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Multicenter Study
. Sep-Oct 2014;10(5):853-8.
doi: 10.1016/j.soard.2013.12.015. Epub 2014 Jan 9.

Effect of Perioperative Management on Short-Term Outcomes After Sleeve Gastrectomy: A 600-patient Single-Center Cohort Study

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Multicenter Study

Effect of Perioperative Management on Short-Term Outcomes After Sleeve Gastrectomy: A 600-patient Single-Center Cohort Study

Lionel Rebibo et al. Surg Obes Relat Dis. .

Abstract

Background: Reports on the postoperative outcomes of sleeve gastrectomy (SG) have only been from small, single-center series and meta-analyses of studies with variable SG management. The objective of this study was to evaluate post-SG outcomes in a specialized bariatric surgery center with a routinely performed standardized procedure.

Methods: The postoperative complication rate, operating times, and postoperative data were evaluated from all patients undergoing a primary SG between November 2004 and February 2012. Results were analyzed for 3 separate surgical periods, which differed with perioperative management.

Results: Of 600 patients (mean age: 41.8±11.3; mean body mass index [BMI]: 47.2±16 kg/m²; 80% were women who underwent primary SG), 26.8% had a BMI≥50 kg/m². The mean operating time was 84 minutes. The rate of conversion was 1%. There were no postoperative deaths. The overall complication rate was 8.5%; the major complication rate was 5.6%; the revisional surgery rate was 4.6% and the gastric leak rate was 2.5%. Over the course of the 3 study periods, the operating time fell from 91±32 to 79±22 minutes (P≤.001); the length of hospital stay decreased from 4.5±4.9 to 3.4±4.3 days (P = .02); the major complication rate fell from 6.4% to 5.5% (P = NS); and the gastric fistula rate decreased from 4.6% to 1.9% (P = NS).

Conclusion: In a specialist bariatric surgery center, SG had an acceptable complication rate. Modifications in the perioperative management of SG were associated with a shorter mean operating time and hospital stay and did not increase the major complication or gastric fistula rates.

Keywords: Complications after sleeve gastrectomy; Gastric fistula; Laparoscopic sleeve gastrectomy; Morbid obesity.

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