 pandemic, this approach might reduce in-hospital exposure and save precious resources [10]. Several single institutional reports have shown the feasibility and safety of same-day discharge SG with low postoperative morbidity and nearzero mortality [11][12][13][14][15][16]. However, a shorter length of stay (LOS) may also result in a higher rate of postoperative complications and readmissions when compared with the classic inpatient approach [17].…”

Section: Key Pointsmentioning

confidence: 99%

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Risk Factors for Readmission After Same-Day Discharge Sleeve Gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

et al. 2022

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Background Same-day discharge after sleeve gastrectomy (SG) is gaining popularity. We aimed to determine risk factors associated with readmission in patients who underwent same-day discharge SG. Methods We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database for the period 2015-2018. Patients who underwent SG and were discharged the same day of the operation were included in the analysis. Multivariable logistic regression analysis was performed to determine risk factors for readmission. Results A total of 466,270 SG were performed during the study period; 14,624 (3.1%) patients were discharged the same day and were included in the analysis. Mean age was 43.4 (14.7-80) years and 11,718 (80.1%) were female. Mean preoperative BMI was 43.7 ± 7.4 kg/m 2 . Mean operative time was 58.3 ± 32.4 min. Thirty-day reoperation, reintervention, and mortality rates were 0.7%, 0.7%, and 0.1%, respectively. Readmission rates were similar in same-day discharge and inpatient SG (2.9% vs. 3%, p = 0.5). Female sex (OR 1.52, 95% CI 1.15-2.00), preoperative gastroesophageal reflux disease (OR 1.33, 95% CI 1.08-1.64), renal insufficiency (OR 3.06, 95% CI 1.01-9.32), and intraoperative drain placement (OR 1.78, 95% CI 1.37-2.31) were independent risk factors for readmission following same-day discharge SG. Conclusions Same-day discharge SG appears to be safe and is associated with low readmission rates. However, the identification of preoperative and intraoperative variables associated with higher risk of readmission might help defining safer and more effective same-day discharge protocols.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

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Risk Factors for Readmission After Same-Day Discharge Sleeve Gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

et al. 2022

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“…Although several reports in other surgical fields 24 – 27 have compared outcomes between ASCs and the HS, we are only aware of one similar publication by Oxley et al 28 in the field of immediate implant-based postmastectomy reconstruction, which demonstrated equivalent rates of complications and outcomes between the 2 venues. The feasibility of routinely performing mastectomy and immediate implant-based reconstruction with same-day discharge using an enhanced recovery protocol was established by Dumestre et al 10 in 2017.…”

Section: Introductionmentioning

confidence: 95%

Mastectomy and Prepectoral Reconstruction in an Ambulatory Surgery Center Reduces Major Infectious Complication Rates

Schwartz

2020

Plastic and Reconstructive Surgery - Global Open

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Background: Mastectomy and implant-based reconstruction is typically performed in a hospital setting (HS) with overnight admission. The aim of this study was to evaluate postoperative complications and outcomes with same-day discharge from an ambulatory surgery center (ASC) compared with the same surgery performed in the HS. Methods: Patients who underwent mastectomy and immediate prepectoral tissue expander reconstruction were included in this retrospective study. Surgery was performed in an ASC with same-day discharge or the HS with overnight observation or same-day discharge. Patient demographics, operative details, outcomes, complications, and patient satisfaction were compared. Results: One hundred six women (183 breasts) underwent surgery in the HS, and 103 women (177 breasts) had their surgery in an ASC between August 2014 and September 2019. Demographics, comorbidities, and operative details were similar. Although there was no difference in the rates of most major complications, infectious complications requiring operative intervention were less frequent in the ASC [2.3% (n = 4) versus 11.5% (n = 21); P = 0.001]. Patient satisfaction, evaluated with a 5-point Likert scale, was higher in the ASC. Conclusions: Mastectomy and prepectoral reconstruction in an ASC is a safe alternative to the standard approach of performing this procedure in the HS. Although the rates of most surgical complications are similar between the HS and ASC, we have found a significantly reduced rate of major infectious complications requiring surgical intervention in the ASC which reduces overall cost and patient morbidity. Finally, patient satisfaction was higher in the ASC compared with the HS.

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Trends in bariatric surgery in Texas: an analysis of a statewide administrative database 2013–2017

et al. 2020

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Safety and efficacy of outpatient sleeve gastrectomy: 2534 cases performed in a single free-standing ambulatory surgical center

Cited by 24 publications

References 14 publications

Risk Factors for Readmission After Same-Day Discharge Sleeve Gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

Risk Factors for Readmission After Same-Day Discharge Sleeve Gastrectomy: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database Analysis

Mastectomy and Prepectoral Reconstruction in an Ambulatory Surgery Center Reduces Major Infectious Complication Rates

Trends in bariatric surgery in Texas: an analysis of a statewide administrative database 2013–2017

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