Is ambulatory laparoscopic Roux-en-Y gastric bypass associated with higher adverse events?

Abstract:

OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtained from the BOLD (Bariatric Outcomes Longitudinal Database) for 51,788 laparoscopic gastric bypass (LRYGB) procedures performed between 2007 and 2010. Logistic regression models were used to evaluate age, sex, race, body mass index, insurance status, comorbidities, and LOS as predictors for 30-day mortality, serious complications, and readmissions. RESULTS:Overall patient demographics were as follows: median age, 45 years; median body mass index, 46.3 kg/m; % female, 78.6; % white, 77.8; % private insurance, 86.2; and % comorbidities more than 5 (39.1%). Overall, 30-day outcomes included mortality, 0.1%; serious complications, 0.5%; and readmissions, 3.8%. median LOS was 2 days, and the distribution of LOS was as follows [n (%)]: 0 (1.0), 1 (18.4), 2 (59.0), 3 (17.5), and 4 (4.1). Using the median LOS 2 days as reference, the logistic regression analysis revealed that ambulatory LOS of was significantly associated with increased risk of 30-day mortality (odds ratio: 13.02; P < 0.0001) as was LOS 1 day (odds ratio: 2.02; P < 0.0552). For LOS of 0 day, there was a trend toward an increase in the rate of 30-day serious complications (odds ratio: 1.9; P < 0.16). There was no significant trend between LOS status and 30-day readmission rates. CONCLUSIONS:In this large, prospective, clinical database, LOS of 1 day or less for LRYGB patients was significantly associated with an increased risk of 30-day mortality and a trend toward increased risk of 30-day serious complications.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Morton JM,Winegar D,Blackstone R,Wolfe B

doi

10.1097/SLA.0000000000000227

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

286-92

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

259

pub_type

杂志文章
  • Five hundred intestinal and multivisceral transplantations at a single center: major advances with new challenges.

    abstract:OBJECTIVE:To assess the evolution of visceral transplantation in the milieu of surgical technical modifications, new immunosuppressive protocols, and other management strategies. SUMMARY BACKGROUND DATA:With the clinical feasibility of intestinal and multivisceral transplantation in 1990, multifaceted innovative tacti...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b67725

    authors: Abu-Elmagd KM,Costa G,Bond GJ,Soltys K,Sindhi R,Wu T,Koritsky DA,Schuster B,Martin L,Cruz RJ,Murase N,Zeevi A,Irish W,Ayyash MO,Matarese L,Humar A,Mazariegos G

    更新日期:2009-10-01 00:00:00

  • Three-year follow-up of a prospective randomized trial comparing laparoscopic versus open gastric bypass.

    abstract:OBJECTIVE:To analyze long-term weight loss, changes in comorbidities and quality of life, and late complications after laparoscopic and open gastric bypass. SUMMARY BACKGROUND DATA:Early results from our prospective randomized trial comparing the outcome of laparoscopic versus open gastric bypass demonstrated less pos...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/01.sla.0000197381.01214.76

    authors: Puzziferri N,Austrheim-Smith IT,Wolfe BM,Wilson SE,Nguyen NT

    更新日期:2006-02-01 00:00:00

  • Artificial anal sphincter in severe fecal incontinence: outcome of prospective experience with 37 patients in one institution.

    abstract:OBJECTIVE:To evaluate the outcome of artificial anal sphincter implantation for severe fecal incontinence in 37 consecutive patients operated on in a single institution from 1993 through 2001. SUMMARY BACKGROUND DATA:Implantation of an artificial anal sphincter is proposed in severe fecal incontinence when local treat...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200301000-00008

    authors: Michot F,Costaglioli B,Leroi AM,Denis P

    更新日期:2003-01-01 00:00:00

  • Experimental subcapsular hematoma of the spleen: natural history and radioisotope scan correlation.

    abstract::An experimental model was developed in dogs to correlate radioisotope scan findings of iatrogenic, in vivo, splenic injury with the natural history of the injury as determined by the clinical course and both gross and microscopic observations. It was found that small subcapsular injuries do not appear as discrete foca...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197804000-00011

    authors: Washburn ME,Balk MW,Mazat BA,Zurlo JA

    更新日期:1978-04-01 00:00:00

  • International Multicenter Study on the Impact of Extracapsular Lymph Node Involvement in Primary Surgery Adenocarcinoma of the Esophagus on Overall Survival and Staging Systems.

    abstract:OBJECTIVE:The current pathological lymph node (pN) staging is based on the number of positive lymph nodes but does not take into consideration characteristics of the involved lymph nodes itself. The current study aims to examine the prognostic value of extracapsular lymph node involvement (EC-LNI) and intracapsular lym...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000001463

    authors: Nafteux PR,Lerut AM,Moons J,Hölscher AH,Bollschweiler E,van Berge Henegouwen MI,Lagarde SM,van Lanschot JJ,Messager M,Mariette C,D'Journo XB,Thomas PA,De Leyn PR

