Evidence map›Paper›PMID 38379004›Full record

ArticleSurgical endoscopy2024

Safety and cost of performing laparoscopic sleeve gastrectomy with same day discharge at a large academic hospital.

Joshua P Landreneau, Divyansh Agarwal, Elan Witkowski, Ozanan Meireles, Karen Flanders, Matthew Hutter, Denise Gee

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
7.4field-weighted citation impact, top 2% 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

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
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  4. Observational
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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

7 authors at 2 institutions in 1 country.

Joshua P LandreneauDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. jlandreneau@mgh.harvard.edu.ORCID 0000-0003-4689-0793
Divyansh AgarwalDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Elan WitkowskiDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Ozanan MeirelesDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Karen FlandersDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Matthew HutterDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Denise GeeDivision of Gastrointestinal Surgery and Surgical Oncology, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Harvard University · USMassachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic sleeve gastrectomy (LSG) is the most common surgical treatment for morbid obesity. While certain specialized ambulatory surgery centers offer LSG on an outpatient basis, patients undergoing LSG at most academic centers are admitted to hospital for initial postoperative convalescence and monitoring. Our institution has begun to offer LSG with same-day discharge (SDD) in select patients. We aimed to compare the perioperative outcomes and costs for patients undergoing LSG with inpatient admission versus SDD.

methodsAll patients enrolled in the SDD program from December 2020 through July 2022 were identified from a prospectively maintained database. Patients enrolled in this pathway were analyzed on an intention-to-treat basis even if ultimately admitted postoperatively. Propensity scoring was used to match these patients 1:1 to those with planned inpatient recovery based on age, BMI, and ASA classification.

resultsSeventy-five patients were enrolled in the LSG with SDD program during the study period. Among these, 62 patients (82.7%) had successful immediate postoperative discharge. Reasons for cancelation of planned SDD included anxiety (n = 5), pain (n = 3), nausea (n = 2), and one patient each with hypotension, urinary retention, and bleeding. After matching, there were no differences in age, BMI, or ASA classification in a comparison group of patients with planned inpatient recovery. There were no differences in perioperative complications. There were no readmissions or requirements for outpatient intravenous fluids among patients with SDD, compared to n = 3 (4.0%) and n = 2 (2.7%) in the inpatient cohort, respectively. The total perioperative cost for patients undergoing LSG with planned SDD was 6.8% less than those with inpatient recovery.

conclusionWith appropriate protocols, LSG with same-day discharge can safely be performed at large academic surgery centers without increased morbidity or need for additional services in the perioperative period. SDD may be associated with decreased costs and allows for more efficient hospital bed allocation.

Indexed as

LaparoscopyObesity, MorbidGastrectomyHospitalsHumansPatient DischargePostoperative ComplicationsRetrospective StudiesTreatment OutcomeBariatric surgeryEnhanced recoveryHome hospitalOutpatientSleeve gastrectomy

Identifiers

PMID38379004
OpenAlexW4391962639

What OpenQuestion holds

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Registered trials

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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.