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Cited by 69Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesBody Contouring and Surgery

A comparison of 399 open and 568 laparoscopic gastric bypasses performed during a 4-year period

Sekhar, N., Torquati, A., Youssef, Y., Wright, J. K., Richards, W. O.·2007·Surgical Endoscopy
DOI 10.1007/s00464-006-9151-2
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Abstract

Background Laparoscopic Roux-en-Y gastric bypass surgery (RYGB) was introduced at the authors' institution 5 years ago. The authors analyzed the short- and long-term results of this procedure compared with those for the same procedure using the laparotomy approach over the same period. Methods Retrospective analysis of a prospectively collected bariatric database used the outcome end points used by the American Society of Bariatric Surgery (ASBS) and the American College of Surgeons (ACS) in their center of excellence programs. Results From January 2001 to July 2005, 568 laparoscopic and 399 open gastric bypasses were performed at Vanderbilt University. The patients were from the same bariatric surgery program and therefore received the same pre- and postoperative care. The hospital length of stay in the laparoscopic group was significantly shorter (2.5 +/- 2.4 days) than in the open group (3.7 +/- 3.7 days; p = 0.001). The procedure time was significantly shorter in the laparoscopic group (164 +/- 50 min) than in the open group (195 +/- 50 min; p = 0.0001). The follow-up assessment response at 2 years was 76.6%. At 2 years, the excess weight loss (EWL) was significantly greater in the laparoscopic group (71.3% +/- 18.4%) than in the open group (67.3% +/- 15.3%; p = 0.03). The wound infection rate was significantly higher in open group (9.2%) than in the laparoscopic group (1.7%; p = 0.001). There was no significant difference in 30-day mortality: open (0.50%) versus laparoscopic (0.17%; p = 0.371). There was no significant difference in the 30-day reoperation rate between the open (2.4%) and laparoscopic (2.6%; p = 0.705) groups. The 30-day readmission rate was similar in the open (5.0%) and laparoscopic (5.2%; p = 0.852) groups, as was the rate of leakage from the gastrojejunostomy in the open (0.50%) and laparoscopic (0.35%; p = 0.127) groups. The conversion rate from laparoscopic procedure to laparotomy was 1.7%. Conclusion In the authors' institution, a laparoscopic bariatric surgery program with a very low rate of morbidity and mortality has been introduced. Operative time, hospital stay, and wound complications are reduced with the laparoscopic approach. The laparoscopic and open procedures are equally safe, with equivalent 30-day mortality, readmission, reoperation, and gastrojejunostomy leakage rates.

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Crossref · 10.1007/s00464-006-9151-2

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  • A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table.

    “A total of 10 studies (12 articles) met the inclusion criteria, were rated as good or fair quality, and are included in the summary table.141,142,144,148,151,155,156,159,161,168,169,172”

    From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2014) · cites this paper as [161]

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Authors
Sekhar, N., Torquati, A., Youssef, Y., Wright, J. K., & Richards, W. O.
Affiliations
Vanderbilt University Medical Center (US)
Corresponding author
Richards, W. O.
ORCID
Venue
Surgical Endoscopy
Publisher
Springer Science and Business Media LLC
Published
2007-02-07
Volume
21
Issue
4
Pages
665-668
ISSN
  • 0930-2794 (ISSN-L)
  • 1432-2218
DOI
10.1007/s00464-006-9151-2
OpenAlex
W2010973228
Cited by
69
References
17
Citations by year
2024: 2 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 6 · 2012: 8
FWCI
7.90
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Surgical Endoscopy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
Keywords
laparoscopic Roux-en-Y gastric bypass, bariatric surgery, excess weight loss, length of hospital stay, wound infection, 30-day mortality, reoperation, hospital readmission, surgical technique comparison, morbid obesity, postoperative outcomes
MeSH terms
Adult, Aged, Female, Follow-Up Studies, Humans, Laparotomy, Male, Middle Aged, Obesity, Morbid, Laparoscopy, Postoperative Complications, Probability, Prospective Studies, Retrospective Studies, Severity of Illness Index, United States, Gastric Bypass, Weight Loss, Body Mass Index, Survival Rate, Chi-Square Distribution, Treatment Outcome, Patient Satisfaction, Risk Assessment

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