Evidence map›Paper›PMID 40473949›Full record

ArticleSurgical endoscopy2025

Getting more than what you pay for? Managing complications of bariatric tourism at an academic center near the US-Mexico border.

Graham J Spurzem, Patricia Ruiz-Cota, Amanda Rocha, Andres Fontaine-Nicola, Edgardo Reyes, Kiersten Gabaldon, Agustina Altolaguirre, Hannah M Hollandsworth, Bryan J Sandler, Santiago Horgan and 2 more

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In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

12 authors.

Graham J SpurzemDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA. gspurzem@health.ucsd.edu.ORCID http://orcid.org/0000-0002-1134-1754
Patricia Ruiz-CotaDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Amanda RochaDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Andres Fontaine-NicolaDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Edgardo ReyesDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Kiersten GabaldonUniversity of California San Diego School of Medicine, San Diego, CA, USA.
Agustina AltolaguirreDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Hannah M HollandsworthDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Bryan J SandlerDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Santiago HorganDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Garth R JacobsenDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.
Ryan C BroderickDepartment of Surgery, Division of Minimally Invasive Surgery, University of California San Diego, 9300 Campus Point Dr., La Jolla, San Diego, CA, 92037, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPotential barriers exist for patients who desire bariatric surgery. Medical tourism, defined as international travel for the purpose of seeking medical care, has emerged as a popular alternative. Despite attempts at care standardization, substantial variation remains regarding institutional accreditation and the availability of appropriate postoperative bariatric care abroad. Management of postoperative complications therefore often falls to providers in the patient's home country. We present our experience with the clinical and financial implications of bariatric tourism as an academic center located 30 miles from the US-Mexico border.

methodsA retrospective review of a prospectively maintained database identified patients who underwent cross-border bariatric surgery and then presented to our institution for management of postoperative complications from 2014 to 2024. Outcomes included type and number of procedural interventions required for complication management, length of stay (LOS), total intensive care unit (ICU) days, emergency department (ED) visits, readmissions, and mortality. Hospital charge and payment data for each patient were obtained, accounting for total LOS, interventions performed, readmissions, and ED visits.

resultsA total of 91 patients were identified. The most common index procedure performed abroad was laparoscopic sleeve gastrectomy (N = 63, 69.2%). Common presenting complications included anastomotic/staple line leak (N = 30, 33.0%) and postoperative abdominal pain/nausea/vomiting (N = 24, 26.4%). In total, 194 procedural interventions were performed for complication management, including 112 upper endoscopies (57.7%) and 21 major surgical procedures (10.8%). 56.0% of patients required hospital admission on initial presentation and 19.8% required ICU admission. Anastomotic/staple line leak generated the highest mean hospital charges per patient ($424,975.89 ± $406,136.65), followed by enterocutaneous fistula ($277,076.50 ± $256,475.24). Overall mortality rate was 3.3% (N = 3).

conclusionBariatric tourism can present patients and local healthcare systems with significant clinical and financial challenges. Further studies are warranted to more comprehensively evaluate the implications of this practice.

Indexed as

Bariatric SurgeryMedical TourismObesity, MorbidPostoperative ComplicationsAcademic Medical CentersAdultFemaleHumansLength of StayMaleMexicoMiddle AgedPatient ReadmissionRetrospective StudiesUnited StatesBariatric surgeryBariatric tourismGastric bypassMedical tourismSleeve gastrectomy

Identifiers

PMID40473949
PMCPMC12222374

What OpenQuestion holds

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LicenceCC BY
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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.