Bariatric surgery - complications and safety of laparoscopic sleeve gastrectomy performed at a lower-volume tertiary care center

Falk, Vanessa Sophie (2022) Bariatric surgery - complications and safety of laparoscopic sleeve gastrectomy performed at a lower-volume tertiary care center. Masters thesis, Memorial University of Newfoundland.

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Abstract

Newfoundland and Labrador (NL) has the highest rate of obesity in Canada, prompting the establishment of a bariatric surgery program at the Health Sciences Centre in St. John’s, NL. This retrospective study examined less than 30-day complication rates in over 200 consecutive patients between May 2011 and February 2014 who underwent laparoscopic sleeve gastrectomy (LSG). A chart review was performed and data collected on less than 30-day post-operative complications. Complications were graded and reported using the Clavien-Dindo Classification. Grades I and II were defined as minor and grades III and higher were defined as major. The first 209 LSG patients were reviewed. The mean BMI was 49.2 kg/m2, 81% were female and the average age was 43 years. Comorbidities included: hypertension (55.0%), obstructive sleep apnea (46.4%), dyslipidemia (42.1%), diabetes (37.3%), osteoarthritis (36.4%), cardiovascular disease with previous cardiac stents (5.3%). Furthermore, 38.3% of patients reported psychiatric diagnoses such as depression and anxiety. The overall 30-day complication rate was 15.3%. The complication rate for minor complications was 13.4% and for major complications was 1.9% (i.e., two leaks, one stricture and one fistula). Our results support the feasibility of safely performing LSG surgery at bariatric centers performing fewer than 125 procedures annually.

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