Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
Same-day discharge sleeve gastrectomy in France on the last decade: a nationwide cohort study on safety and patient selection.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Rebibo Lionel, Tropeano Anne-Isabelle, Vilfaillot Aurelie, Lu Estelle, Dupont Axelle, Carette Claire, Mariani Antoine, Rives-Lange Claire, Katsahian Sandrine
Аннотация
BACKGROUND: Sleeve gastrectomy (SG) is the most performed bariatric procedure worldwide. However, large-scale data concerning SG performed as same-day discharge (SDD) surgery are scarce.
OBJECTIVES: To compare 90-day morbi-mortality between SDD and inpatient SG using a nationwide French database over a 9-year period.
SETTING: Comprehensive data from the French National Health Data System including data over 599 surgical centers.
METHODS: From January 2015 to December 2023, all patients aged 18-70 years who underwent SG for obesity (244,992 patients) were included and divided into two groups: SG as SDD (SDD group) and SG as inpatient surgery (control group). The primary outcome was a comparison of 90-day morbi-mortality between SDD and inpatient groups. The secondary outcomes included trends in SDD adoption, patient characteristics, and risk factors for complications. Multivariate logistic regression and propensity score matching was used to search for factors influencing completion of SG as SDD.
RESULTS: Among 244,992 patients, 5046 (2.1%) underwent SDD. The SDD rate increased until 2021 (peak: 4.2%) and stabilized thereafter (3.3%). SDD patients were younger (37.3 vs. 39.9 years, P < .001); more often female (82.7% vs. 78.7%, P < .001); and had less hypertension, diabetes, and obstructive sleep apnea (P < .001). Concerning our primary objective, SDD was associated with lower morbi-mortality (7.5% vs. 8.3%, P = .033) in our total cohort study. After propensity score matching, no difference was found between SDD and inpatient group (odds ratio [OR] = .94, P = .324). Risk factors for morbi-mortality included diabetes (OR = 1.33, P < .001), renal insufficiency (OR = 4.90, P < .001), and anticoagulant therapy (OR = 1.45, P < .001). Older age, type 2 diabetes, hypertension, obstructive sleep apnea, and oral anticoagulation therapy were negatively associated with the completion of SDD, whereas the type of surgical center was positively associated with its completion.
CONCLUSIONS: SDD for SG remains underutilized in France but is associated with lower morbi-mortality, likely due to stringent patient selection. Older age, type 2 diabetes, hypertension, obstructive sleep apnea, and oral anticoagulation therapy were independently associated with a lower probability of completing SDD.
OBJECTIVES: To compare 90-day morbi-mortality between SDD and inpatient SG using a nationwide French database over a 9-year period.
SETTING: Comprehensive data from the French National Health Data System including data over 599 surgical centers.
METHODS: From January 2015 to December 2023, all patients aged 18-70 years who underwent SG for obesity (244,992 patients) were included and divided into two groups: SG as SDD (SDD group) and SG as inpatient surgery (control group). The primary outcome was a comparison of 90-day morbi-mortality between SDD and inpatient groups. The secondary outcomes included trends in SDD adoption, patient characteristics, and risk factors for complications. Multivariate logistic regression and propensity score matching was used to search for factors influencing completion of SG as SDD.
RESULTS: Among 244,992 patients, 5046 (2.1%) underwent SDD. The SDD rate increased until 2021 (peak: 4.2%) and stabilized thereafter (3.3%). SDD patients were younger (37.3 vs. 39.9 years, P < .001); more often female (82.7% vs. 78.7%, P < .001); and had less hypertension, diabetes, and obstructive sleep apnea (P < .001). Concerning our primary objective, SDD was associated with lower morbi-mortality (7.5% vs. 8.3%, P = .033) in our total cohort study. After propensity score matching, no difference was found between SDD and inpatient group (odds ratio [OR] = .94, P = .324). Risk factors for morbi-mortality included diabetes (OR = 1.33, P < .001), renal insufficiency (OR = 4.90, P < .001), and anticoagulant therapy (OR = 1.45, P < .001). Older age, type 2 diabetes, hypertension, obstructive sleep apnea, and oral anticoagulation therapy were negatively associated with the completion of SDD, whereas the type of surgical center was positively associated with its completion.
CONCLUSIONS: SDD for SG remains underutilized in France but is associated with lower morbi-mortality, likely due to stringent patient selection. Older age, type 2 diabetes, hypertension, obstructive sleep apnea, and oral anticoagulation therapy were independently associated with a lower probability of completing SDD.