Comparing outcomes of laparoscopic versus open bariatric surgery

被引:102
|
作者
Weller, Wendy E. [1 ]
Rosati, Carl [2 ,3 ,4 ]
机构
[1] SUNY Albany, Sch Publ Hlth, Dept Hlth Policy Management & Behav, Rensselaer, NY 12144 USA
[2] Albany Med Ctr, Dept Surg, Sect Trauma, Albany, NY USA
[3] Albany Med Ctr, Dept Surg, Sect Crit Care, Albany, NY USA
[4] Albany Med Ctr, Dept Surg, Sect Gen & Laparoscop Surg, Albany, NY USA
关键词
D O I
10.1097/SLA.0b013e31816d953a
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: The objective of this study was to use nationally representative data to compare outcomes of open gastric bypass (OGB) versus laparoscopic gastric bypass (LGB) surgery. Background: The number of bariatric procedures continues to grow. Increasingly, these surgeries are being performed laparoscopically. However, few population-based studies have examined differences in outcomes between LGB and OGB surgeries. Population-based studies can provide further insight into differences in outcomes between open and laparoscopic bariatric procedures. Methods: Using the Nationwide Inpatient Sample, we identified adults undergoing LGB or OGB surgery during 2005 (n = 19,156). Following preliminary descriptive statistics, multiple logistic and linear regressions were used to obtain risk-adjusted outcomes, including postoperative in-hospital complications, reoperation, length of stay, and total charges. Results: The majority of patients in the study sample (74.5%) underwent laparoscopic bypass surgery in 2005. After adjusting for patient and hospital level factors, patients undergoing OGB surgery were more likely to experience reoperation as well as the following complications: pulmonary (odds ratio [OR] = 1.92 (1.54-2.38), P < 0.001); cardiovascular (OR = 1.54 [1.07-2.23], P = 0.02); procedural (OR = 1.29 [1.06-1.57], P < 0.01); sepsis (OR = 2,18 [1.50-3.16], P < 0.001); and anastomotic leak (OR = 1.32 [1.021.71], P = 0.03). After risk adjustment, LGB was associated with a shorter length of stay but higher total charges. Conclusion: Overall, LGB patients are less likely to experience reoperation and postoperative complications in the hospital and have a shorter length of stay but incur higher total charges than OGB patients.
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页码:10 / 15
页数:6
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