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Effect of operative times in bariatric surgery on outcomes: a matched analysis of the MBSAQIP database

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Abstract

Background

The implications of operative time (OT) have been studied in different surgical specialties, showing a correlation with higher incidence rates of postoperative complications. However, the impact of OT on bariatric surgery complications is not well elucidated.

Methods

A retrospective review of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database between 2015 and 2019 was performed. A total of 358,382 SG patients and 123,357 RYGB patients were included. The median OT was 68 min (10–720) and 113 min (10–640) for the sleeve gastrectomy (SG) group and the Roux-en-Y gastric bypass group, respectively. The groups were subdivided into two subgroups based on OT in comparison to the median time of each group. The subgroups were compared for surgical complications and outcomes. To reduce selection bias and risk of confounders, we performed a propensity score matching (PSM) for 22 variables.

Results

In the PSM-matched cohort, 18,915 SG and 6,495 RYGB patients were included in each subgroup. The SG cohort showed higher rates of Clavien–Dindo Class 1, 2, 3a, 4, and 5 complications as well as higher rates of readmission, reoperation, and reintervention in the longer OT group before matching. After PSM, the subgroup with longer times continued to have higher rates of Clavien–Dindo Class 2 complications and higher rates of readmission and reoperation. Similarly, there were higher rates of all Clavien–Dindo class complications as well as readmission, reoperation, and reintervention in the RYGB group with higher OT. After PSM, there were still higher rates of Clavien–Dindo Class 3a complications as well as readmission and reintervention in the RYGB subgroup with prolonged OT.

Conclusion

In both SG and RYGB, longer OT was associated with increased rates of complications as well as readmission, reoperation, and reintervention. Surgeons should be cognizant of the increased rates of complications when operative times are longer.

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Authors and Affiliations

  1. Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA

    Benjamin Clapp & John Corbett

  2. Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Katie Marrero, Ishna Sharma, Karl Hage, Robert A. Vierkant, Travis McKenzie & Omar M. Ghanem

  3. Division of General and GI Surgery, Emory University School of Medicine, Atlanta, GA, USA

    Scott S. Davis Jr.

  4. Endocrine and Metabolic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Omar M. Ghanem

Authors
  1. Benjamin Clapp
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  2. Katie Marrero
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  3. John Corbett
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  4. Ishna Sharma
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  5. Karl Hage
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  6. Robert A. Vierkant
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  7. Travis McKenzie
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  8. Scott S. Davis Jr.
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  9. Omar M. Ghanem
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Correspondence to Omar M. Ghanem.

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Disclosures

Drs Benjamin Clapp, Katie Marrero, John Corbett, Ishna Sharma, Karl Hage, Robert A. Vierkant, Travis McKenzie, Scott S. Davis Jr., and Omar M. Ghanem have no conflicts of interest or financial ties to disclose.

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Clapp, B., Marrero, K., Corbett, J. et al. Effect of operative times in bariatric surgery on outcomes: a matched analysis of the MBSAQIP database. Surg Endosc 37, 4113–4122 (2023). https://doi.org/10.1007/s00464-023-09927-6

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  • DOI: https://doi.org/10.1007/s00464-023-09927-6

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