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Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass.

Publication ,  Journal Article
Almahmeed, T; Gonzalez, R; Nelson, LG; Haines, K; Gallagher, SF; Murr, MM
Published in: Arch Surg
October 2007

OBJECTIVE: To document the effect of anastomotic leaks on morbidity and mortality after Roux-en-Y gastric bypass (RYGB) for obesity. DESIGN: Prospectively collected data on 840 consecutive patients who underwent RYGB between 1998 and 2005. Multivariate logistic regression analysis was used to determine the effect of anastomotic leaks on postoperative morbidity independent of sex, age, preoperative body mass index, access (open vs laparoscopic), calendar year of RYGB, and comorbidities. P < .05 was considered significant. RESULTS: A total of 36 patients (4.3%) developed leaks after RYGB. Patients who developed anastomotic leaks had a significantly higher overall complication rate (61% vs 20%, P < .001), mortality (14% vs 4%, P = .01), and duration of hospital stay (24.5 vs 4.5 days, P < .001) compared with patients who did not develop leaks. In a multivariate logistic regression model, anastomotic leaks increased the likelihood of mortality (odds ratio [OR], 15; 95% confidence interval [CI], 3-80; P = .002) and overall complications (OR, 6; 95% CI, 3-13; P < .001), specifically sepsis (OR, 27; 95% CI, 2-472; P = .02), renal failure (OR, 16; 95% CI, 3-99; P = .003), small-bowel obstruction (OR, 11; 95% CI, 2-68; P = .008), internal hernia (OR, 10; 95% CI, 2-51; P = .008), thromboembolism (OR, 9; 95% CI, 3-27; P < .001), and incisional hernia (OR, 5; 95% CI, 2-13; P = .001). CONCLUSIONS: Anastomotic leaks significantly increase the likelihood of developing additional life-threatening complications after RYGB. Close and aggressive monitoring is recommended for early detection and management of added complications, should they occur.

Duke Scholars

Published In

Arch Surg

DOI

ISSN

0004-0010

Publication Date

October 2007

Volume

142

Issue

10

Start / End Page

954 / 957

Location

United States

Related Subject Headings

  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Almahmeed, T., Gonzalez, R., Nelson, L. G., Haines, K., Gallagher, S. F., & Murr, M. M. (2007). Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass. Arch Surg, 142(10), 954–957. https://doi.org/10.1001/archsurg.142.10.954
Almahmeed, Taghreed, Rodrigo Gonzalez, Lana G. Nelson, Krista Haines, Scott F. Gallagher, and Michel M. Murr. “Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass.Arch Surg 142, no. 10 (October 2007): 954–57. https://doi.org/10.1001/archsurg.142.10.954.
Almahmeed T, Gonzalez R, Nelson LG, Haines K, Gallagher SF, Murr MM. Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass. Arch Surg. 2007 Oct;142(10):954–7.
Almahmeed, Taghreed, et al. “Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass.Arch Surg, vol. 142, no. 10, Oct. 2007, pp. 954–57. Pubmed, doi:10.1001/archsurg.142.10.954.
Almahmeed T, Gonzalez R, Nelson LG, Haines K, Gallagher SF, Murr MM. Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass. Arch Surg. 2007 Oct;142(10):954–957.

Published In

Arch Surg

DOI

ISSN

0004-0010

Publication Date

October 2007

Volume

142

Issue

10

Start / End Page

954 / 957

Location

United States

Related Subject Headings

  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Logistic Models
  • Length of Stay
  • Humans