Surgeon Experience, Sleep Apnea, and Hypertension Associated with Complications After Laparoscopic Roux-en-Y Stomach Bypass

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Predictors of Complication and Sub-Optimal Weight Loss after Laparoscopic Roux-en-Y Gastric Bypass: a series of 188 patients.

An analysis of patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) may identify factors predictive of complication and of suboptimal weight loss.

Results

Of the 188 patients who underwent laparoscopic Roux-en-Y gastric bypass, 50 (26.6%) developed complications that required an invasive therapeutic intervention, including 2 deaths. The average follow-up was 351 days (range, 89-1019 days). Multivariate analysis by stepwise logistic regression identified surgeon experience, sleep apnea (P =.003; odds ratio, 3.0; 95% confidence interval, 1.3-7.1), and hypertension (P =.07; odds ratio, 2.0; 95% confidence interval, 1.0-4.0) as predictors of complications. The most common complication requiring therapeutic intervention was stricture at the gastrojejunal anastomosis, occurring in 27 patients (14.4%). Of the 115 patients who underwent surgery more than 1 year previously, 1-year follow-up data were available for 93 (81%). The body mass index (weight in kilograms divided by the square of height in meters) decreased from 53 +/- 8 preoperatively to 35 +/- 6 at 1 year. The mean +/- SD percentage of excess body weight lost at 1 year was 61% +/- 14%. Diabetes mellitus was negatively correlated with percentage of excess body weight lost at 1 year (P =.06).

Conclusion

Surgeon experience, sleep apnea, and hypertension are associated with complications after laparoscopic Roux-en-Y gastric bypass. Diabetes mellitus may be associated with poorer postoperative weight loss.

Source:
Perugini RA, Mason R, Czerniach DR, Novitsky YW, Baker S, Litwin DE, Kelly JJ. Department of Surgery and the Informatics Unit, University of Massachusetts Medical School, Worcester 01655, USA. 2003

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