Abdelrahman Mohammad Galal1,2,3,4, Evert-Jan Boerma5,6, Sofie Fransen5,6, Berry Meesters5,6, Steven Olde Damink7, Jan Willem Greve8,9,10. 1. Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands. abdrhmangalal@yahoo.com. 2. Dutch Obesity Clinic South, Heerlen, The Netherlands. abdrhmangalal@yahoo.com. 3. Maastricht University Medical Center, Maastricht, The Netherlands. abdrhmangalal@yahoo.com. 4. Department of General Surgery, Sohag Faculty of Medicine, Sohag University Hospitals, Sohag, Egypt. abdrhmangalal@yahoo.com. 5. Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands. 6. Dutch Obesity Clinic South, Heerlen, The Netherlands. 7. Maastricht University Medical Center, Maastricht, The Netherlands. 8. Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands. j.greve@zuyderland.nl. 9. Dutch Obesity Clinic South, Heerlen, The Netherlands. j.greve@zuyderland.nl. 10. Maastricht University Medical Center, Maastricht, The Netherlands. j.greve@zuyderland.nl.
Abstract
OBJECTIVES: Evaluate the safety of fast track (FT) surgery program in patients undergoing primary and revisional bariatric surgery (conversion from one procedure to another); identify limiting factors for early discharge and predictive factors for readmission. METHODS: This is a retrospective review of 730 consecutive morbidly obese patients who underwent bariatric surgery between January 2016 and December 2017. Fast track protocol was applied on all patients. Target discharge was after one-night stay. The primary end point is length of stay. The secondary end point is frequency of hospital contact after discharge, readmissions and reinterventions within 30 days. RESULTS: Primary procedures (n = 633) were banded Roux-en-Y gastric bypass (BRYGB, 79.3%), sleeve gastrectomy (10.7%), gastric band (4.7%) and others (5.3%). Mean age (± SD) was 44.32 ± 11.26 years, and mean BMI (± SD) was 43.58 ± 6.12 kg/m2. Conversion procedures (n = 97) were gastric band to BRYGB (40.2%), or to adjustable BRYGB (39.2%), Mason to BRYGB (11.3%), sleeve to BRYGB (4.1%) and others (5.2%). Mean age (± SD) was 47.22 ± 9.1 years, and mean BMI (± SD) was 37.9 ± 7.27 kg/m2. Mean LOS in primary patients was 1.3 ± 0.99, and that in conversion patients was 1.5 ± 1.4. Successful discharge at one night or less was achieved in 650 cases (573 primary and 77 conversion). After one-night discharge, incidence of contact to the hospital, readmission and reintervention was 23.9%, 5.9% and 1.9%, in the primary group and 31.2%, 13% and 5.2% in the conversion group. CONCLUSION: One-night discharge in FT managed conversion procedures is safe, compared to primary procedures. It is associated with higher readmission rates; however, the postdischarge hospital contacts and surgical complications were not statistically significant different.
OBJECTIVES: Evaluate the safety of fast track (FT) surgery program in patients undergoing primary and revisional bariatric surgery (conversion from one procedure to another); identify limiting factors for early discharge and predictive factors for readmission. METHODS: This is a retrospective review of 730 consecutive morbidly obesepatients who underwent bariatric surgery between January 2016 and December 2017. Fast track protocol was applied on all patients. Target discharge was after one-night stay. The primary end point is length of stay. The secondary end point is frequency of hospital contact after discharge, readmissions and reinterventions within 30 days. RESULTS: Primary procedures (n = 633) were banded Roux-en-Y gastric bypass (BRYGB, 79.3%), sleeve gastrectomy (10.7%), gastric band (4.7%) and others (5.3%). Mean age (± SD) was 44.32 ± 11.26 years, and mean BMI (± SD) was 43.58 ± 6.12 kg/m2. Conversion procedures (n = 97) were gastric band to BRYGB (40.2%), or to adjustable BRYGB (39.2%), Mason to BRYGB (11.3%), sleeve to BRYGB (4.1%) and others (5.2%). Mean age (± SD) was 47.22 ± 9.1 years, and mean BMI (± SD) was 37.9 ± 7.27 kg/m2. Mean LOS in primary patients was 1.3 ± 0.99, and that in conversion patients was 1.5 ± 1.4. Successful discharge at one night or less was achieved in 650 cases (573 primary and 77 conversion). After one-night discharge, incidence of contact to the hospital, readmission and reintervention was 23.9%, 5.9% and 1.9%, in the primary group and 31.2%, 13% and 5.2% in the conversion group. CONCLUSION: One-night discharge in FT managed conversion procedures is safe, compared to primary procedures. It is associated with higher readmission rates; however, the postdischarge hospital contacts and surgical complications were not statistically significant different.
Authors: Bradley N Reames; Daniel Bacal; Robert W Krell; John D Birkmeyer; Nancy J O Birkmeyer; Jonathan F Finks Journal: Surg Obes Relat Dis Date: 2014-03-28 Impact factor: 4.734
Authors: Alex W Lois; Matthew J Frelich; Natasha A Sahr; Samuel F Hohmann; Tao Wang; Jon C Gould Journal: Surgery Date: 2015-05-29 Impact factor: 3.982
Authors: A Thorell; A D MacCormick; S Awad; N Reynolds; D Roulin; N Demartines; M Vignaud; A Alvarez; P M Singh; D N Lobo Journal: World J Surg Date: 2016-09 Impact factor: 3.352
Authors: Zhamak Khorgami; Jacob A Petrosky; Amin Andalib; Ali Aminian; Philip R Schauer; Stacy A Brethauer Journal: Surg Obes Relat Dis Date: 2016-02-02 Impact factor: 4.734
Authors: Elizabeth R Berger; Kristopher M Huffman; Teresa Fraker; Anthony T Petrick; Stacy A Brethauer; Bruce L Hall; Clifford Y Ko; John M Morton Journal: Ann Surg Date: 2018-01 Impact factor: 12.969
Authors: Jonathan Carter; Steven Elliott; Jennifer Kaplan; Matthew Lin; Andrew Posselt; Stanley Rogers Journal: Surg Obes Relat Dis Date: 2014-05-23 Impact factor: 4.734