Kamal Abi Mosleh, Sara Bocchinfuso, Katarzyna Bartosiak, Richard S Betancourt, Simon Laplante, Todd A Kellogg, Tayyab S Diwan, Omar M Ghanem
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引用次数: 0
Abstract
Background: Sleeve gastrectomy (SG) is the most performed bariatric procedure in the United States due to its favorable safety profile. However, managing patients on chronic immunosuppressive therapy (CIT) during bariatric surgery poses challenges, particularly in balancing surgical outcomes with the risks associated with CIT interruption. This study aims to compare the short-term outcomes of SG in patients who temporarily discontinued CIT versus those who continued it perioperatively.
Methods: A retrospective review was conducted of 75 patients on CIT who underwent SG at a single academic center between 2008 and 2022. Patients were categorized based on perioperative CIT management: 20 (26.7%) interrupted CIT and 55 (73.3%) continued therapy. Data on patient demographics, CIT indications, operative details, and short-term outcomes, including complications and readmissions, were analyzed.
Results: The most common CIT indication was organ transplantation (61.4%), predominantly in the non-interruption group, while rheumatoid arthritis was the leading indication (50%) among patients who interrupted CIT. Early complications (≤ 30 days) were significantly higher in the non-interruption group (20% vs. 5%, p = 0.031), with bleeding being the most frequent (7 cases), followed by wound infections (4 cases). In contrast, the interruption group experienced only one complication, a wound infection. Weight outcomes were similar between groups, with no significant differences in percentage of total weight loss (%TWL) at 3 or 6 months. Notably, the interruption group had no 30-day readmissions or reoperations, compared to 16.4% and 5.5%, respectively, in the non-interruption group.
Conclusions: Temporary interruption of CIT in SG patients is associated with lower early complication rates and improved short-term outcomes. These findings highlight the importance of individualized perioperative CIT management and suggest potential benefits of CIT interruption when clinically feasible.
期刊介绍：
Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research.
Topics covered in the journal include:
-Surgical aspects of:
Interventional endoscopy,
Ultrasound,
Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology,
-Gastroenterologic surgery
-Thoracic surgery
-Traumatic surgery
-Orthopedic surgery
-Pediatric surgery
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