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Erschienen in:
03.05.2016
Shorter than 24-h hospital stay for sleeve gastrectomy is safe and feasible
Erschienen in: Surgical Endoscopy | Ausgabe 12/2016
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Background
Bariatric surgery is currently the most effective treatment for morbid obesity. Short-stay procedures have gained popularity in many surgical sub-specialties. Main benefits are early discharge, minimal loss of productivity, cost reductions, and a reduced risk of infections. Such procedures can be undertaken if the patient’s safety is not jeopardized. Laparoscopic sleeve gastrectomy (LSG) has consolidated itself as a primary bariatric technique. One matter of discussion relates to its associated quick postoperative recovery, as debate rages over whether there are patient benefits to hospital stays beyond 24 h.
Objective
To assess the safety of short-stay LSG.
Design
Cross-sectional, descriptive, retrospective analysis of a consecutive series.
Methods
We retrospectively analyzed data collected on hospital stays, readmission rates, early and midterm major complications, and re-intervention rates on 2629 primary LSG performed between February 2007 and August 2014.
Results
Out of 2629 patients, 2590 (98.52 %) were discharged within the first 24 h. Thirty-nine (1.48 %) required a longer admission: 16 (0.61 %) for vomiting and 23 (0.87 %) for bleeding, 5 (0.19 %) of whom required a second procedure within those first 24 h. Four patients (0.15 %) were readmitted for dehydration between day 2 and 4. A total of 26 leaks (0.99 %) occurred between postoperative days 6 and 41. Ten intra-abdominal hematomas (0.38 %) were diagnosed after the 7th postoperative day, and seven patients (0.27 %) required percutaneous drainage. Five abdominal collections (0.19 %), unrelated to either fistulas or bleeding, were diagnosed between day 6 and 16. No major complications occurred on postoperative days 2 through 5.
Conclusions
Our evidence suggests that hospital stays after LSG beyond 24 h are unnecessary in patients with no persistent vomiting or signs of bleeding or leaks; major complications generally present either within the first 24 h or after the fifth postoperative day.