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Does the future of laparoscopic sleeve gastrectomy lie in the outpatient surgery center? A retrospective study of the safety of 3162 outpatient sleeve gastrectomies

2018; Elsevier BV; Volume: 14; Issue: 10 Linguagem: Inglês

10.1016/j.soard.2018.05.027

1878-7533

Amit Surve, Daniel Cottam, Hinali Zaveri, Austin Cottam, Legrand Belnap, Christina Richards, Walter Medlin, Titus D. Duncan, Karleena Tuggle, Alberto Zorak, Thomas W. Umbach, Matthew Apel, Peter Billing, Josiah Billing, Robert Landerholm, Kurt Stewart, Jedediah Kaufman, Eric Harris, Michael L. Williams, Christopher D. Hart, William R. Johnson, Christy Lee, Ciara Lee, John DeBarros, Michael Orris, Bleu Schniederjan, Bo Neichoy, Aneesh Dhorepatil, Samuel Cottam, Benjamin Horsley,

Esophageal and GI Pathology

Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure that can be performed as an outpatient procedure.The aim of the study was to determine whether same-day discharge LSG is safe when performed in an outpatient surgery center.Outpatient surgery centers.The medical records of 3162 patients who underwent primary LSG procedure by 21 surgeons at 9 outpatient surgery centers from January 2010 through February 2018 were retrospectively reviewed.Three thousand one hundred sixty-two patients were managed with enhanced recovery after surgery protocol and were included in this analysis. The mean age and preoperative body mass index were 43.1 ± 10.8 years and 42.1 ± 7.1 kg/m2, respectively. Sleep apnea, type 2 diabetes, gastroesophageal reflux disease, hypertension, and hyperlipidemia were seen in 14.4%, 13.5%, 24.7%, 30.4%, and 17.6% patients, respectively. The mean total operative time was 56.4 ± 16.9 minutes (skin to skin). One intraoperative complication (.03%) occurred. The hospital transfer rate was .2%. The 30-day follow-up rate was 85%. The postoperative outcomes were analyzed based on the available data. The 30-day readmission, reoperation, reintervention, and emergency room visit rates were .6%, .6%, .2%, and .1%, respectively. The 30-day mortality rate was 0%. The total short-term complication rate was 2.5%.Same-day discharge seems to be safe when performed in an outpatient surgery center in selected patients. It would appear that outpatient surgery centers are a viable option for patients with minimal surgical risks.