Evidence map›Paper›PMID 37740112›Full record

ArticleSurgical endoscopy2023

Evaluating outcomes among surgeons who changed their technique for gastric bypass: a state-wide analysis from 2011 to 2021.

Ahmad M Hider, Hollis Johanson, Aaron J Bonham, Amir A Ghaferi, Jonathan Finks, Anne P Ehlers, Arthur M Carlin, Oliver A Varban

Open access · greenAbstract read
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Ahmad M HiderDepartment of Surgery, Michigan Medicine, University of Michigan Medical School, 1500 E Medical Center Drive, 2210 Taubman Center, Ann Arbor, MI, 48109, USA. amhider@med.umich.edu.ORCID 0000-0001-8897-8932
Hollis JohansonDepartment of Surgery, Henry Ford Health, Detroit, MI, USA.
Aaron J BonhamCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Amir A GhaferiMichigan Bariatric Surgery Collaborative, Ann Arbor, MI, USA.
Jonathan FinksDepartment of Surgery, Michigan Medicine, University of Michigan Medical School, 1500 E Medical Center Drive, 2210 Taubman Center, Ann Arbor, MI, 48109, USA.
Anne P EhlersDepartment of Surgery, Michigan Medicine, University of Michigan Medical School, 1500 E Medical Center Drive, 2210 Taubman Center, Ann Arbor, MI, 48109, USA.
Arthur M CarlinDepartment of Surgery, Henry Ford Health, Detroit, MI, USA.
Oliver A VarbanDepartment of Surgery, Henry Ford Health, Detroit, MI, USA.
University of Michigan · USHenry Ford Health System · USMedical College of Wisconsin · US

Funding

Sex as a Biologic Variable in Groin HerniaK08DK135919 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Anne Pugel Ehlers · 2024 to 2026
$478k
NIDDK NIH HHS K08 DK135919NIDDK NIH HHS L30 DK134076
6 · The paper itself

Abstract

introductionTechnical variation exists when performing the gastrojejunostomy during Roux-en-Y gastric bypass (RYGB). However, it is unclear whether changing technique results in improved outcomes or patient harm.

methodsSurgeons participating in a state-wide bariatric surgery quality collaborative who completed a survey on how they perform a typical RYGB in 2011 and again in 2021 were included in the analysis (n = 31). Risk-adjusted 30-day complication rates and case characteristics for cases in 2011 were compared to those in 2021 among surgeons who changed their gastrojejunostomy technique from end-to-end anastomosis (EEA) to either a linear staple or handsewn anastomosis (LSA/HSA). In addition, case characteristics and outcomes among surgeons who maintained an EEA technique throughout the study period were assessed.

resultsA total of 15 surgeons (48.3%) changed their technique from EEA to LSA/HSA while 7 surgeons (22.3%) did not. Nine surgeons did LSA or HSA the entire period and therefore were not included. Surgeons who changed their technique had significantly lower rates of surgical complications in 2021 when compared to 2011 (1.9% vs 5.1%, p = 0.0015), including lower rates of wound complications (0.5% vs 2.1%, p = 0.0030) and stricture (0.1% vs 0.5%, p = 0.0533). Likewise, surgeons who did not change their EEA technique, also experienced a decrease in surgical complications (1.8% vs 5.8%, p < 0.0001), wound complications (0.7% vs 2.1%, p < 0.0001) and strictures (0.2% vs 1.2%, p = 0.0006). Surgeons who changed their technique had a significantly higher mean annual robotic bariatric volume in 2021 (30.0 cases vs 4.9 cases, p < 0.0001) when compared to those who did not.

conclusionsSurgeons who changed their gastrojejunostomy technique from circular stapled to handsewn demonstrated greater utilization of the robotic platform than those who did not and experienced a similar decrease in adverse events during the study period, despite altering their technique. Surgeons who chose to modify their operative technique may be more likely to adopt newer technologies.

Indexed as

Bariatric SurgeryGastric BypassLaparoscopyObesity, MorbidSurgeonsConstriction, PathologicGastrectomyHumansPostoperative ComplicationsRetrospective StudiesBariatric outcomesEnd-to-end anastomosisHealth outcomesLinear stapleSleeve gastrectomy

Identifiers

PMID37740112
PMCPMC12452050
OpenAlexW4386951865

What OpenQuestion holds

Textmetadata
LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.