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Bleeding during laparoscopic gastric bypass surgery as a risk factor for less favorable outcome: A cohort study from the Scandinavian Obesity Surgery Registry
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-4958-1611
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
Department of Surgery, Örebro University Hospital, Örebro, Sweden.
Department of Surgery, Örebro University Hospital, Örebro, Sweden.
2017 (English)In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 13, no 10, p. 1735-1740, article id S1550-7289(17)30289-7Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Intraoperative adverse events are known to be associated with postoperative complications; however, little is known about whether or not blood loss during laparoscopic gastric bypass surgery affects the outcome.

OBJECTIVE: To see if intraoperative bleeding was associated with a less favorable outcome, and to identify patient-specific risk factors for intraoperative bleeding.

SETTING: Nationwide, Sweden.

METHODS: Patients who underwent laparoscopic gastric bypass surgery between January 8, 2007, and September 15, 2015, were included in the study. The volume of intraoperative blood loss was compared with data from follow-up at day 30 and 1 and 2 years after surgery. Patient-specific factors were analyzed as potential risk factors for intraoperative bleeding.

RESULTS: The study included 43,157 patients. Intraoperative bleeding was associated with an increased risk for postoperative complication (100-499 mL, odds ratio [OR] 2.97, 95% confidence interval [95%CI] 2.53-3.50;>500 mL OR 3.34, 95%CI 2.05-5.44), lower weight loss (<100 mL, 82.4±24.19% excess body mass index-loss [%EBMIL]; 100-499 mL, 76.9±24.24 %EBMIL, P<.0001;>500 mL 76.9±23.89 %EBMIL, P = .063) and lower reported quality-of-life 2 years after surgery (<100 mL, Obesity-related Problem scale (OP) 21.1±24.46; 100-499 mL, OP 25.0±26.62, P = .008;>500 mL, OP 25.2±24.46, P = .272). Diabetes (OR 1.30, 95%CI 1.08-1.58), age (OR 1.02, 95%CI 1.02-1.03), and body mass index (OR 1.03, 95%CI 1.02-1.05) were patient-specific risk factors for intraoperative bleeding≥100 mL, whereas intentional preoperative weight loss was associated with a lower risk (OR .50, 95%CI .43-.57).

CONCLUSION: Intraoperative bleeding was associated with less favorable outcome after laparoscopic gastric bypass surgery. Age, body mass index, and diabetes were risk factors for intraoperative bleeding, while preoperative weight reduction seems to be protective.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 13, no 10, p. 1735-1740, article id S1550-7289(17)30289-7
Keywords [en]
Gastric bypass; Laparoscopic; Bariatric surgery; Intraoperative complication; Postoperative complication; Adverse outcome; Risk factor; Bleeding
National Category
Surgery General Practice
Identifiers
URN: urn:nbn:se:oru:diva-60794DOI: 10.1016/j.soard.2017.05.028ISI: 000414823500018PubMedID: 28688860Scopus ID: 2-s2.0-850218408142-s2.0-85021840814OAI: oai:DiVA.org:oru-60794DiVA, id: diva2:1149618
Note

Funding agencies:

Örebro County Council  

Örebro University 

Available from: 2017-10-16 Created: 2017-10-16 Last updated: 2018-08-06Bibliographically approved

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Stenberg, ErikSzabo, Eva

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