Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass: a Cohort of 500 Consecutive Patients

Introduction There is an increasing demand on hospital capacity worldwide due to the COVID-19 pandemic and local staff shortages. Novel care pathways have to be developed in order to keep bariatric and metabolic surgery maintainable. Same-day discharge (SDD) after laparoscopic Roux-en-Y gastric bypa...

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Bibliographic Details
Published in:Obesity surgery 2023-03, Vol.33 (3), p.706-713
Main Authors: Kleipool, Suzanne C., Nijland, Leontien M. G., de Castro, Steve M. M., Vogel, Marlou, Bonjer, H. Jaap, Marsman, Hendrik A., van Rutte, Pim W. J., van Veen, Ruben N.
Format: Article
Language:English
Subjects:
Body mass index
Cohort Studies
COVID-19
COVID-19 - etiology
Gastric Bypass - adverse effects
Gastric Bypass - methods
Gastrointestinal surgery
Humans
Laparoscopy - methods
Medicine
Medicine & Public Health
Obesity, Morbid - surgery
Original Contributions
Pandemics
Patient Discharge
Patient Readmission
Recovery (Medical)
Retrospective Studies
Sleep apnea
Surgery
Treatment Outcome
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Summary:Introduction There is an increasing demand on hospital capacity worldwide due to the COVID-19 pandemic and local staff shortages. Novel care pathways have to be developed in order to keep bariatric and metabolic surgery maintainable. Same-day discharge (SDD) after laparoscopic Roux-en-Y gastric bypass (RYGB) is proved to be feasible and could potentially solve this challenge. The aim of this study was to investigate whether SDD after RYGB is safe for a selected group of patients. Methods In this single-center cohort study, low-risk patients were selected for primary RYGB with intended same-day discharge with remote monitoring. All patients were operated according to ERAS protocol. There were strict criteria on approval upon same-day discharge. It was demanded that patients should contact the hospital in case of any signs of complications. Primary outcome was the rate of successful same-day discharge without readmission within 48 h. Secondary outcomes included short-term complications, emergency department visits, readmissions, and mortality. Results Five hundred patients underwent RYGB with intended SDD, of whom 465 (93.0%) were successfully discharged. Twenty-one patients (4.5%) were readmitted in the first 48 h postoperatively. None of these patients had a severe bleeding. This results in a success rate of 88.8% of SDD without readmission within 48 h. Conclusions Same-day discharge after RYGB is safe, provided that patients are carefully selected and strict discharge criteria are used. It is an effective care pathway to reduce the burden on hospital capacity. Graphical Abstract
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-023-06464-y