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Obesity Surgery
Published in: Obesity Surgery 4/2020

01-04-2020 | Bariatric Surgery | Original Contributions

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

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

Published in: Obesity Surgery | Issue 4/2020

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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.
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Metadata
Title
Fast Track Program in Conversion Bariatric Surgery, as Safe as in Primary Bariatric Surgery?
Authors
Abdelrahman Mohammad Galal
Evert-Jan Boerma
Sofie Fransen
Berry Meesters
Steven Olde Damink
Jan Willem Greve
Publication date
01-04-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04268-7

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