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2014 (Engelska)Ingår i: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 260, nr 6, s. 1040-1047Artikel i tidskrift (Refereegranskat) Published
Abstract [en]
OBJECTIVE: To identify risk factors for serious and specific early complications of laparoscopic gastric bypass surgery using a large national cohort of patients.
BACKGROUND: Bariatric procedures are among the most common surgical procedures today. There is, however, still a need to identify preoperative and intraoperative risk factors for serious complications.
METHODS: From the Scandinavian Obesity Surgery Registry database, we identified 26,173 patients undergoing primary laparoscopic gastric bypass operation for morbid obesity between May 1, 2007, and September 30, 2012. Follow-up on day 30 was 95.7%. Preoperative data and data from the operation were analyzed against serious postoperative complications and specific complications.
RESULTS: The overall risk of serious postoperative complications was 3.4%. Age (adjusted P = 0.028), other additional operation [odds ratio (OR) = 1.50; confidence interval (CI): 1.04-2.18], intraoperative adverse event (OR = 2.63; 1.89-3.66), and conversion to open surgery (OR = 4.12; CI: 2.47-6.89) were all risk factors for serious postoperative complications. Annual hospital volume affected the rate of serious postoperative complications. If the hospital was in a learning curve at the time of the operation, the risk for serious postoperative complications was higher (OR = 1.45; CI: 1.22-1.71). The 90-day mortality rate was 0.04%.
CONCLUSIONS: Intraoperative adverse events and conversion to open surgery are the strongest risk factors for serious complications after laparoscopic gastric bypass surgery. Annual operative volume and total institutional experience are important for the outcome. Patient related factors, in particular age, also increased the risk but to a lesser extent.
Ort, förlag, år, upplaga, sidor
Lippincott Williams & Wilkins, 2014
Nyckelord
bariatric surgery; laparoscopic gastric bypass; postoperative complications; risk factors
Nationell ämneskategori
Kirurgi
Forskningsämne
Kirurgi
Identifikatorer
urn:nbn:se:oru:diva-40584 (URN)10.1097/SLA.0000000000000431 (DOI)000345217200018 ()24374541 (PubMedID)2-s2.0-84922330659 (Scopus ID)
Konferens
6th Congress of the International Federation for the Surgery of Obesity and Metabolic Disorders, European Chapter, Brussels, Belgium, April 30 - May 3, 2014
Projekt
Preventing complications in bariatric surgery
2015-01-152015-01-082020-12-01Bibliografiskt granskad