1. Does the future of laparoscopic sleeve gastrectomy lie in the outpatient surgery center? A retrospective study of the safety of 3162 outpatient sleeve gastrectomies
- Author
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William H. Johnson, Benjamin Horsley, Christopher J Hart, Karleena R. Tuggle, Bleu Schniederjan, Bo Neichoy, Matthew Apel, Jedediah A. Kaufman, Samuel Cottam, Christina Richards, Hinali Zaveri, Aneesh Dhorepatil, Michael Orris, Thomas Umbach, Ciara Lee, Eric Harris, Josiah Billing, Michael D. Williams, John DeBarros, Titus Duncan, Peter Billing, Robert Landerholm, Christy Lee, Austin Cottam, Kurt Stewart, Daniel Cottam, Amit Surve, Legrand Belnap, Alberto Zorak, and Walter Medlin
- Subjects
Adult ,Male ,medicine.medical_specialty ,Sleeve gastrectomy ,Intraoperative Complication ,medicine.medical_treatment ,Surgicenters ,Outpatient surgery ,Operative Time ,Bariatric Surgery ,030209 endocrinology & metabolism ,Ambulatory Care Facilities ,Patient Readmission ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Gastrectomy ,medicine ,Humans ,Retrospective Studies ,business.industry ,Mortality rate ,Medical record ,Sleep apnea ,Retrospective cohort study ,medicine.disease ,Patient Discharge ,Surgery ,Obesity, Morbid ,Ambulatory Surgical Procedures ,030211 gastroenterology & hepatology ,Female ,Laparoscopy ,Patient Safety ,business ,Complication ,Facilities and Services Utilization ,Forecasting - Abstract
Background Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure that can be performed as an outpatient procedure. Objectives The aim of the study was to determine whether same-day discharge LSG is safe when performed in an outpatient surgery center. Setting Outpatient surgery centers. Methods The medical records of 3162 patients who underwent primary LSG procedure by 21 surgeons at 9 outpatient surgery centers from January 2010 through February 2018 were retrospectively reviewed. Results Three thousand one hundred sixty-two patients were managed with enhanced recovery after surgery protocol and were included in this analysis. The mean age and preoperative body mass index were 43.1 ± 10.8 years and 42.1 ± 7.1 kg/m2, respectively. Sleep apnea, type 2 diabetes, gastroesophageal reflux disease, hypertension, and hyperlipidemia were seen in 14.4%, 13.5%, 24.7%, 30.4%, and 17.6% patients, respectively. The mean total operative time was 56.4 ± 16.9 minutes (skin to skin). One intraoperative complication (.03%) occurred. The hospital transfer rate was .2%. The 30-day follow-up rate was 85%. The postoperative outcomes were analyzed based on the available data. The 30-day readmission, reoperation, reintervention, and emergency room visit rates were .6%, .6%, .2%, and .1%, respectively. The 30-day mortality rate was 0%. The total short-term complication rate was 2.5%. Conclusions Same-day discharge seems to be safe when performed in an outpatient surgery center in selected patients. It would appear that outpatient surgery centers are a viable option for patients with minimal surgical risks.
- Published
- 2018