Evidence map›Paper›PMID 38862824›Full record

ArticleSurgical endoscopy2024

A superior approach? The role of robotic sleeve gastrectomy in patients with super super obesity using the 2019-2022 MBSAQIP database.

Alba Zevallos, Jorge Cornejo, Jennifer Brown, Joaquin Sarmiento, Fatemeh Shojaeian, Farzad Mokhtari-Esbuie, Alisa Coker, Gina Adrales, Christina Li, Raul Sebastian

Erratum issuedAbstract readComparative Study
PubMed Publisher
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. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Alba ZevallosDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.ORCID 0000-0001-5567-9733
Jorge CornejoDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Jennifer BrownDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Joaquin SarmientoDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Fatemeh ShojaeianDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Farzad Mokhtari-EsbuieDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Alisa CokerDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Gina AdralesDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Christina LiDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA.
Raul SebastianDepartment of Surgery, Northwest Hospital, Randallstown, MD, USA. Rsebast04@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic sleeve gastrectomy (LSG) in patients with BMI ≥ 60 presents technical challenges, that might be overcome by robotic surgery, but its effectiveness has not been rigorously evaluated. We compared the 30-day outcomes of LSG and robotic sleeve gastrectomy (RSG) in patients with BMI < 60 versus ≥ 60 and between LSG and RSG in patients with BMI ≥ 60.

methodsPatients aged 18-65 years who underwent sleeve gastrectomy were included using the 2019-2022 MBSAQIP database. We performed a Propensity Score Matching analysis, with 21 preoperative characteristics. We compared 30-day postoperative outcomes for patients with BMI < 60 versus ≥ 60 using either a laparoscopic (Analysis 1) or robotic approach (Analysis 2) and compared LSG versus RSG in patients with BMI ≥ 60 (Analysis 3).

results297,250 patients underwent LSG and 81,008 RSG. Propensity-matched¸ outcomes in analysis 1 (13,503 matched cases), showed that patients with BMI ≥ 60 had higher rates of mortality (0.1% vs. 0.0%, p = 0.014), staple line leak (0.3% vs. 0.2%, p = 0.035), postoperative bleeding (0.2% vs 0.1%, p = 0.028), readmissions (3.5% vs. 2.4%, p < 0.001), and interventions (0.7% vs. 0.5%, p = 0.028) when compared to patients with BMI < 60. In analysis 2 (4350 matched cases), patients with BMI ≥ 60 demonstrated longer operative times, length of stay, and higher rates of unplanned ICU when compared to patients with BMI < 60. In analysis 3 (4370 matched cases), patients who underwent RSG had fewer readmissions (2.9% vs. 3.7%, p = 0.037), staple line leaks (0.1% vs. 0.3%, p = 0.029), and postoperative bleeding (0.1% vs. 0.3%, p = 0.045), compared to LSG. Conversely, a longer operative time (92.74 ± 38.65 vs. 71.69 ± 37.45 min, p < 0.001) was reported.

conclusionLSG patients with BMI ≥ 60 have higher rates of complications compared to patients with a BMI < 60. Moreover, some outcomes may be improved with the robotic approach in patients with BMI ≥ 60. These results underscore the importance of considering a robotic approach in this super super obese population.

Indexed as

GastrectomyLaparoscopyObesity, MorbidRobotic Surgical ProceduresAdolescentAdultAgedBody Mass IndexDatabases, FactualFemaleHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsBariatric surgeryMinimally invasive surgeryRobotic surgerySleeve gastrectomy

Identifiers

PMID38862824

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.