    更新日期:2015-11-01 00:00:00

  • Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage.

    abstract:OBJECTIVE:To evaluate the relation between delay in surgery because of preoperative biliary drainage (PBD) and survival in patients scheduled for surgery for pancreatic head cancer. BACKGROUND:Patients with obstructive jaundice due to pancreatic head cancer can undergo PBD. The associated delay of surgery can lead to ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0b013e3181fd36a2

    authors: Eshuis WJ,van der Gaag NA,Rauws EA,van Eijck CH,Bruno MJ,Kuipers EJ,Coene PP,Kubben FJ,Gerritsen JJ,Greve JW,Gerhards MF,de Hingh IH,Klinkenbijl JH,Nio CY,de Castro SM,Busch OR,van Gulik TM,Bossuyt PM,Gouma DJ

    更新日期:2010-11-01 00:00:00

  • Intratumoral Genetic Heterogeneity in Rectal Cancer: Are Single Biopsies representative of the entirety of the tumor?

    abstract:OBJECTIVE:Demonstrate intratumoral genetic heterogeneity in rectal cancer. BACKGROUND:Several clinical management decisions in rectal cancer may be influenced by pretreatment biopsy information. However, in the setting of significant intratumoral heterogeneity, biopsies may not be representative of the entirety of the...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001937

    authors: Bettoni F,Masotti C,Habr-Gama A,Correa BR,Gama-Rodrigues J,Vianna MR,Vailati BB,São Julião GP,Fernandez LM,Galante PA,Camargo AA,Perez RO

    更新日期:2017-01-01 00:00:00

  • Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone.

    abstract:OBJECTIVE:To investigate the pattern of nodal metastasis, morbidity, recurrence rates of papillary thyroid carcinoma (PTC), and parathyroid hormone (PTH) responses following neck dissection (ND) plus total thyroidectomy (TT). SUMMARY BACKGROUND DATA:While hypoparathyroidism develops after TT plus ND, little is known o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000250451.59685.67

    authors: Roh JL,Park JY,Park CI

    更新日期:2007-04-01 00:00:00

  • Management of combined pancreatoduodenal injuries.

    abstract::From 1969 to 1985, 129 patients with combined pancreatoduodenal injuries were treated at one urban trauma center. A total of 104 patients (80.6%) had penetrating wounds, and multiple visceral and vascular injuries were usually associated with the pancreatoduodenal injury. Primary repair or resection of one or both org...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198706000-00009

    authors: Feliciano DV,Martin TD,Cruse PA,Graham JM,Burch JM,Mattox KL,Bitondo CG,Jordan GL Jr

    更新日期:1987-06-01 00:00:00

  • Abdominal aortic aneurysm in high-risk patients. Outcome of selective management based on size and expansion rate.

    abstract::Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198409000-00003

    authors: Bernstein EF,Chan EL

    更新日期:1984-09-01 00:00:00

  • The Carbon Footprint of Surgical Operations: A Systematic Review.

    abstract:OF BACKGROUND DATA AND OBJECTIVES:Operating theatres are typically the most resource-intensive area of a hospital, 3-6 times more energy-intensive than the rest of the hospital and a major contributor of waste. The primary objective of this systematic review was to evaluate existing literature calculating the carbon fo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003951

    authors: Rizan C,Steinbach I,Nicholson R,Lillywhite R,Reed M,Bhutta MF

    更新日期:2020-12-01 00:00:00

  • Gastrointestinal adaptation following small bowel bypass for obesity.

    abstract::Small intestinal morphologic and biochemical changes were studied following jejuno-ileal bypass for obesity after body weight stabilization had occurred. Four patients underwent biopsy of in-continuity and bypassed jejunal and ileal segments of the small intestine 11 to 22 months after the bypass operation. Microscopi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197706000-00005

    authors: Dudrick SJ,Daly JM,Castro G,Akhtar M

    更新日期:1977-06-01 00:00:00

  • A small arterial substitute: expanded microporous polytetrafluoroethylene: patency versus porosity.

