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Safety and outcomes of performing laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy at an ambulatory site of a tertiary care hospital in Ontario. | LitMetric

Safety and outcomes of performing laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy at an ambulatory site of a tertiary care hospital in Ontario.

Can J Surg

From the Division of General Surgery, Department of Surgery, Queen's University, Kingston, Ont. (Deghan Manshadi, Robertson, Zevin); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Dehghan); and the Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ont. (Reimer)

Published: February 2022

AI Article Synopsis

  • Bariatric surgery in Ontario is publicly funded and typically conducted in accredited hospitals; this study examines its safety and outcomes in an ambulatory setting.
  • A retrospective analysis of 314 patients revealed that most underwent laparoscopic Roux-en-Y gastric bypass, with a low complication rate and no recorded deaths within 90 days post-surgery.
  • Results suggest that while LRYGB and sleeve gastrectomy can be safely performed at ambulatory sites, there remain potential risks, indicating the need for careful consideration before proceeding without full hospital affiliation.

Article Abstract

Background: In Ontario, bariatric surgery is publicly funded and is performed only in accredited tertiary care hospitals. The purpose of our study was to report on the safety and outcomes of performing bariatric surgery at an ambulatory site of a tertiary care hospital in southern Ontario.

Methods: We conducted a retrospective cohort study of all adult (age ≥ 18 yr) patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) at the ambulatory site of our tertiary care hospital between September 2016 and August 2018. The 2 sites are 1.4 km apart. Patient demographic characteristics, duration of surgery, intraoperative and 90-day postoperative complications, number of transfers and readmission to the tertiary care hospital, and emergency department visits were collected.

Results: A total of 314 patients (285 women [90.8%] and 29 men [9.2%] with a mean age of 41.8 yr [standard deviation (SD) 8.9 yr]) underwent surgery: LRYGB in 295 cases (93.9%) and LSG in 19 (6.0%). The mean body mass index was 45.3 (SD 5.1), the median American Society of Anesthesiologists score was 3 (range 2-4), and the median Edmonton Obesity Staging System score was 2 (range 0-4). The mean operative time was 119.8 (SD 23.1) minutes for LRYGB and 96.2 (SD 22.0) minutes for LSG, and the mean length of stay was 2.1 (SD 0.6) days and 2.1 (SD 0.2) days, respectively. Thirteen patients (4.1%) required transfer to the tertiary care hospital for a postoperative complication. Of 312 patients, 29 (9.3%) presented to emergency department within 90 days after surgery, and 8 (2.6%) required readmission to hospital; no deaths were reported.

Conclusion: The findings suggest that LRYGB and LSG can be performed safely at an ambulatory site of a tertiary care hospital. However, caution should be exercised in performing these procedures at an ambulatory site without a tertiary care hospital affiliation, as patients may require urgent transfer for a serious postoperative complication.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900739PMC
http://dx.doi.org/10.1503/cjs.007120DOI Listing

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