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Defining Global Ben...
Defining Global Benchmarks in Bariatric Surgery A Retrospective Multicenter Analysis of Minimally Invasive Roux-en-Y Gastric Bypass and Sleeve Gastrectomy
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- Gero, Daniel (författare)
- Univ Hosp Zurich, Switzerland
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- Raptis, Dimitri A. (författare)
- Univ Hosp Zurich, Switzerland; Royal Free Hosp, England
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- Vleeschouwers, Wouter (författare)
- AZ Sint Jan Brugge Oostende, Belgium
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- van Veldhuisen, Sophie L. (författare)
- Rijnstate Hosp, Netherlands
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- San Martin, Andres (författare)
- Dipreca Hosp, Chile
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- Xiao, Yao (författare)
- Varberg Hosp, Sweden; Univ Gothenburg, Sweden
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- Galvao, Manoela (författare)
- Adv Inst Bariatr and Metab Surg, Brazil
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- Giorgi, Marcoandrea (författare)
- Brown Univ, RI 02906 USA
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- Benois, Marine (författare)
- Univ Cote Azur, France
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- Espinoza, Felipe (författare)
- Clin Las Condes, Chile
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- Hollyman, Marianne (författare)
- Musgrove Pk Hosp, England
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- Lloyd, Aaron (författare)
- Fresno Heart and Surg Hosp, CA USA
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- Hosa, Hanna (författare)
- Univ Hosp Zurich, Switzerland
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- Schmidt, Henner (författare)
- Univ Hosp Zurich, Switzerland
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- Garcia-Galocha, Jose Luis (författare)
- Univ Complutense Madrid, Spain
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- van de Vrande, Simon (författare)
- AZ Sint Blasius Hosp, Belgium
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- Chiappetta, Sonja (författare)
- Sana Klinikum Offenbach, Germany
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- Lo Menzo, Emanuele (författare)
- Cleveland Clin Florida, FL USA
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- Aboud, Cristina Mamedio (författare)
- Oswaldo Cruz German Hosp, Brazil
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- Luthy, Sandra Gagliardo (författare)
- Clarunis St Clara Hosp, Switzerland; Univ Hosp Basel, Switzerland
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- Orchard, Philippa (författare)
- Southmead Hosp, England
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- Rothe, Steffi (författare)
- Vienna Med Univ, Austria
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- Prager, Gerhard (författare)
- Vienna Med Univ, Austria
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- Pournaras, Dimitri J. (författare)
- Southmead Hosp, England
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- Cohen, Ricardo (författare)
- Oswaldo Cruz German Hospital, Sao Paulo, Brazil
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- Rosenthal, Raul (författare)
- Cleveland Clin Florida, FL USA
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- Weiner, Rudolf (författare)
- Sana Klinikum Offenbach, Germany
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- Himpens, Jacques (författare)
- AZ Sint Blasius Hosp, Belgium; Vienna Med Univ, Austria; St Pierre Univ Hosp, Belgium
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- Torres, Antonio (författare)
- Univ Complutense Madrid, Spain
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- Higa, Kelvin (författare)
- Fresno Heart and Surg Hosp, CA USA
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- Welbourn, Richard (författare)
- Musgrove Park Hospital, Taunton, UK
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- Berry, Marcos (författare)
- Clin Las Condes, Chile
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- Boza, Camilo (författare)
- Clin Las Condes, Chile
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- Iannelli, Antonio (författare)
- Univ Cote Azur, France
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- Vithiananthan, Sivamainthan (författare)
- Brown Univ, RI 02906 USA
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- Ramos, Almino (författare)
- Adv Inst Bariatr and Metab Surg, Brazil
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- Olbers, Torsten (författare)
- Linköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken ViN,Univ Gothenburg, Sweden
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- Sepulveda, Matias (författare)
- Dipreca Hosp, Chile
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- Hazebroek, Eric J. (författare)
- Rijnstate Hosp, Netherlands
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- Dillemans, Bruno (författare)
- AZ Sint Jan Brugge Oostende, Belgium
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- Staiger, Roxane D. (författare)
- Univ Hosp Zurich, Switzerland
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- Puhan, Milo A. (författare)
- Univ Zurich, Switzerland
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- Peterli, Ralph (författare)
- Clarunis St Clara Hosp, Switzerland; Univ Hosp Basel, Switzerland
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- Bueter, Marco (författare)
- Univ Hosp Zurich, Switzerland
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(creator_code:org_t)
- Lippincott Williams & Wilkins, 2019
- 2019
- Engelska.
