Original articleEffect of surgical techniques on clinical outcomes after laparoscopic gastric bypass—results from the Michigan Bariatric Surgery Collaborative
Section snippets
Study population
The present study was based on an analysis of data from the Michigan Bariatric Surgery Collaborative (MBSC), which has been previously described in greater detail [16], [17]. The MBSC is a regional consortium of hospitals and surgeons performing bariatric surgery in Michigan. The collaborative currently collects data for >95% of patients undergoing bariatric surgery in the state, with an annual enrollment of approximately 5000 patients into its clinical registry. Participating centers submit
Patient characteristics
During the study period, 10,236 patients had undergone LGB at 21 centers by 51 surgeons. A total of 9904 patients were included in the present analysis, because the remainder had undergone LGB by a surgeon who did not complete the survey. The baseline patient characteristics stratified by anastomosis type and the use of buttress were similar for all groups (Table 1). The mean age of the entire cohort was 45 years, and the mean body mass index was 48 kg/m2; 80% of the patients were women.
Surgeon characteristics
A total
Discussion
To the best of our knowledge, the present study represents one of the largest series of LGB patients and reflects the results across a broad spectrum of surgical practices. Because of the richness of the clinical registry and the collaborative nature of our consortium, we had a unique opportunity to explore the relationship between the technical variations and patient outcomes for what many consider to be 1 of the most technically challenging operations.
In the present study, we identified a
Conclusion
Our results have demonstrated a greater rate of wound and bleeding complications associated with the CS technique. However, given the benefits of this approach, such as ease of use and consistent size of the anastomosis, improving the technique might prove preferable to abandoning it. Improvement efforts should focus on determining the most appropriate staple height to minimize intraluminal bleeding and identifying strategies to protect the wound from the fired stapler. Finally, consideration
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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