%0 Journal Article %T Laparoscopic sleeve gastrectomy as day-case surgery versus conventional hospitalization: results of the DAYSLEEVE randomized clinical trial. %A Alqahtani AR %A Elahmedi M %A Amro N %A Abdurabu HY %A Abdo N %A Alqahtani S %A Boutros A %A Ebishi A %A Al-Darwish A %A Alqahtani AR %A Elahmedi M %A Amro N %A Abdurabu HY %A Abdo N %A Alqahtani S %A Boutros A %A Ebishi A %A Al-Darwish A %A Alqahtani AR %A Elahmedi M %A Amro N %A Abdurabu HY %A Abdo N %A Alqahtani S %A Boutros A %A Ebishi A %A Al-Darwish A %J Surg Obes Relat Dis %V 18 %N 9 %D Sep 2022 %M 35803849 %F 3.709 %R 10.1016/j.soard.2022.05.023 %X 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.