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Ingår i: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 270:5, s. 859-867
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objective: To define “best possible” outcomes for bariatric surgery (BS)(Roux-en-Y gastric bypass [RYGB] and sleeve gastrectomy [SG]).Background: Reference values for optimal surgical outcomes in well-defined low-risk bariatric patients have not been established so far. Consequently, outcome comparison across centers and over time is impeded by heterogeneity in case-mix.Methods: Out of 39,424 elective BS performed in 19 high-volume academic centers from 3 continents between June 2012 and May 2017, we identified 4120 RYGB and 1457 SG low-risk cases defined by absence of previous abdominal surgery, concomitant procedures, diabetes mellitus, sleep apnea, cardiopathy, renal insufficiency, inflammatory bowel disease, immunosuppression, anticoagulation, BMI>50 kg/m2 and age>65 years. We chose clinically relevant endpoints covering the intra- and postoperative course. Complications were graded by severity using the comprehensive complication index. Benchmark values were defined as the 75th percentile of the participating centers’ median values for respective quality indicators.Results: Patients were mainly females (78%), aged 38±11 years, with a baseline BMI 40.8 ± 5.8 kg/m2. Over 90 days, 7.2% of RYGB and 6.2% of SG patients presented at least 1 complication and no patients died (mortality in nonbenchmark cases: 0.06%). The most frequent reasons for readmission after 90-days following both procedures were symptomatic cholelithiasis and abdominal pain of unknown origin. Benchmark values for both RYGB and SG at 90-days postoperatively were 5.5% Clavien-Dindo grade ≥IIIa complication rate, 5.5% readmission rate, and comprehensive complication index ≤33.73 in the subgroup of patients presenting at least 1 grade ≥II complication.Conclusion: Benchmark cutoffs targeting perioperative outcomes in BS offer a new tool in surgical quality-metrics and may be implemented in quality-improvement cycle.ClinicalTrials.gov Identifier NCT03440138
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- bariatric surgery; benchmark; complication; morbidity; outcome research; quality assessment; Roux-en-Y gastric bypass; sleeve gastrectomy
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- Av författaren/redakt...
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Gero, Daniel
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Raptis, Dimitri ...
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Vleeschouwers, W ...
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van Veldhuisen, ...
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San Martin, Andr ...
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Xiao, Yao
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visa fler...
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Galvao, Manoela
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Giorgi, Marcoand ...
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Benois, Marine
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Espinoza, Felipe
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Hollyman, Marian ...
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Lloyd, Aaron
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Hosa, Hanna
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Schmidt, Henner
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Garcia-Galocha, ...
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van de Vrande, S ...
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Chiappetta, Sonj ...
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Lo Menzo, Emanue ...
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Aboud, Cristina ...
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Luthy, Sandra Ga ...
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Orchard, Philipp ...
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Rothe, Steffi
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Prager, Gerhard
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Pournaras, Dimit ...
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Cohen, Ricardo
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Rosenthal, Raul
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Weiner, Rudolf
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Himpens, Jacques
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Torres, Antonio
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Higa, Kelvin
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Welbourn, Richar ...
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Berry, Marcos
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Boza, Camilo
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Iannelli, Antoni ...
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Vithiananthan, S ...
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Ramos, Almino
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Olbers, Torsten
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Sepulveda, Matia ...
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Hazebroek, Eric ...
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Dillemans, Bruno
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Staiger, Roxane ...
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Puhan, Milo A.
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Peterli, Ralph
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Bueter, Marco
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