Puget Sound Surgical Center, Edmonds, Washington.
Puget Sound Surgical Center, Edmonds, Washington.
Surg Obes Relat Dis. 2014 Jan-Feb;10(1):101-5. doi: 10.1016/j.soard.2013.07.005. Epub 2013 Jul 17.
A growing body of evidence supports the laparoscopic sleeve gastrectomy (LSG) as a safe and effective procedure for sustained weight loss and amelioration of weight-related co-morbidities. Procedures performed in ambulatory surgery centers (ASC) can provide several advantages over hospital-based surgery. We present our results of 250 consecutive patients undergoing LSG in an ASC. The objective of this study was to assess the safety and efficacy of outpatient LSG in a freestanding ASC.
Data was collected prospectively from 250 consecutive patients who underwent LSG at a freestanding ASC. Patients were excluded from the ASC if they weighed>450 pounds, if anticipated operative time was>2 hours, if the patient had impaired mobility limiting early ambulation, or if there were medical problems requiring postoperative monitoring beyond 23 hours. Revisions were not included in this study.
Mean age was 47 years (range, 23-74 yr). Mean preoperative body mass index (BMI) was 43 kg/m² (29-71 kg/m²). Mean operative time was 60 minutes (31-161 min). Mean recovery room time was 131 minutes (30-385 min). Mean percent excess weight loss (%EWL) was 60% at 1 year and 63% at 2 years. Nine patients (3.6%) were readmitted within 30 days. Two patients (.8%) were transferred from the ASC to a hospital. There was 1 staple line leak (.4%). There were no open conversions and no deaths.
LSG can be performed safely in a freestanding ASC in select patients with outcomes comparable to the inpatient standard. Additional studies are needed to formulate selection criteria and guidelines to maximize patient safety and outcomes.
越来越多的证据支持腹腔镜袖状胃切除术（LSG）作为一种安全有效的持续减重和改善与体重相关的合并症的方法。在日间手术中心（ASC）进行的手术可以提供许多优于医院手术的优势。我们报告了在 ASC 中进行的 250 例连续 LSG 患者的结果。本研究的目的是评估独立 ASC 中门诊 LSG 的安全性和有效性。
从在独立 ASC 中接受 LSG 的 250 例连续患者中前瞻性收集数据。如果患者体重>450 磅、预计手术时间>2 小时、移动能力受损限制早期活动、或存在需要术后监测超过 23 小时的医疗问题，则患者将被排除在 ASC 之外。本研究不包括修订手术。
平均年龄为 47 岁（范围，23-74 岁）。平均术前体重指数（BMI）为 43 kg/m²（29-71 kg/m²）。平均手术时间为 60 分钟（31-161 分钟）。平均恢复室时间为 131 分钟（30-385 分钟）。1 年时的平均超重减轻百分比（%EWL）为 60%，2 年时为 63%。9 例患者（3.6%）在 30 天内再次入院。2 例患者（0.8%）从 ASC 转至医院。有 1 例吻合口漏（0.4%）。无开放式转换，无死亡。
在符合条件的患者中，LSG 可在独立 ASC 中安全进行，其结果与住院标准相当。需要进一步研究制定选择标准和指南，以最大限度地提高患者安全性和结果。
