Complications After Laparoscopic Roux-en-Y Gastric Bypass in 1573 Consecutive Patients: Are There Predictors?

Détails

ID Serval
serval:BIB_E4D482C26D02
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Complications After Laparoscopic Roux-en-Y Gastric Bypass in 1573 Consecutive Patients: Are There Predictors?
Périodique
Obesity Surgery
Auteur(s)
Dayer-Jankechova A., Fournier P., Allemann P., Suter M.
ISSN
1708-0428 (Electronic)
ISSN-L
0960-8923
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
26
Numéro
1
Pages
12-20
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Roux-en-Y gastric bypass (RYGBP), one of the commonest performed bariatric procedures, remains a technically challenging operation associated with significant morbidity in high-risk patients. This study was conducted in order to identify predictors of complications after laparoscopic RYGBP.
METHODS: Our prospectively established database has been assessed to review 30-day and in-hospital complications graded according to a validated scoring system (Clavien-Dindo) and separated into minor (Clavien-Dindo I-IIIa) and major (Clavien-Dindo IIIb-IV) complications. Patient- and procedure-related factors were analyzed using univariate analysis. Significant factors associated with morbidity were introduced into a multivariate analysis to identify independent predictors.
RESULTS: Between 1999 and 2012, 1573 patients underwent laparoscopic RYGBP, 374 male and 1199 female. Mean age was 41 years, and mean body mass index (BMI) was 44.5 kg/m(2). One hundred fifty-nine procedures were reoperations. One hundred fifty (9.5 %) patients developed at least one complication, and 43 (2.7 %) had major complications, leading to death in one case (0.06 %). Risk factors for morbidity were male gender (p = 0.006) and overall experience of the team (p < 0.0001). Prolonged 3-day antibiotic therapy was associated with significantly reduced overall (p < 0.0001) and major (p = 0.005) complication rates. Major complications were associated with smoking (p = 0.016).
CONCLUSIONS: The most significant individual risk factors for early complications after RYGBP are male gender, limited surgical experience, and single dose of antibiotics. RYGBP should be performed by experienced teams. Smoking should be discontinued before surgery. Prolonged antibiotic therapy could be considered, especially if a circular stapled gastrojejunostomy is performed with the anvil introduced transorally.
Mots-clé
Adolescent, Adult, Aged, Body Mass Index, Female, Gastric Bypass/adverse effects, Gastric Bypass/methods, Humans, Laparoscopy/adverse effects, Laparoscopy/methods, Male, Middle Aged, Obesity, Morbid/surgery, Perioperative Care/methods, Reoperation/adverse effects, Reoperation/methods, Risk Factors, Sex Factors, Treatment Outcome, Young Adult
Pubmed
Web of science
Création de la notice
27/01/2016 9:03
Dernière modification de la notice
20/08/2019 16:08
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