Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026
Comparative safety of same-day discharge with remote monitoring after laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Abosheisha Mohamed, Nasr Elmoatazbellah, Asaad Ahmad, Kandeel Muhammed, Alqasem Mustafa, Bylapudi Seshu, Omran Mohamed Ammar, Kortobi Ghaith, Boalot Ahmed, Wahb Mohamed, Terra Mohamed, Swealem Ahmed, Abdelglil Momen, Ismaiel Mohamed, Wilson Jeremy, Magee Conor
Аннотация
BACKGROUND: Bariatric surgery, primarily laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB), is an effective treatment for obesity. As the demand for healthcare increases, same-day discharge (SDD) supported by remote monitoring (RM) is being explored to optimize resources without compromising safety. This systematic review and meta-analysis aimed to evaluate the safety and clinical outcomes of SDD with RM for primary bariatric surgery.
METHODS: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PROSPERO registration (CRD420251124540), a comprehensive search was conducted across PubMed, Scopus, and Web of Science. Six observational studies involving 1581 patients (LSG: 1164; LRYGB: 417) met the inclusion criteria. Outcomes included pooled readmission and complication rates, which were analyzed using a generalized linear mixed model.
RESULTS: The overall pooled readmission rate for the RM subgroup was 3.35% (95% CI, 2.57%-4.36%). Subgroup analysis revealed a significantly lower readmission rate for LSG (2.66%) than for LRYGB (5.28%, P = .012). Major complications (Clavien-Dindo grade ≥3) were rare at 1.58% and were comparable between procedures. The overall complication rate was 3.80%. Meta-regression indicated that surgery type was not a significant moderator for major or overall complications, suggesting that the higher readmission rate for LRYGB was largely driven by manageable functional issues, such as dehydration.
CONCLUSION: Both LSG and LRYGB appear to have favorable safety profiles in an outpatient setting with RM, with LSG demonstrating an advantage of significantly fewer readmissions in the early postoperative period.
METHODS: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PROSPERO registration (CRD420251124540), a comprehensive search was conducted across PubMed, Scopus, and Web of Science. Six observational studies involving 1581 patients (LSG: 1164; LRYGB: 417) met the inclusion criteria. Outcomes included pooled readmission and complication rates, which were analyzed using a generalized linear mixed model.
RESULTS: The overall pooled readmission rate for the RM subgroup was 3.35% (95% CI, 2.57%-4.36%). Subgroup analysis revealed a significantly lower readmission rate for LSG (2.66%) than for LRYGB (5.28%, P = .012). Major complications (Clavien-Dindo grade ≥3) were rare at 1.58% and were comparable between procedures. The overall complication rate was 3.80%. Meta-regression indicated that surgery type was not a significant moderator for major or overall complications, suggesting that the higher readmission rate for LRYGB was largely driven by manageable functional issues, such as dehydration.
CONCLUSION: Both LSG and LRYGB appear to have favorable safety profiles in an outpatient setting with RM, with LSG demonstrating an advantage of significantly fewer readmissions in the early postoperative period.