Trends in Drain Utilization in Bariatric Surgery: an Analysis of the MBSAQIP Database 2015–2017
Autor: | Christopher Dodoo, Babak Sadri, Ellen Wicker, Ginger Coleman, Robert Cullen, Benjamin Clapp, Alan H. Tyroch, Ira L. Swinney, Carlos Lodeiro |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy Demographics Wilcoxon signed-rank test Databases Factual Endocrinology Diabetes and Metabolism medicine.medical_treatment Original Contributions Provocative test Gastric bypass Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program 030209 endocrinology & metabolism computer.software_genre Abdominal drains Accreditation Continuous variable 03 medical and health sciences 0302 clinical medicine Postoperative Complications Enhanced recovery medicine Prevalence Humans Skewed data Bariatric surgery Nutrition and Dietetics Database business.industry Middle Aged Quality Improvement MBSAQIP Surgery Obesity Morbid Treatment Outcome Drainage 030211 gastroenterology & hepatology Female Laparoscopy business computer |
Zdroj: | Obesity Surgery |
ISSN: | 1708-0428 0960-8923 |
Popis: | Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (SG) are the two most common bariatric operations. With the implementation of enhanced recovery protocols, the use of drains should decrease. Methods The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was queried for the years 2015–2017. Our inclusion criteria included all patients undergoing a primary LRYGB, SG, and revisions. We examined demographics, operative characteristics, the use of drains, and postoperative complications. Continuous variables were summarized using means and standard deviations (SD). Categorical variables were summarized using frequencies and proportions. Student’s T test (Wilcoxon sum rank test in the case of skewed data) and chi-squared analysis were used to assess the baseline differences in drain utilization. Results From 2015 to 2017, there were 388,239 bariatric cases performed without drains and 100,221 performed with drains. Twenty-nine percent of LRYGB patients had a drain placed but only 16.7% of SG patients. The percentage of LRYGB that had a drain dropped from 33.1 to 24.6% during the study period and that of SG dropped from 20.3 to 13.6%. Patients that had drains placed were more likely to have a provocative test at the time of surgery (prevalence ratio (PR) 2.24) and to have a postoperative swallow study (PR 1.93). Conclusions Drains are still commonly used in bariatric patients. Over the study period, there was a decrease in the use of drains in both bypass and sleeve patients. Patients with a drain were more likely to have had a provocative test and a swallow study and have a higher rate of complications and mortality. Electronic supplementary material The online version of this article (10.1007/s11695-019-04215-6) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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