Tomás Jakob1, Patricio Cal2, Luciano Deluca2, Ezequiel Fernández2. 1. Centro de Rehabilitación Quirúrgica de la Obesidad, Riobamba 429, Office 806, CP1025, Buenos Aires, Argentina. tomasjakob@intramed.net. 2. Centro de Rehabilitación Quirúrgica de la Obesidad, Riobamba 429, Office 806, CP1025, Buenos Aires, Argentina.
Abstract
BACKGROUND: Bariatric surgery is currently the most effective treatment for morbid obesity. Short-stay procedures have gained popularity in many surgical sub-specialties. Main benefits are early discharge, minimal loss of productivity, cost reductions, and a reduced risk of infections. Such procedures can be undertaken if the patient's safety is not jeopardized. Laparoscopic sleeve gastrectomy (LSG) has consolidated itself as a primary bariatric technique. One matter of discussion relates to its associated quick postoperative recovery, as debate rages over whether there are patient benefits to hospital stays beyond 24 h. OBJECTIVE: To assess the safety of short-stay LSG. DESIGN: Cross-sectional, descriptive, retrospective analysis of a consecutive series. METHODS: We retrospectively analyzed data collected on hospital stays, readmission rates, early and midterm major complications, and re-intervention rates on 2629 primary LSG performed between February 2007 and August 2014. RESULTS: Out of 2629 patients, 2590 (98.52 %) were discharged within the first 24 h. Thirty-nine (1.48 %) required a longer admission: 16 (0.61 %) for vomiting and 23 (0.87 %) for bleeding, 5 (0.19 %) of whom required a second procedure within those first 24 h. Four patients (0.15 %) were readmitted for dehydration between day 2 and 4. A total of 26 leaks (0.99 %) occurred between postoperative days 6 and 41. Ten intra-abdominal hematomas (0.38 %) were diagnosed after the 7th postoperative day, and seven patients (0.27 %) required percutaneous drainage. Five abdominal collections (0.19 %), unrelated to either fistulas or bleeding, were diagnosed between day 6 and 16. No major complications occurred on postoperative days 2 through 5. CONCLUSIONS: Our evidence suggests that hospital stays after LSG beyond 24 h are unnecessary in patients with no persistent vomiting or signs of bleeding or leaks; major complications generally present either within the first 24 h or after the fifth postoperative day.
BACKGROUND: Bariatric surgery is currently the most effective treatment for morbid obesity. Short-stay procedures have gained popularity in many surgical sub-specialties. Main benefits are early discharge, minimal loss of productivity, cost reductions, and a reduced risk of infections. Such procedures can be undertaken if the patient's safety is not jeopardized. Laparoscopic sleeve gastrectomy (LSG) has consolidated itself as a primary bariatric technique. One matter of discussion relates to its associated quick postoperative recovery, as debate rages over whether there are patient benefits to hospital stays beyond 24 h. OBJECTIVE: To assess the safety of short-stay LSG. DESIGN: Cross-sectional, descriptive, retrospective analysis of a consecutive series. METHODS: We retrospectively analyzed data collected on hospital stays, readmission rates, early and midterm major complications, and re-intervention rates on 2629 primary LSG performed between February 2007 and August 2014. RESULTS: Out of 2629 patients, 2590 (98.52 %) were discharged within the first 24 h. Thirty-nine (1.48 %) required a longer admission: 16 (0.61 %) for vomiting and 23 (0.87 %) for bleeding, 5 (0.19 %) of whom required a second procedure within those first 24 h. Four patients (0.15 %) were readmitted for dehydration between day 2 and 4. A total of 26 leaks (0.99 %) occurred between postoperative days 6 and 41. Ten intra-abdominal hematomas (0.38 %) were diagnosed after the 7th postoperative day, and seven patients (0.27 %) required percutaneous drainage. Five abdominal collections (0.19 %), unrelated to either fistulas or bleeding, were diagnosed between day 6 and 16. No major complications occurred on postoperative days 2 through 5. CONCLUSIONS: Our evidence suggests that hospital stays after LSG beyond 24 h are unnecessary in patients with no persistent vomiting or signs of bleeding or leaks; major complications generally present either within the first 24 h or after the fifth postoperative day.
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