    abstract::Eighty-nine grafts of expanded microporous polytetrafluoroethylene (PTFE) with a diameter of 4 mm, were placed in the carotid and femoral arteries of dogs. The animals were sacrificed at varying intervals beginning three days after operation. Four animals remain alive with patent grafts 10 months post-operatively. Twe...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197508000-00010

    authors: Campbell CD,Goldfarb D,Roe R

    更新日期:1975-08-01 00:00:00

  • Role of Serum Carcinoma Embryonic Antigen (CEA) Level in Localized Pancreatic Adenocarcinoma: CEA Level Before Operation is a Significant Prognostic Indicator in Patients With Locally Advanced Pancreatic Cancer Treated With Neoadjuvant Therapy Followed by

    abstract:OBJECTIVE:The aim of the study was to identify the prognostic factors before neoadjuvant chemoradiotherapy (NCRT) in the patients with localized PDAC. Furthermore, to identify the post-surgical survival predictors of patients with LAPC. SUMMARY OF BACKGROUND DATA:Surgical resection may occupy an important position in ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004148

    authors: Kato H,Kishiwada M,Hayasaki A,Chipaila J,Maeda K,Noguchi D,Gyoten K,Fujii T,Iizawa Y,Tanemura A,Murata Y,Kuriyama N,Usui M,Sakurai H,Isaji S,Mizuno S

    更新日期:2020-07-24 00:00:00

  • Effects of hemorrhagic shock on adrenal response in a rat model.

    abstract:INTRODUCTION:There is a documented association between critically ill patients who are in refractory shock and adrenal insufficiency. The underlying pathophysiology may be related to ischemia, necrosis, reperfusion, or resuscitative dilution. We hypothesize this blunted adrenal response is due to ischemia and necrosis ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000216759.36819.1b

    authors: Rushing GD,Britt RC,Britt LD

    更新日期:2006-05-01 00:00:00

  • Remission of type 2 diabetes after Roux-en-Y gastric bypass or sleeve gastrectomy is associated with a distinct glycemic profile.

    abstract:BACKGROUND:Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) have been associated with a high remission rate of type 2 diabetes mellitus (T2DM). However, whether such remission is associated with full restoration of postprandial glucose profile and/or the potentially nonrestored glycemic profile is associate...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000586

    authors: Jiménez A,Ceriello A,Casamitjana R,Flores L,Viaplana-Masclans J,Vidal J

    更新日期:2015-02-01 00:00:00

  • Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial.

    abstract:OBJECTIVES:To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND:PJ and PG are established methods for reconstruction in pancreatoduod...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000001240

    authors: Keck T,Wellner UF,Bahra M,Klein F,Sick O,Niedergethmann M,Wilhelm TJ,Farkas SA,Börner T,Bruns C,Kleespies A,Kleeff J,Mihaljevic AL,Uhl W,Chromik A,Fendrich V,Heeger K,Padberg W,Hecker A,Neumann UP,Junge K,Kalff

    更新日期:2016-03-01 00:00:00

  • Management of Five Hundred Patients With Gut Failure at a Single Center: Surgical Innovation Versus Transplantation With a Novel Predictive Model.

    abstract:OBJECTIVE(S):To define the evolving role of integrative surgical management including transplantation for patients gut failure (GF). METHODS:A total of 500 patients with total parenteral nutrition-dependent catastrophic and chronic GF were referred for surgical intervention particularly transplantation and comprised t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003523

    authors: Abu-Elmagd KM,Armanyous SR,Fujiki M,Parekh NR,Osman M,Scalish M,Newhouse E,Fouda Y,Lennon E,Shatnawei A,Kirby D,Steiger E,Khanna A,Radhakrishnan K,Quintini C,Hashimoto K,Barnes J,Costa G

    更新日期:2019-10-01 00:00:00

  • Carotid endarterectomy: neurologic complications as related to surgical techniques.

    abstract::Three hundred seventeen carotid endarterectomies performed on 240 consecutive patients in four Charleston hospitals were reviewed. The overall incidence of stroke was 10.7% and the mortality 3.2%. From these 317 operations a standardized series of 253 operations performed on neurologically stable patients was analyzed...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197706000-00010

    authors: Prioleau WH Jr,Alken AF,Hairston P

    更新日期:1977-06-01 00:00:00

  • Carcinoid tumors of the rectum: a multi-institutional international collaboration.

    abstract:OBJECTIVE:This study aims to describe recent experience with rectal carcinoids in European and North American centers. BACKGROUND:While considered indolent, the propensity of carcinoids to metastasize can be significant. METHODS:Rectal carcinoid patients were identified from prospective databases maintained at 9 inst...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0b013e3181fb8df6

    authors: Shields CJ,Tiret E,Winter DC,International Rectal Carcinoid Study Group.

    更新日期:2010-11-01 00:00:00

  • Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404.

    abstract:OBJECTIVE:A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery in terms of overall survival was conducted, and short-term surgical outcomes are demonstrated. BACKGROUND:The efficacy and safety outcome of laparoscopic surgery for clinical stages II/III colon cancer underg...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000000499

    authors: Yamamoto S,Inomata M,Katayama H,Mizusawa J,Etoh T,Konishi F,Sugihara K,Watanabe M,Moriya Y,Kitano S,Japan Clinical Oncology Group Colorectal Cancer Study Group.

