Fast Track Program in Conversion Bariatric Surgery, as Safe as in Primary Bariatric Surgery?

Abdelrahman Mohammad Galal*, Evert-Jan Boerma, Sofie Fransen, Berry Meesters, Steven Olde Damink, Jan Willem Greve*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

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/m(2). 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/m(2). 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.

Original languageEnglish
Pages (from-to)1291-1302
Number of pages12
JournalObesity Surgery
Volume30
Issue number4
Early online date20 Dec 2019
DOIs
Publication statusPublished - Apr 2020

Keywords

  • Fast track surgery
  • Bariatric surgery
  • Revision
  • Conversion
  • Gastric bypass
  • Follow up
  • Complications
  • LAPAROSCOPIC GASTRIC BYPASS
  • LENGTH-OF-STAY
  • HOSPITAL STAY
  • SLEEVE GASTRECTOMY
  • PERIOPERATIVE CARE
  • ENHANCED RECOVERY
  • OUTCOMES
  • COMPLICATIONS
  • READMISSIONS
  • PREDICTORS

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