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Surgical Endoscopy

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01-06-2020 | Sleeve Gastrectomy

Bariatric peri-operative outcomes are affected by annual procedure-specific surgeon volume

Authors: Maria S. Altieri, Aurora D. Pryor, Jie Yang, Lizhou Nie, Mark A. Talamini, Konstantinos Spaniolas

Published in: Surgical Endoscopy | Issue 6/2020

Abstract

Background

There is limited data examining specific annual surgeon procedural volumes associated with improvement of postoperative outcomes following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

Objectives

Effect of surgeon volume on procedural outcomes.

Methods

Using the SPARCS Administrative database, patients undergoing laparoscopic RYGB or SG between 2010–2014 were analyzed. Multivariable generalized linear mixed regression models were first used to analyze the influences of 3 yearly mean volumes (combined, RYGB and SG mean volumes) on each of three surgical outcomes: 30-day readmission, peri-operative complications, and extended length of stay (LOS), while accounting for patient specific variables.

Results

A total of 46,511 laparoscopic bariatric procedures were included in the study. Risk for any complication and 30-day readmissions following RYGB decreased with increasing RYGB volume up to a specific volume and stayed similar afterward (OR 0.97, 95% CI 0.96–0.98 while volume < 247.9 cases/year and OR 0.99, 95% CI 0.98–0.99 while volume < 354.1 cases/year, respectively) while risk for extended LOS decreased with increasing combined bariatric mean volume up to a specific volume and stayed similar afterward (OR 0.9, 95% CI 0.85–0.95 while volume < 62.1 cases/year). Similar patterns were found for extended LOS and complications following SG (OR 0.82, 95% CI 0.72–0.93 while SG volume < 26.3 cases/year and OR 0.94, 95% CI 0.91–0.98 while combined volume < 62.1 cases/year, respectively), while 30-day readmission following SG significantly increased when combined bariatric volume being more than 138 cases/year (OR 1.10, 95% CI 1.00–1.21 while combined volume > 138 cases/year)).

Conclusions

Bariatric procedure peri-operative outcomes are affected by procedure-specific annual surgeons’ volume.

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Title: Bariatric peri-operative outcomes are affected by annual procedure-specific surgeon volume
Authors: Maria S. Altieri
Aurora D. Pryor
Jie Yang
Lizhou Nie
Mark A. Talamini
Konstantinos Spaniolas
Publication date: 01-06-2020
Publisher: Springer US
Keyword: Sleeve Gastrectomy
Published in: Surgical Endoscopy / Issue 6/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07048-7

At a glance: The STEP trials

Springer Medicine

Bariatric peri-operative outcomes are affected by annual procedure-specific surgeon volume

Abstract

Background

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusions

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