Analysis of aborted bariatric surgeries and potential opportunities.

Autor: Pearl LM; Department of Surgery, Henry Ford Health, Detroit, MI, USA.; Henry Ford Macomb Hospital, 16151 19 Mile Road, Suite 215, Clinton Township, MI, 48038, USA., Varban OA; Department of Surgery, Henry Ford Health, Detroit, MI, USA.; Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA., Bonham AJ; Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA., Stricklen A; Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA., Kia MA; Department of Surgery, McLaren Flint Hospital, Flint, MI, USA.; Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA., Finks JF; Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA.; Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA., Carlin AM; Department of Surgery, Henry Ford Health, Detroit, MI, USA. acarlin1@hfhs.org.; Michigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA. acarlin1@hfhs.org.; Henry Ford Macomb Hospital, 16151 19 Mile Road, Suite 215, Clinton Township, MI, 48038, USA. acarlin1@hfhs.org.; Wayne State University School of Medicine, Detroit, MI, USA. acarlin1@hfhs.org.; Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA. acarlin1@hfhs.org.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Sep; Vol. 38 (9), pp. 5363-5367. Date of Electronic Publication: 2024 Jul 22.
DOI: 10.1007/s00464-024-11047-8
Abstrakt: Background: Aborted bariatric surgeries are an undesirable experience for patients as they are subjected to potential physical harm and emotional distress. A thorough investigation of aborted bariatric surgeries has not been previously reported. This information may allow the discovery of opportunities to mitigate the risk of aborting some bariatric operations.
Methods: Data from the Michigan Bariatric Surgery Collaborative, a statewide bariatric surgery registry, were used to identify all aborted primary bariatric operations from June 2006 through January 2023. The reasons for aborting surgery were divided into seven categories. Stepwise logistic regression was performed to identify independent predictors of aborted procedures for potentially modifiable factors.
Results: A total of 115,004 patients underwent bariatric surgery with 555 (0.48%) procedures aborted. Of those having an aborted operation the mean age was 52 years and mean BMI was 49.8 with females accounting for 72%. Sleeve gastrectomy had the lowest aborted rate (0.38%) as compared to gastric bypass, adjustable gastric banding, and biliopancreatic diversion (p < 0.0001). The most common aborted surgery reason categories included adhesions and hernias, tumors and anatomic anomalies, and inadequate visualization due to either hepatomegaly or abdominal wall thickness. The most significant (p < 0.0001) independent predictors of aborted surgeries due to hepatomegaly or abdominal wall thickness were BMI ≥ 60 (OR 10.7), BMI 50 to 59 (OR 3.1) and diabetes mellitus (OR 2.7). Preoperative weight loss was a protective factor for aborting surgery due to hepatomegaly or abdominal wall thickness (OR 0.9; p < 0.0001).
Conclusions: Aborted surgeries are uncommon and occur in approximately 1 in 200 primary bariatric operations with the lowest rate identified in sleeve gastrectomy. Nearly 20% of operations are aborted due to hepatomegaly or abdominal wall thickness and targeting patients with elevated BMIs and diabetes mellitus for preoperative weight loss might reduce the risk of these types of aborted procedures.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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