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Background <p>Patients undergoing gastric bypass are typically admitted overnight, however same-day discharge after Roux-en-Y Gastric Bypass (SDD-RYGB) procedure may lead to improved patient throughput and satisfaction. The safety profile of this approach has not been well studied. Therefore, we aimed to determine the perioperative and 30-day outcomes in patients undergoing SDD-RYGB compared to patients who required an overnight admission.</p> Methods <p>The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was used for years 2015–2022. Propensity score matching (PSM) was conducted using clinically and statistically significant preoperative characteristics to create two patient groups (SDD-RYGB and overnight admission). Postoperative outcomes were analyzed.</p> Results <p>A total of 4845 patients underwent SDD-RYGB. PSM yielded 4843 patient pairs. PSM sensitivity analysis was completed and demonstrated adequate matching between both groups. After PSM, patients undergoing the SDD-RYGB had an acceptable 30-day postoperative complication rate as compared to those with an overnight admission. Patients who had an overnight admission did have an increased rate of concurrent adhesiolysis during their RYGB procedure (3.92% vs 2.89%; <i>p</i> = 0.006). SDD-RYGB patients experienced a lower rate of postoperative intervention (0.89% vs 1.36%; <i>p</i> = 0.035), with similar rates of readmission (3.74% vs 4.10%; <i>p</i> = 0.425), re-operation (1.24% vs 0.93%; <i>p</i> = 0.172), and death (0.19% vs 0.08%; <i>p</i> = 0.267). Patients also experienced equal rates of postoperative bleeding (0.56% vs 0.39%; <i>p</i> = 0.302) and postoperative leak (0.19% vs 0.25%; <i>p</i> = 0.663). Patients undergoing SDD-RYGB were more likely to require postoperative outpatient dehydration treatment (5.66% vs 3.86%; <i>p</i> &lt; 0.001).</p> Conclusions <p>SDD-RYGB is generating continued interest and in appropriately selected patients has similar rates of major morbidity compared to those who are admitted overnight for 1–2&#xa0;days. SDD-RYGB may have the potential to reduce hospital burden and cost while providing patients with a safe operation and expeditious recovery.</p>

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Outcomes comparison for same-day laparoscopic Roux-en-Y gastric bypass: a propensity score matched analysis utilizing the MBSAQIP PUF

  • 期刊论文

  • 发表日期：

    2025年6月27日

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  • Samuel C. Perez,
  • Saeed Arefanian,
  • Joshua Landrenaeu,
  • Andrew A. Wheeler

摘要

Background

Patients undergoing gastric bypass are typically admitted overnight, however same-day discharge after Roux-en-Y Gastric Bypass (SDD-RYGB) procedure may lead to improved patient throughput and satisfaction. The safety profile of this approach has not been well studied. Therefore, we aimed to determine the perioperative and 30-day outcomes in patients undergoing SDD-RYGB compared to patients who required an overnight admission.

Methods

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was used for years 2015–2022. Propensity score matching (PSM) was conducted using clinically and statistically significant preoperative characteristics to create two patient groups (SDD-RYGB and overnight admission). Postoperative outcomes were analyzed.

Results

A total of 4845 patients underwent SDD-RYGB. PSM yielded 4843 patient pairs. PSM sensitivity analysis was completed and demonstrated adequate matching between both groups. After PSM, patients undergoing the SDD-RYGB had an acceptable 30-day postoperative complication rate as compared to those with an overnight admission. Patients who had an overnight admission did have an increased rate of concurrent adhesiolysis during their RYGB procedure (3.92% vs 2.89%; p = 0.006). SDD-RYGB patients experienced a lower rate of postoperative intervention (0.89% vs 1.36%; p = 0.035), with similar rates of readmission (3.74% vs 4.10%; p = 0.425), re-operation (1.24% vs 0.93%; p = 0.172), and death (0.19% vs 0.08%; p = 0.267). Patients also experienced equal rates of postoperative bleeding (0.56% vs 0.39%; p = 0.302) and postoperative leak (0.19% vs 0.25%; p = 0.663). Patients undergoing SDD-RYGB were more likely to require postoperative outpatient dehydration treatment (5.66% vs 3.86%; p < 0.001).

Conclusions

SDD-RYGB is generating continued interest and in appropriately selected patients has similar rates of major morbidity compared to those who are admitted overnight for 1–2 days. SDD-RYGB may have the potential to reduce hospital burden and cost while providing patients with a safe operation and expeditious recovery.