Methods
A retrospective study utilising data from the National Bariatric Surgery
Register was performed. Ethical approval for the study was obtained via
the local review board. Inclusion criteria was all patients who
underwent either only a laparoscopic sleeve gastrectomy or a Roux-en-Y
bypass between July 2015 and February 2018. All surgeries were performed
by a single senior bariatric surgeon (SR) at a single site (King’s
College Hospital, London) to reduce bias. Any patients who had immediate
complications intra- or peri-operatively were excluded from the study
such as bleeding or those requiring additional intra-operative
procedures. Six such patients were excluded. A total of 230 patients
(112 Sleeve Gastectomies and 118 Gastric Bypasses) were identified for
the study.
All patients were managed according to the department surgical protocol.
The principles of this protocol are:
- Pre-operative counselling and patient education
- Antithrombotic prophylaxis (Dalteparin 5,000 units, OD
<100kg, BD >100kg)
- Laparoscopic surgery
- Balanced intravenous fluid therapy
- Early mobilisation
Post-operative length of stay was defined as the number of 24 hour
periods from completion of the operation to the day of discharge.
Discharge criteria was:
- Patient tolerating free fluids
- Healing surgical wounds with no evidence of infection/dehiscence
- Afebrile
- Pain controlled with oral analgesia
- No requirement for intravenous support
- Balanced diuresis
- Mobility allowing for completion of required daily activities
Data was collected using Microsoft Excel (Microsoft ® Excel for Mac,
Version 15.28. Redmond, Washington, United States). All data was
collected by healthcare professionals and was anonymised. The
significance of: BMI, ASA grade, a diagnosis of diabetes and the day of
the week the operation occurred, on post-operative stay was evaluated
using Kruskal Wallis analysis. Post hoc analysis was done with
Mann-Whitney testing. Statistics was performed using SPSS (’IBM Corp.
Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk,
New Yord: IBM Corp.) The threshold for statistical significance was
0.05.