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. 2021 Jan;17(1):177-184.
doi: 10.1016/j.soard.2020.08.013. Epub 2020 Aug 26.

Panniculectomy at the time of bariatric surgery: a propensity score-matched analysis of outcomes in the MBSAQIP database

Selim G Gebran  1 , Philip J Wasicek  1 , Ledibabari M Ngaage  2 , Arthur J Nam  1 , Mark D Kligman  3 , Yvonne M Rasko  4
Affiliations

Panniculectomy at the time of bariatric surgery: a propensity score-matched analysis of outcomes in the MBSAQIP database

Selim G Gebran et al. Surg Obes Relat Dis. 2021 Jan.

Abstract

Background: Body contouring in the postbariatric surgery patient improves quality of life and daily function.

Objectives: To determine the risk profile of panniculectomy when performed in select patients at the time of bariatric surgery.

Setting: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) participating centers.

Methods: We examined the MBSAQIP database (2016-2017), in which data on 379,544 bariatric surgeries are reported. Concurrent panniculectomy procedures were identified by Current Procedural Technology (CPT) codes. Patient characteristics and in-hospital as well as 30-day complications were compared between the body contouring group and propensity score-matched bariatric surgery controls.

Results: One hundred twenty-four patients met inclusion criteria and were matched to 248 controls. An infra-umbilical panniculectomy was performed in the majority of patients (n = 94, 75.8%). Most patients received an open rather than laparoscopic bariatric surgery (n = 87, 70.2%). There were no statistically significant differences between 30-day mortality (1.9%), wound complications (11.5%), readmission (12.5%) and reoperation (5.8%) between the 2 groups (P > .05). Wound complications occurred in 11.5% of patients and were associated with prolonged hospital stay (odds ratio 4.65, 95% confidence interval 1.99-10.86, P < .001) and a body mass index (BMI) > 50 (odds ratio 3.19, 95% confidence interval 1.02-9.96, P = .046).

Conclusion: In select patients, panniculectomy at the time of bariatric surgery was not associated with increased in-hospital or 30-day adverse outcomes compared with matched bariatric surgery controls. This procedure may be performed in select patients, with awareness that revision surgery may be needed once weight loss stabilizes.

Keywords: Abdominoplasty; Body contouring; Combined procedures; Open bariatric surgery; Reconstructive surgery; Wound complications.

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