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Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients.

Publication ,  Conference
Kim, Y; Shi, J; Freeman, CM; Jung, AD; Dhar, VK; Shah, SA; Woodle, ES; Diwan, TS
Published in: Surgery
August 2017

BACKGROUND: While previous studies have demonstrated short-term efficacy of laparoscopic sleeve gastrectomy in candidates awaiting renal transplantation, the combination of morbid obesity and end-stage renal disease presents unique challenges to perioperative care. We demonstrate how increasing experience and the development of postoperative care guidelines can improve outcomes in this high-risk population. METHODS: Single-center medical records were reviewed for renal transplantation candidates undergoing laparoscopic sleeve gastrectomy between 2011 and 2015 by a single surgeon. Postoperative care protocols were established and continually refined throughout the study period, including a multidisciplinary approach to inpatient management and hospital discharge planning. The first 100 laparoscopic sleeve gastrectomy patients were included and divided into 4 equal cohorts based on case sequence. RESULTS: Compared with the first 25 patients undergoing laparoscopic sleeve gastrectomy, the last 25 patients had shorter operative times (97.8 ± 27.9 min vs 124.2 ± 33.6 min), lower estimated blood loss (6.6 ± 20.8 mL vs 34.0 ± 38.1 mL), and shorter hospital duration of stay (1.7 ± 2.1 days vs 2.9 ± 0.7 days) (P < .01 each). Readmission rates, complications, and 1-year mortality did not differ significantly. CONCLUSION: Increasing experience and the development of clinical care guidelines in this high-risk population is associated with reduced health care resource utilization and improved perioperative outcomes.

Duke Scholars

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Published In

Surgery

DOI

EISSN

1532-7361

Publication Date

August 2017

Volume

162

Issue

2

Start / End Page

358 / 365

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Operative Time
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Length of Stay
  • Kidney Transplantation
  • Kidney Failure, Chronic
 

Citation

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ICMJE
MLA
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Kim, Y., Shi, J., Freeman, C. M., Jung, A. D., Dhar, V. K., Shah, S. A., … Diwan, T. S. (2017). Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients. Surgery, 162(2), 358–365. https://doi.org/10.1016/j.surg.2017.02.011
Kim, Young, Junzi Shi, Christopher M. Freeman, Andrew D. Jung, Vikrom K. Dhar, Shimul A. Shah, E Steve Woodle, and Tayyab S. Diwan. “Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients.Surgery 162, no. 2 (August 2017): 358–65. https://doi.org/10.1016/j.surg.2017.02.011.
Kim Y, Shi J, Freeman CM, Jung AD, Dhar VK, Shah SA, et al. Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients. Surgery. 2017 Aug;162(2):358–65.
Kim, Young, et al. “Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients.Surgery, vol. 162, no. 2, Aug. 2017, pp. 358–65. Pubmed, doi:10.1016/j.surg.2017.02.011.
Kim Y, Shi J, Freeman CM, Jung AD, Dhar VK, Shah SA, Woodle ES, Diwan TS. Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients. Surgery. 2017 Aug;162(2):358–365.
Journal cover image

Published In

Surgery

DOI

EISSN

1532-7361

Publication Date

August 2017

Volume

162

Issue

2

Start / End Page

358 / 365

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Operative Time
  • Obesity, Morbid
  • Middle Aged
  • Male
  • Length of Stay
  • Kidney Transplantation
  • Kidney Failure, Chronic