Predictors and outcomes of bleed after sleeve gastrectomy: an analysis of the MBSAQIP data registry.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 09 01 2019
revised: 29 05 2019
accepted: 19 07 2019
pubmed: 9 10 2019
medline: 1 9 2020
entrez: 9 10 2019
Statut: ppublish

Résumé

Bleeding after laparoscopic sleeve gastrectomy (LSG) is an important complication associated with significant morbidity and a drastic increase in healthcare resources. Multiple strategies have been developed to minimize bleeding, including varying bougie size, line reinforcement, and intra-operative tranexamic acid. These techniques, however, have been implemented without a clear understanding of the pre-, intra-, and postoperative predictors of bleeding in patients undergoing SG. The purpose of this study was to examine predictors and outcomes associated with postoperative bleeding in patients undergoing LSG. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement data registry. We identified Metabolic and Bariatric Surgery Accreditation and Quality Improvement patients who underwent LSG in 2015 and 2016. Primary outcomes of interest include identifying the prevalence, impact, and predictors of bleeding in LSG patients. Our secondary outcomes of interest include characterizing overall complication rates in LSG patients. Univariate analysis of pre-, intra-, and postoperative variables was performed using Χ A total of 175,353 patients underwent LSG from 2015 to 2016. The majority of patients were female (79.0%), with a mean age of 44.4 ± 12.0 years and a mean body mass index of 45.2 kg/m Bleeding after LSG is associated with increased complications, readmission and reoperation rates, and mortality at 30 days. Staple-line reinforcement techniques independently predict a lower risk of postoperative bleeding after LSG. Adoption of these techniques may therefore have an important role in reducing morbidity and mortality for patients who undergo LSG.

Sections du résumé

BACKGROUND BACKGROUND
Bleeding after laparoscopic sleeve gastrectomy (LSG) is an important complication associated with significant morbidity and a drastic increase in healthcare resources. Multiple strategies have been developed to minimize bleeding, including varying bougie size, line reinforcement, and intra-operative tranexamic acid. These techniques, however, have been implemented without a clear understanding of the pre-, intra-, and postoperative predictors of bleeding in patients undergoing SG.
OBJECTIVES OBJECTIVE
The purpose of this study was to examine predictors and outcomes associated with postoperative bleeding in patients undergoing LSG.
SETTING METHODS
The Metabolic and Bariatric Surgery Accreditation and Quality Improvement data registry.
METHODS METHODS
We identified Metabolic and Bariatric Surgery Accreditation and Quality Improvement patients who underwent LSG in 2015 and 2016. Primary outcomes of interest include identifying the prevalence, impact, and predictors of bleeding in LSG patients. Our secondary outcomes of interest include characterizing overall complication rates in LSG patients. Univariate analysis of pre-, intra-, and postoperative variables was performed using Χ
RESULTS RESULTS
A total of 175,353 patients underwent LSG from 2015 to 2016. The majority of patients were female (79.0%), with a mean age of 44.4 ± 12.0 years and a mean body mass index of 45.2 kg/m
CONCLUSION CONCLUSIONS
Bleeding after LSG is associated with increased complications, readmission and reoperation rates, and mortality at 30 days. Staple-line reinforcement techniques independently predict a lower risk of postoperative bleeding after LSG. Adoption of these techniques may therefore have an important role in reducing morbidity and mortality for patients who undergo LSG.

Identifiants

pubmed: 31590999
pii: S1550-7289(19)30337-5
doi: 10.1016/j.soard.2019.07.017
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1675-1681

Informations de copyright

Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Valentin Mocanu (V)

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada. Electronic address: Vmocanu1987@gmail.com.

Jerry Dang (J)

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Farah Ladak (F)

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Noah Switzer (N)

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Daniel W Birch (DW)

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Canada.

Shahzeer Karmali (S)

Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada; Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Canada.

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