Safety and Outcomes of Laparoscopic Sleeve Gastrectomy in a General Surgery Residency Program.
Adolescent
Adult
Aged
Clinical Competence
Female
Gastrectomy
/ education
General Surgery
/ education
Humans
Incidence
Internship and Residency
Laparoscopy
/ education
Male
Middle Aged
Obesity, Morbid
/ surgery
Operative Time
Postoperative Complications
/ epidemiology
Retrospective Studies
Young Adult
Bariatric Surgery
Fellowship
Resident Training
Sleeve Gastrectomy
Journal
JSLS : Journal of the Society of Laparoendoscopic Surgeons
ISSN: 1938-3797
Titre abrégé: JSLS
Pays: United States
ID NLM: 100884618
Informations de publication
Date de publication:
Historique:
entrez:
21
4
2021
pubmed:
22
4
2021
medline:
6
7
2021
Statut:
ppublish
Résumé
With the escalation of surgical treatment of morbid obesity, there is a growing interest in the training of bariatric surgeons. Laparoscopic sleeve gastrectomy (LSG) gained popularity both as a first-stage approach and as a stand-alone procedure. The aim of this study was to assess detectable differences in LSG with intra-operative resident involvement. We reviewed obese patients, who had undergone LSG between January 1, 2017 and January 31, 2020. Collected data reported demographic factors, operative time, postoperative complications, and outcomes. Among 313 patients who met the inclusion criteria, 94 were men and 219 were women. The procedures were performed either by an expert bariatric surgeon (group 1), or a general surgery resident (group 2), respectively in 228 and 85 cases. Mean operative time of the first group was 65.3 ± 18.8 minutes, while it was 74.3 ± 17.2 among trainees (p < 0.001). Perioperative complications were diagnosed in 13 patients (10 in group 1 and 3 in group 2). Mean excess body weight loss after 12 months was 87.7 ± 28.2% in the first group and 81.1 ± 31.6% in the residents group. Between the two groups, we found no differences in the incidence of perioperative complications and in surgical outcomes. Trainee involvement was associated with increased operative time, with no correlation with a worse postoperative course. Residents can safely perform LSG in referral centers under the supervision of an expert bariatric surgeon. Trainee involvement is not related to increased leak rate, nor to suboptimal short-term outcome.
Sections du résumé
BACKGROUND
BACKGROUND
With the escalation of surgical treatment of morbid obesity, there is a growing interest in the training of bariatric surgeons. Laparoscopic sleeve gastrectomy (LSG) gained popularity both as a first-stage approach and as a stand-alone procedure.
OBJECTIVES
OBJECTIVE
The aim of this study was to assess detectable differences in LSG with intra-operative resident involvement.
METHODS
METHODS
We reviewed obese patients, who had undergone LSG between January 1, 2017 and January 31, 2020. Collected data reported demographic factors, operative time, postoperative complications, and outcomes.
RESULTS
RESULTS
Among 313 patients who met the inclusion criteria, 94 were men and 219 were women. The procedures were performed either by an expert bariatric surgeon (group 1), or a general surgery resident (group 2), respectively in 228 and 85 cases. Mean operative time of the first group was 65.3 ± 18.8 minutes, while it was 74.3 ± 17.2 among trainees (p < 0.001). Perioperative complications were diagnosed in 13 patients (10 in group 1 and 3 in group 2). Mean excess body weight loss after 12 months was 87.7 ± 28.2% in the first group and 81.1 ± 31.6% in the residents group. Between the two groups, we found no differences in the incidence of perioperative complications and in surgical outcomes. Trainee involvement was associated with increased operative time, with no correlation with a worse postoperative course.
CONCLUSIONS
CONCLUSIONS
Residents can safely perform LSG in referral centers under the supervision of an expert bariatric surgeon. Trainee involvement is not related to increased leak rate, nor to suboptimal short-term outcome.
Identifiants
pubmed: 33879991
doi: 10.4293/JSLS.2020.00063
pii: JSLS.2020.00063
pmc: PMC8035819
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2021 by SLS, Society of Laparoscopic & Robotic Surgeons.
Références
Surg Obes Relat Dis. 2013 Jan-Feb;9(1):88-93
pubmed: 22055389
Surg Endosc. 2012 Dec;26(12):3442-8
pubmed: 22648124
Obes Surg. 2013 Apr;23(4):427-36
pubmed: 23338049
Obes Surg. 2012 Mar;22(3):411-5
pubmed: 21562796
Surg Endosc. 2011 Jan;25(1):88-97
pubmed: 20526621
Riv Psichiatr. 2019 May-Jun;54(3):127-130
pubmed: 31282493
JAMA. 2012 Jan 4;307(1):56-65
pubmed: 22215166
J Am Coll Surg. 2014 Feb;218(2):253-60
pubmed: 24315885
JAMA. 2004 Oct 13;292(14):1724-37
pubmed: 15479938
Obes Surg. 2009 May;19(5):544-8
pubmed: 19280267
Nutrients. 2020 Mar 01;12(3):
pubmed: 32121618
JAMA Surg. 2015 Feb;150(2):144-51
pubmed: 25535681
Obes Surg. 2016 Sep;26(9):1999-2005
pubmed: 26815984
Riv Psichiatr. 2019 Jan-Feb;54(1):8-17
pubmed: 30760932
J Am Coll Surg. 2011 Aug;213(2):261-6
pubmed: 21624841
Surg Obes Relat Dis. 2009 Jul-Aug;5(4):469-75
pubmed: 19632646
Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006575
pubmed: 19160288
Surg Obes Relat Dis. 2015 Jul-Aug;11(4):758-64
pubmed: 26117166
Surg Endosc. 2016 Sep;30(9):3741-8
pubmed: 26675935
Obes Surg. 2005 Sep;15(8):1124-8
pubmed: 16197783
Updates Surg. 2017 Mar;69(1):101-107
pubmed: 28266000
Surg Obes Relat Dis. 2014 May-Jun;10(3):450-4
pubmed: 24448100
Gastroenterol Res Pract. 2019 Dec 1;2019:3742075
pubmed: 31871448
J Obes. 2017;2017:4703236
pubmed: 28261497
Surg Endosc. 2014 Jan;28(1):242-8
pubmed: 23996341
Surgery. 2012 Jul;152(1):21-5
pubmed: 22503322
Obes Surg. 2003 Jun;13(3):329-30
pubmed: 12852397
Surg Obes Relat Dis. 2016 May;12(4):750-756
pubmed: 27178618
World J Surg. 2016 Sep;40(9):2065-83
pubmed: 26943657
Obes Surg. 2016 Jan;26(1):146-50
pubmed: 26464239