Abstract
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as one of the most effective treatments for morbid obesity. Surgical site infections are the most common complication after LRYGB surgery. Objective: To compare the superficial surgical site infections (sSSI) rate before and after the implementation of our intraoperative technique. Setting: Academic medical center. Methods: Our intraoperative technique relies on sterile coverage of the circular stapler, sterile specimen-bag retrieval of the gastrojejunostomy enteric remnant, and port site Penrose drainage. We analyzed our sSSI outcomes before and after implementation of our technique in all LRYGBs performed by a single surgeon from 2009 to 2015. We took into account patient age; sex; baseline body mass index (BMI); smoking status; and co-morbidities such as diabetes, hypertension, and hyperlipidemia. χ2 and multivariate analysis were performed. Results: We performed 486 LRYGBs in 2009-2015. The cohort before implementation of our technique (group 1) included 164 patients (33.7%) and the cohort after implementation (group 2) included 322 patients (66.3%). Both groups were similar in age, sex, smoking status, and rates of diabetes and hyperlipidemia but differed in BMI, operative time, and prevalence of hypertension. Hypertension was not a confounder for sSSI (P = .35). The sSSI rate was 9.15% for group 1 and 3.42% for group 2 (P = .0079). Controlling for BMI and operative time, multivariate analysis revealed a significant reduction in sSSI (odds ratio 2.98 [95% CI 1.33-6.69]) with our technique. Conclusions: We describe a reproducible intraoperative technique that significantly reduces sSSI in LRYGB procedures. Our technique has the potential of hastening postoperative recovery.
| Original language | English (US) |
|---|---|
| Journal | Surgery for Obesity and Related Diseases |
| DOIs | |
| State | Accepted/In press - Nov 6 2015 |
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Keywords
- Bariatric Surgery
- Intraoperative Technique
- Laparoscopic Roux-en-Y Gastric Bypass
- Morbid Obesity
- Surgical Site Infection
- Wound Infection
ASJC Scopus subject areas
- Surgery
Cite this
An intraoperative technique to reduce superficial surgical site infections in circular stapler-constructed laparoscopic Roux-en-Y gastric bypass. / Zhang, Yang; Serrano, Oscar K.; Melvin, W. Scott; Camacho, Diego.
In: Surgery for Obesity and Related Diseases, 06.11.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An intraoperative technique to reduce superficial surgical site infections in circular stapler-constructed laparoscopic Roux-en-Y gastric bypass
AU - Zhang, Yang
AU - Serrano, Oscar K.
AU - Melvin, W. Scott
AU - Camacho, Diego
PY - 2015/11/6
Y1 - 2015/11/6
N2 - Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as one of the most effective treatments for morbid obesity. Surgical site infections are the most common complication after LRYGB surgery. Objective: To compare the superficial surgical site infections (sSSI) rate before and after the implementation of our intraoperative technique. Setting: Academic medical center. Methods: Our intraoperative technique relies on sterile coverage of the circular stapler, sterile specimen-bag retrieval of the gastrojejunostomy enteric remnant, and port site Penrose drainage. We analyzed our sSSI outcomes before and after implementation of our technique in all LRYGBs performed by a single surgeon from 2009 to 2015. We took into account patient age; sex; baseline body mass index (BMI); smoking status; and co-morbidities such as diabetes, hypertension, and hyperlipidemia. χ2 and multivariate analysis were performed. Results: We performed 486 LRYGBs in 2009-2015. The cohort before implementation of our technique (group 1) included 164 patients (33.7%) and the cohort after implementation (group 2) included 322 patients (66.3%). Both groups were similar in age, sex, smoking status, and rates of diabetes and hyperlipidemia but differed in BMI, operative time, and prevalence of hypertension. Hypertension was not a confounder for sSSI (P = .35). The sSSI rate was 9.15% for group 1 and 3.42% for group 2 (P = .0079). Controlling for BMI and operative time, multivariate analysis revealed a significant reduction in sSSI (odds ratio 2.98 [95% CI 1.33-6.69]) with our technique. Conclusions: We describe a reproducible intraoperative technique that significantly reduces sSSI in LRYGB procedures. Our technique has the potential of hastening postoperative recovery.
AB - Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as one of the most effective treatments for morbid obesity. Surgical site infections are the most common complication after LRYGB surgery. Objective: To compare the superficial surgical site infections (sSSI) rate before and after the implementation of our intraoperative technique. Setting: Academic medical center. Methods: Our intraoperative technique relies on sterile coverage of the circular stapler, sterile specimen-bag retrieval of the gastrojejunostomy enteric remnant, and port site Penrose drainage. We analyzed our sSSI outcomes before and after implementation of our technique in all LRYGBs performed by a single surgeon from 2009 to 2015. We took into account patient age; sex; baseline body mass index (BMI); smoking status; and co-morbidities such as diabetes, hypertension, and hyperlipidemia. χ2 and multivariate analysis were performed. Results: We performed 486 LRYGBs in 2009-2015. The cohort before implementation of our technique (group 1) included 164 patients (33.7%) and the cohort after implementation (group 2) included 322 patients (66.3%). Both groups were similar in age, sex, smoking status, and rates of diabetes and hyperlipidemia but differed in BMI, operative time, and prevalence of hypertension. Hypertension was not a confounder for sSSI (P = .35). The sSSI rate was 9.15% for group 1 and 3.42% for group 2 (P = .0079). Controlling for BMI and operative time, multivariate analysis revealed a significant reduction in sSSI (odds ratio 2.98 [95% CI 1.33-6.69]) with our technique. Conclusions: We describe a reproducible intraoperative technique that significantly reduces sSSI in LRYGB procedures. Our technique has the potential of hastening postoperative recovery.
KW - Bariatric Surgery
KW - Intraoperative Technique
KW - Laparoscopic Roux-en-Y Gastric Bypass
KW - Morbid Obesity
KW - Surgical Site Infection
KW - Wound Infection
UR - http://www.scopus.com/inward/record.url?scp=84961778288&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84961778288&partnerID=8YFLogxK
U2 - 10.1016/j.soard.2016.01.003
DO - 10.1016/j.soard.2016.01.003
M3 - Article
C2 - 27021153
AN - SCOPUS:84961778288
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
SN - 1550-7289
ER -