    更新日期:2014-07-01 00:00:00

  • A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma.

    abstract:OBJECTIVE:To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable large hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Resection of HCC is potentially curative, but local recurrence is very common. There is currently no effective neoadjuvant or adjuvant therapy. METHODS:F...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e3181961c16

    authors: Zhou WP,Lai EC,Li AJ,Fu SY,Zhou JP,Pan ZY,Lau WY,Wu MC

    更新日期:2009-02-01 00:00:00

  • Clinicopathological aspects of high bile duct cancer. Experience with resection and bypass surgical treatments.

    abstract::This report reviews the experience of the Hepatobiliary Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London with 16 patients having proximal extrahepatic bile duct malignancy who underwent resection and a comparable group of 15 patients who had surgical bypass. The purposes of the review were to eval...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198406000-00001

    authors: Beazley RM,Hadjis N,Benjamin IS,Blumgart LH

    更新日期:1984-06-01 00:00:00

  • Increased Rate of Long-term Mortality Among Burn Survivors: A Population-based Matched Cohort Study.

    abstract:OBJECTIVE:To estimate long-term mortality following major burn injury compared with matched controls. SUMMARY BACKGROUND DATA:The effect of sustaining a major burn injury on long-term life expectancy is poorly understood. METHODS:Using health administrative data, all adults who survived to discharge after major burn ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002722

    authors: Mason SA,Nathens AB,Byrne JP,Diong C,Fowler RA,Karanicolas PJ,Moineddin R,Jeschke MG

    更新日期:2019-06-01 00:00:00

  • Tissue- and time-dependent upregulation of cytokine mRNA in a murine model for the multiple organ dysfunction syndrome.

    abstract:OBJECTIVE:We sought to quantitate the course of specific cytokine mRNA expression in tissues that exhibit increasing histopathological changes in time in an animal model for the multiple organ dysfunction syndrome (MODS). SUMMARY BACKGROUND DATA:The development of treatment protocols for MODS requires elucidation of t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000130725.52373.e7

    authors: Volman TJ,Goris RJ,van der Meer JW,Hendriks T

    更新日期:2004-07-01 00:00:00

  • Carotid endarterectomy in the community hospital in patients age 80 and older.

    abstract:OBJECTIVE:To determine whether the rates of death and complications of carotid endarterectomy (CE) were different in the octogenarian population than in patients younger than age 80. SUMMARY BACKGROUND DATA:The utility of CE depends on the ability of the surgeon and hospital to attain low rates of death and complicati...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200006000-00001

    authors: Maxwell JG,Taylor AJ,Maxwell BG,Brinker CC,Covington DL,Tinsley E Jr

    更新日期:2000-06-01 00:00:00

  • Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.

    abstract:OBJECTIVE:This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA:Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002089

    authors: Johnston MJ,Arora S,King D,Darzi A

    更新日期:2018-01-01 00:00:00

  • Is Less More? A Microsimulation Model Comparing Cost-effectiveness of the Revised American Thyroid Association's 2015 to 2009 Guidelines for the Management of Patients With Thyroid Nodules and Differentiated Thyroid Cancer.

    abstract:OBJECTIVE:To assess relative clinical and economic performance of the revised American Thyroid Association (ATA) thyroid cancer guidelines compared to current standard of care. BACKGROUND:Diagnosis of thyroid cancer in the United States has tripled whereas mortality has only marginally increased. Most patients present...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003074

    authors: White C,Weinstein MC,Fingeret AL,Randolph GW,Miyauchi A,Ito Y,Zhan T,Ali A,Gazelle GS,Lubitz CC

    更新日期:2020-04-01 00:00:00

  • Fas and Fas-ligand expression in human pancreatic cancer.

    abstract:OBJECTIVE:To investigate Fas and FasL expression in pancreatic tissues and cultured pancreatic cancer cell lines, and to assess the ability of anti-Fas antibodies to induce apoptosis. SUMMARY BACKGROUND DATA:Activation of the Fas receptor by Fas-ligand (FasL) results in apoptosis, and dysregulation of this pathway may...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200003000-00010

    authors: Kornmann M,Ishiwata T,Kleeff J,Beger HG,Korc M

    更新日期:2000-03-01 00:00:00

  • Combination anti-CD2 and anti-CD3 monoclonal antibodies induce tolerance while altering interleukin-2, interleukin-4, tumor necrosis factor, and transforming growth factor-beta production.

    abstract:OBJECTIVE:These studies were designed to elucidate the mechanism by which signals delivered by anti-CD2 monoclonal antibody (MoAb) interfere with activational signals delivered by anti-CD3 MoAb and induce long-term graft survival and tolerance. SUMMARY BACKGROUND DATA:Anti-CD2 or anti-CD3 MoAb can prolong allograft su...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199310000-00009

    authors: Chavin KD,Qin L,Lin J,Woodward JE,Baliga P,Bromberg JS

    更新日期:1993-10-01 00:00:00