BACKGROUND: Intestinal leak is a potentially lethal complication of Roux en-Y gastric bypass (GBP). Identification of patients at high risk for leak may reduce complication rates of surgeons early in the procedure learning curve. METHODS: A total of 3073 patients who underwent GBP were analyzed using univariate and multivariate logistic regression analyses of the following preoperative factors: hypertension (HTN), diabetes mellitus (DM), sleep apnea (SA), age, gender, weight, body mass index (BMI), and surgery type. Multivariate logistic regression analysis was performed for each procedure type. RESULTS: There were 48 (1.5%) deaths. Independent risk factors for death included leak, weight, procedure type, and HTN. A total of 102 (3.2%) leaks were found. Independent factors for leak included age, male gender, SA, and procedure type. CONCLUSION: The data suggests that older, heavier male patients with multiple comorbid conditions are at increased risk for leak and mortality. Surgeons early in their learning curve should avoid these high-risk patients to reduce complications.
BACKGROUND: Intestinal leak is a potentially lethal complication of Roux en-Y gastric bypass (GBP). Identification of patients at high risk for leak may reduce complication rates of surgeons early in the procedure learning curve. METHODS: A total of 3073 patients who underwent GBP were analyzed using univariate and multivariate logistic regression analyses of the following preoperative factors: hypertension (HTN), diabetes mellitus (DM), sleep apnea (SA), age, gender, weight, body mass index (BMI), and surgery type. Multivariate logistic regression analysis was performed for each procedure type. RESULTS: There were 48 (1.5%) deaths. Independent risk factors for death included leak, weight, procedure type, and HTN. A total of 102 (3.2%) leaks were found. Independent factors for leak included age, male gender, SA, and procedure type. CONCLUSION: The data suggests that older, heavier male patients with multiple comorbid conditions are at increased risk for leak and mortality. Surgeons early in their learning curve should avoid these high-risk patients to reduce complications.
Authors: Jeffrey L Carson; Peter M Scholz; Anita Y Chen; Eric D Peterson; Jeffrey Gold; Stephen H Schneider Journal: J Am Coll Cardiol Date: 2002-08-07 Impact factor: 24.094
Authors: Eduardo G H de Moura; Manoel P Galvão-Neto; Almino C Ramos; Eduardo T H de Moura; Thales D Galvão; Diogo T H de Moura; Flávio C Ferreira Journal: Surg Endosc Date: 2011-12-17 Impact factor: 4.584
Authors: Nasser Sakran; Ahmad Assalia; Ahud Sternberg; Yoram Kluger; Anton Troitsa; Eran Brauner; Sebastiaan Van Cauwenberge; Marieke De Visschere; Bruno Dillemans Journal: Obes Surg Date: 2011-02 Impact factor: 4.129
Authors: Arnaud Lemmers; Damien My Tan; Mostafa Ibrahim; Patrizia Loi; Daniel De Backer; Jean Closset; Jacques Devière; Olivier Le Moine Journal: Obes Surg Date: 2015-11 Impact factor: 4.129