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. 2021 Jan-Mar;25(1):e2020.00077.
doi: 10.4293/JSLS.2020.00077.

Gender as a Deterministic Factor in Procedure Selection and Outcomes in Bariatric Surgery

Japjot Bal  1 , Nicole Ilonzo  2 , Tiwalade Adediji  3 , I Michael Leitman  1
Affiliations

Gender as a Deterministic Factor in Procedure Selection and Outcomes in Bariatric Surgery

Japjot Bal et al. JSLS. 2021 Jan-Mar.

Abstract

Background and objectives: With obesity rates rising in the United States, bariatric surgery has become a well-established and effective treatment for morbid obesity and its comorbid conditions. Laparoscopic Roux-en-Y gastric bypass and laparoscopic Sleeve Gastrectomy are two of the more common bariatric procedures. This study analyzes whether gender differences play a role in procedure selection and outcomes following either procedure.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database for years 2015 to 2017, we assessed demographics, postoperative complications, and readmission rates. Chi-square analysis, student t-test, and propensity analyses were performed appropriately.

Results: Data review found that men presenting for bariatric surgery had a higher incidence of comorbidities and higher body mass index than women. More men than women underwent Sleeve Gastrectomy (68.5% vs 63.0%, P <0.0001), while more women than men underwent Laparoscopic Roux-en-Y gastric bypass (37.0% vs 31.5%, P < 0.0001). In the Laparoscopic Roux-en-Y group, men experienced more postoperative complications, including cardiac arrest (0.2% vs 0.1%, P = 0.02) and unplanned intubation (0.4% vs 0.2%, P = 0.02). In the Sleeve Gastrectomy group, men experienced more postoperative complications, including myocardial infarction (0.2% vs 0.1%, P = 0.006). In both groups, women experienced higher rates of unplanned readmissions (3.5% vs 2.8%, P = 0.0012).

Conclusions: This study found that men are more likely to undergo Sleeve Gastrectomy than Laparoscopic Roux-en-Y gastric bypass, despite higher complication rates for both. Women have higher rates of unplanned readmission rates regardless of procedure, despite lower postoperative morbidity.

Keywords: Bariatric surgery; Complications; Gender; Patient readmission.

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Conflict of interest statement

Conflicts of Interest: none.

Figures

Figure 1.
Figure 1.
Percentage of Patients Undergoing Roux-en-Y Gastric Bypass (P < 0.0001) and Sleeve Gastrectomy (P < 0.0001) Based Upon Gender.
Figure 2.
Figure 2.
Percentage of Patients with Unplanned Readmission Related to Initial Procedure (P = 0.0012) Based Upon Gender.
See this image and copyright information in PMC

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