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Is laparoscopic sleeve gastrectomy safer than laparoscopic gastric bypass? a comparison of 30-day complications using the MBSAQIP data registry.
Kumar, Sandhya B; Hamilton, Barbara C; Wood, Stephanie G; Rogers, Stanley J; Carter, Jonathan T; Lin, Matthew Y.
Afiliação
  • Kumar SB; Department of Surgery, University of California San Francisco, San Francisco, California. Electronic address: sandhya.kumar@ucsf.edu.
  • Hamilton BC; Department of Surgery, University of California San Francisco, San Francisco, California.
  • Wood SG; Department of Surgery, University of California San Francisco, San Francisco, California.
  • Rogers SJ; Department of Surgery, University of California San Francisco, San Francisco, California.
  • Carter JT; Department of Surgery, University of California San Francisco, San Francisco, California.
  • Lin MY; Department of Surgery, University of California San Francisco, San Francisco, California.
Surg Obes Relat Dis ; 14(3): 264-269, 2018 03.
Article em En | MEDLINE | ID: mdl-29519658
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become popular due to its technical ease and excellent short-term results. Understanding the risk profile of LSG compared with the gold standard laparoscopic Roux-en-Y gastric bypass (LRYGB) is critical for patient selection. OBJECTIVES: To use traditional regression techniques and random forest classification algorithms to compare LSG with LRYGB using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Data Registry. SETTING: United States. METHODS: Outcomes were leak, morbidity, and mortality within 30 days. Variable importance was assessed using random forest algorithms. Multivariate models were created in a training set and evaluated on the testing set with receiver operating characteristic curves. The adjusted odds of each outcome were compared. RESULTS: Of 134,142 patients, 93,062 (69%) underwent LSG and 41,080 (31%) underwent LRYGB. One hundred seventy-eight deaths occurred in 96 (.1%) of LSG patients compared with 82 (.2%) of LRYGB patients (P<.001). Morbidity occurred in 8% (5.8% in LSG versus 11.7% in LRYGB, P<.001). Leaks occurred in 1% (.8% in LSG versus 1.6% in LRYGB, P<.001). The most important predictors of all outcomes were body mass index, albumin, and age. In the adjusted multivariate models, LRYGB had higher odds of all complications (leak: odds ratio 2.10, P<.001; morbidity: odds ratio 2.02, P<.001; death: odds ratio 1.64, P<.01). CONCLUSION: In the Metabolic and Bariatric Surgery Accreditation and Quality Improvements data registry for 2015, LSG had half the risk-adjusted odds of death, serious morbidity, and leak in the first 30 days compared with LRYGB.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Derivação Gástrica / Laparoscopia / Gastrectomia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Derivação Gástrica / Laparoscopia / Gastrectomia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2018 Tipo de documento: Article