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.

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.