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. 2023 Mar;33(3):807-812.
doi: 10.1007/s11695-022-06439-5. Epub 2023 Jan 4.

Feasibility of Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass in Patients with Well-Regulated Obstructive Sleep Apnea

Suzanne C Kleipool  1 , Steve M M de Castro  2 , Marlou Vogel  3 , Herre J Reesink  4 , Pim W J van Rutte  2 , Ruben N van Veen  2
Affiliations

Feasibility of Same-Day Discharge After Laparoscopic Roux-en-Y Gastric Bypass in Patients with Well-Regulated Obstructive Sleep Apnea

Suzanne C Kleipool et al. Obes Surg. 2023 Mar.

Abstract

Introduction: Same-day discharge after bariatric surgery is increasingly being performed. In current practice, patients with only minor comorbidities are considered eligible for same-day discharge after laparoscopic Roux-en-Y gastric bypass (RYGB). Obstructive sleep apnea (OSA) is a common comorbidity in patients with morbid obesity, with a prevalence of around 70-80% among patients undergoing bariatric surgery. Continuous positive airway pressure (CPAP) is the current gold standard treatment for OSA. We aimed to investigate whether same-day discharge after RYGB is feasible for patients with compliant use of CPAP.

Methods: In this single-center prospective feasibility study, patients were selected who were scheduled for RYGB and were adequately treated for OSA. Compliance on the use of CPAP had to be proved (> 4 h per night for 14 consecutive nights). There were strict criteria on approval upon same-day discharge. The primary outcome was the rate of successful same-day discharge. Secondary outcomes included short-term complications, emergency department presentations, readmissions, and mortality.

Results: Forty-nine patients underwent RYGB with intended same-day discharge, of whom 45 (92%) were successfully discharged. Three patients had an overnight stay because of divergent vital signs and one patient due to a delayed start of the surgery. Two patients (4%) were readmitted in the first 48 h postoperatively, both due to intraluminal bleeding which was managed conservatively (Clavien-Dindo 2). There were no severe complications in the first 48 h after surgery.

Conclusion: Same-day discharge after RYGB can be considered feasible for selected patients with well-regulated OSA.

Keywords: Gastric bypass; OSA; Obstructive sleep apnea; RYGB; Same-day discharge.

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Conflict of interest statement

The authors declare no competing interests.

References

    1. DATO jaarrapportage. 2019. Available from: https://dica.nl/jaarrapportage-2019/dato
    1. Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142(4):621–32. doi: 10.1016/j.surg.2007.07.018. - DOI - PubMed
    1. Zellmer JD, Mathiason MA, Kallies KJ, et al. Is laparoscopic sleeve gastrectomy a lower risk bariatric procedure compared with laparoscopic Roux-en-Y gastric bypass? A meta-analysis. Am J Surg. 2014;208(6):903–10. doi: 10.1016/j.amjsurg.2014.08.002. - DOI - PubMed
    1. Leepalao MC, Arredondo D, Speights F, et al. Same-day discharge on laparoscopic Roux-en-Y gastric bypass patients: an outcomes review. Surg Endosc. 2020;34(8):3614–7. doi: 10.1007/s00464-019-07139-5. - DOI - PubMed
    1. Nijland LMG, de Castro SMM, Vogel M, et al. Feasibility of same-day discharge after laparoscopic Roux-en-Y gastric bypass using remote monitoring. Obes Surg. 2021;31(7):2851–8. doi: 10.1007/s11695-021-05384-z. - DOI - PMC - PubMed