Published in:
01-09-2020 | Sleeve Gastrectomy | Original Contributions
Reoperation Incidence and Severity Within 6 Months After Bariatric Surgery: a Propensity-Matched Study from Nationwide Data
Published in: Obesity Surgery | Issue 9/2020
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Background
Data about incidence and severity of reoperations up to 6 months after bariatric surgery are currently limited. The aim of this cohort study was to evaluate the incidence and severity of reoperations after initial bariatric surgical procedures and to compare this between the 3 most frequent current surgical procedures (sleeve, gastric bypass, gastric banding).
Study Design
Nationwide observational cohort study using data from French Hospital Information System (2013–2015) to evaluate incidence and severity of reoperations within 6 months after bariatric surgery. Hazard ratios (HR) of longitudinal comparison between historical propensity-matched cohorts were estimated from a Fine and Gray’s model using competing risk of death.
Results
Cumulative reoperation rates increased from postoperative day-30 to day-180. Consequently, 31.1 to 90.0% of procedures would have been missed if the reoperation rate was based solely on a 30-day follow-up. Reoperation rate at 6 months was significantly higher after gastric bypass than after sleeve (HR 0.64; IC 95% [0.53–0.77]) and corresponded to moderate-risk reoperations (HR 0.65; IC 95% [0.53–0.78]). Reoperation rate at 6 months was significantly higher after gastric banding than after sleeve (HR 0.08; IC 95% [0.07–0.09]) and corresponded to moderate-risk reoperations (HR 0.08; IC 95% [0.07–0.10]).
Conclusion
Cumulative incidence of reoperations increased from 30 days to 6 months after sleeve, gastric bypass, or gastric banding and corresponded to moderate-risk surgical procedures. Consequently, 30-day reoperation rate should no longer be considered when evaluating complications and surgical performance after bariatric surgery.