Abstract：
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric intervention with short operative time and low morbidity and mortality. However, ambulatory sleeve gastrectomy is underutilized.
OBJECTIVE: This clinical trial compares feasibility, perioperative outcomes, and weight loss of patients undergoing ambulatory LSG with same-day discharge versus conventional hospitalization with next-day discharge.
METHODS: Hospital and ambulatory surgery center.
METHODS: Patients who satisfied low-acuity criteria were randomized to undergo day-case LSG in the ambulatory surgery center with same-day discharge (DC LSG) or LSG with conventional hospitalization and next-day discharge (CH LSG) between December 2018 and December 2020. The primary outcomes were 30-day adverse events, hospitalizations, reoperations, and readmissions, and the secondary outcome was weight loss during the first year.
RESULTS: Of 2541 screened patients, 1544 patients were randomized in the study. Mean age and body mass index were 31.7 ± 9.1 years versus 31.8 ± 9.2 years and 39.6 ± 5.8 kg/m2 versus 40.0 ± 5.7 kg/m2 in the DC LSG group (n = 777) and in the CH LSG group (n = 777), respectively. Eighteen patients (2.3%) in the DC LSG were transferred to the hospital for overnight stay. Additionally, 13 patients (1.7%) requested additional stay without a medical indication for a total overnight stay rate of 4%. One DC LSG patient (.1%) was readmitted, and 2 CH LSG patients (.3%) stayed for an extra day. Seventeen percent of DC LSG patients had unscheduled consultations during the first postoperative week compared with 6% of CH LSG patients (P < .001). Those 2 groups were similar in baseline characteristics. There were no reoperations or mortality in either group, and weight loss results were similar; At 1-year follow-up, DC LSG percent excess weight loss was 87% ± 17% compared with 85% ± 17% in the CH LSG group. The follow-up rate was 100%.
CONCLUSIONS: LSG is feasible as a day-case procedure with comparable outcomes to conventional hospitalization.
OBJECTIVE: This clinical trial compares feasibility, perioperative outcomes, and weight loss of patients undergoing ambulatory LSG with same-day discharge versus conventional hospitalization with next-day discharge.
METHODS: Hospital and ambulatory surgery center.
METHODS: Patients who satisfied low-acuity criteria were randomized to undergo day-case LSG in the ambulatory surgery center with same-day discharge (DC LSG) or LSG with conventional hospitalization and next-day discharge (CH LSG) between December 2018 and December 2020. The primary outcomes were 30-day adverse events, hospitalizations, reoperations, and readmissions, and the secondary outcome was weight loss during the first year.
RESULTS: Of 2541 screened patients, 1544 patients were randomized in the study. Mean age and body mass index were 31.7 ± 9.1 years versus 31.8 ± 9.2 years and 39.6 ± 5.8 kg/m2 versus 40.0 ± 5.7 kg/m2 in the DC LSG group (n = 777) and in the CH LSG group (n = 777), respectively. Eighteen patients (2.3%) in the DC LSG were transferred to the hospital for overnight stay. Additionally, 13 patients (1.7%) requested additional stay without a medical indication for a total overnight stay rate of 4%. One DC LSG patient (.1%) was readmitted, and 2 CH LSG patients (.3%) stayed for an extra day. Seventeen percent of DC LSG patients had unscheduled consultations during the first postoperative week compared with 6% of CH LSG patients (P < .001). Those 2 groups were similar in baseline characteristics. There were no reoperations or mortality in either group, and weight loss results were similar; At 1-year follow-up, DC LSG percent excess weight loss was 87% ± 17% compared with 85% ± 17% in the CH LSG group. The follow-up rate was 100%.
CONCLUSIONS: LSG is feasible as a day-case procedure with comparable outcomes to conventional hospitalization.
摘要：
背景：腹腔镜袖状胃切除术（LSG）是一种有效的减肥干预措施，手术时间短，发病率和死亡率低。然而,门诊袖状胃切除术未得到充分利用。
目的：这项临床试验比较了可行性，围手术期结局,以及当天出院的门诊LSG患者与第二天出院的常规住院患者的体重减轻。
方法：医院和门诊手术中心。
方法：符合低视力标准的患者在2018年12月至2020年12月期间，在门诊手术中心随机接受日间LSG，当日出院（DCLSG）或LSG，常规住院和次日出院（CHLSG）。主要结果是30天不良事件，住院治疗,重新操作,和再入院，次要结局是第一年的体重减轻.
结果：在2541名筛查患者中，研究中随机分配了1544名患者。在DCLSG组（n=777）和CHLSG组（n=777）中，平均年龄和体重指数分别为31.7±9.1岁和31.8±9.2岁和39.6±5.8kg/m2和40.0±5.7kg/m2，分别。DCLSG中的18名患者（2.3％）被转移到医院过夜。此外,13名患者（1.7％）要求在没有医学指征的情况下额外住院，总过夜住院率为4％。1例DCLSG患者（0.1%）再次入院，2例CHLSG患者（3％）多停留一天。17％的DCLSG患者在术后第一周进行了计划外咨询，而CHLSG患者为6％（P<.001）。两组的基线特征相似。两组均无再次手术或死亡,和体重减轻结果相似；在1年随访时，DCLSG过量体重减轻百分比为87%±17%,而CHLSG组为85%±17%。随访率为100%。
结论：LSG作为日间手术是可行的，其结果与常规住院相当。
目的：这项临床试验比较了可行性，围手术期结局,以及当天出院的门诊LSG患者与第二天出院的常规住院患者的体重减轻。
方法：医院和门诊手术中心。
方法：符合低视力标准的患者在2018年12月至2020年12月期间，在门诊手术中心随机接受日间LSG，当日出院（DCLSG）或LSG，常规住院和次日出院（CHLSG）。主要结果是30天不良事件，住院治疗,重新操作,和再入院，次要结局是第一年的体重减轻.
结果：在2541名筛查患者中，研究中随机分配了1544名患者。在DCLSG组（n=777）和CHLSG组（n=777）中，平均年龄和体重指数分别为31.7±9.1岁和31.8±9.2岁和39.6±5.8kg/m2和40.0±5.7kg/m2，分别。DCLSG中的18名患者（2.3％）被转移到医院过夜。此外,13名患者（1.7％）要求在没有医学指征的情况下额外住院，总过夜住院率为4％。1例DCLSG患者（0.1%）再次入院，2例CHLSG患者（3％）多停留一天。17％的DCLSG患者在术后第一周进行了计划外咨询，而CHLSG患者为6％（P<.001）。两组的基线特征相似。两组均无再次手术或死亡,和体重减轻结果相似；在1年随访时，DCLSG过量体重减轻百分比为87%±17%,而CHLSG组为85%±17%。随访率为100%。
结论：LSG作为日间手术是可行的，其结果与常规住院相当。
