Piotr Major1, Jakub Droś2, Artur Kacprzyk2, Michał Pędziwiatr3, Piotr Małczak3, Michał Wysocki3, Michał Janik4, Maciej Walędziak4, Krzysztof Paśnik4, Hady Razak Hady5, Jacek Dadan5, Monika Proczko-Stepaniak6, Łukasz Kaska6, Paweł Lech7, Maciej Michalik7, Michał Duchnik8, Krzysztof Kaseja8, Maciej Pastuszka9, Paweł Stepuch9, Andrzej Budzyński3. 1. Second Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland; Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Kraków, Poland. Electronic address: majorpiotr@gmail.com. 2. Students' Scientific Group at the Second Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland. 3. Second Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland; Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Kraków, Poland. 4. Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland. 5. First Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, Bialystok, Poland. 6. Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland. 7. Chair and Clinic of General, Minimally Invasive and Elderly Surgery, University of Warmia & Mazury, Olsztyn, Poland. 8. Department of General and Vascular Surgery, Individual Public Voivodeship Joint Hospital, Szczecin, Poland. 9. Department of General and Minimally Invasive Surgery, Łęczna, Poland.
Abstract
BACKGROUND: Global experiences in general surgery suggest that previous abdominal surgery may negatively influence different aspects of perioperative care. As the incidence of bariatric procedures has recently increased, it is essential to assess such correlations in bariatric surgery. OBJECTIVES: To assess whether previous abdominal surgery influences the course and outcomes of laparoscopic bariatric surgery. SETTING: Seven referral bariatric centers in Poland. METHODS: We conducted a retrospective analysis of 2413 patients; 1706 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) matched the inclusion criteria. Patients with no history of abdominal surgery were included as group 1, while those who had undergone at least 1 abdominal surgery were included as group 2. RESULTS: Group 2 had a significantly prolonged median operation time for RYGB (P = .012), and the longest operation time was observed in patients who had previously undergone surgeries in both the upper and lower abdomen (P = .002). Such a correlation was not found in SG cases (P = .396). Groups 1 and 2 had similar rates of intraoperative adverse events and postoperative complications (P = .562 and P = .466, respectively). Group 2 had a longer median duration of hospitalization than group 1 (P = .034), while the readmission rate was similar between groups (P = .079). There was no significant difference between groups regarding the influence of the long-term effects of bariatric treatment on weight loss (percentage of follow-up was 55%). CONCLUSIONS: Previous abdominal surgery prolongs the operative time of RYGB and the duration of postoperative hospitalization, but does not affect the long-term outcomes of bariatric treatment.
BACKGROUND: Global experiences in general surgery suggest that previous abdominal surgery may negatively influence different aspects of perioperative care. As the incidence of bariatric procedures has recently increased, it is essential to assess such correlations in bariatric surgery. OBJECTIVES: To assess whether previous abdominal surgery influences the course and outcomes of laparoscopic bariatric surgery. SETTING: Seven referral bariatric centers in Poland. METHODS: We conducted a retrospective analysis of 2413 patients; 1706 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) matched the inclusion criteria. Patients with no history of abdominal surgery were included as group 1, while those who had undergone at least 1 abdominal surgery were included as group 2. RESULTS: Group 2 had a significantly prolonged median operation time for RYGB (P = .012), and the longest operation time was observed in patients who had previously undergone surgeries in both the upper and lower abdomen (P = .002). Such a correlation was not found in SG cases (P = .396). Groups 1 and 2 had similar rates of intraoperative adverse events and postoperative complications (P = .562 and P = .466, respectively). Group 2 had a longer median duration of hospitalization than group 1 (P = .034), while the readmission rate was similar between groups (P = .079). There was no significant difference between groups regarding the influence of the long-term effects of bariatric treatment on weight loss (percentage of follow-up was 55%). CONCLUSIONS: Previous abdominal surgery prolongs the operative time of RYGB and the duration of postoperative hospitalization, but does not affect the long-term outcomes of bariatric treatment.