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A Single-center Experience Examining the Length of Stay and Safety of Early Discharge After Laparoscopic Roux-en-Y Gastric Bypass Surgery

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Abstract

Purpose

This study’s objective was to describe our experience and evaluate the safety of early discharge (ED) following laparoscopic Roux-en-Y gastric bypass (LRYGB) in a specific patient population.

Materials and Methods

Patients undergoing LRYGB at Montefiore Medical Center were retrospectively reviewed. Patients readmitted in the first 30 days following surgery were compared to those patients who were not readmitted. Data analysis was used to compare groups and to determine factors associated with readmission. In addition to patient demographics, length of stay (LOS) was analyzed as an independent risk factor for readmission.

Results

A total of 630 LRYGB were performed during this period. There were 5.1% (n = 32) of patients that required readmission within 30 days of discharge. Readmitted patients had a higher BMI (50.0 vs. 45.8; p = 0.006) and there was a trend for them to be younger (38.4 years vs. 42.0; p = 0.07). There was an increased rate of ED in 2015 (36.7%, n = 121) compared to 2014 (29.9%, n = 90). The readmission rate for ED for the study period was 4.7% (n = 10). There were no observed mortalities in our early discharge group of patients.

Conclusions

Discharge on post-operative day 1 following a LRYGB is safe and is not associated with an increased likelihood of being readmitted within 30 days of discharge. Our single-center experience helps to better characterize current patient profiles and length of stay trends within the field and can be used to establish a randomized controlled trial for discharging patients early after LRYGB.

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Fig. 1: Number of Discharges Per Post-Operative Day

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Authors and Affiliations

  1. Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, 182 East 210th Street, Lower Level, Bronx, NY, 10467, USA

    Melanie H. Howell, Dina Podolsky, Erin Moran-Atkin, Jenny J. Choi & Diego R. Camacho

  2. The Albert Einstein College of Medicine, Bronx, NY, USA

    Aaron Praiss

  3. Department of Surgery, Florida International University, Miami, FL, USA

    Natan Zundel

Authors
  1. Melanie H. Howell
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  2. Aaron Praiss
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  3. Dina Podolsky
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  4. Natan Zundel
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  5. Erin Moran-Atkin
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  6. Jenny J. Choi
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  7. Diego R. Camacho
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Corresponding author

Correspondence to Melanie H. Howell.

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Conflict of Interest Statement

Dr. Howell has nothing to disclose.

Mr. Praiss has nothing to disclose.

Dr. Podolsky has nothing to disclose.

Dr. Zundel reports personal fees from Apolo Endosurgery, personal fees from Ethicon endosurgery, personal fees from Medtronic, personal fees from Olympus, personal fees from Obesity PPM, personal fees from Gordian, however, all of these fees are independent and outside the submitted work.

Dr. Moran-Atkin has nothing to disclose.

Dr. Choi has nothing to disclose.

Dr. Camacho has nothing to disclose.

Statement of Informed Consent

A plan for this study was submitted to and approved by our local institutional review board prior to data collection. As this was a retrospective study, formal consent was not required.

Statement of Human and Animal Rights

A plan for this study was submitted to and approved by our local institutional review board prior to data collection. Patients were counseled and consented for all surgical procedures prior to the conception of this study. This study required the analysis of available data but did not involve human participants directly. However, all practices were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Howell, M.H., Praiss, A., Podolsky, D. et al. A Single-center Experience Examining the Length of Stay and Safety of Early Discharge After Laparoscopic Roux-en-Y Gastric Bypass Surgery. OBES SURG 28, 1225–1231 (2018). https://doi.org/10.1007/s11695-017-2993-y

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  • DOI: https://doi.org/10.1007/s11695-017-2993-y

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