title: Routine gastrostomy tube placement in gastric bypass patients: impact on length of stay and 30-day readmission rate.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. Current average length of hospital stay (LOS) after RYGB is 2-3 days and 30-day readmission rate is 8-13 %. The aim of our study is to evaluate the effect of routine gastrostomy tube placement in perioperative outcomes of RYGB patients.
  
  
  METHODS
  Between January 2008 and December 2010, a total of 840 patients underwent RYGB at our institution. All RYGB patients had gastrostomy tube placed, which was kept for 6 weeks. A retrospective review of a prospectively collected database was performed for all RYGB patients, noting the outcomes and complications of the procedure.
  
  
  RESULTS
  Average LOS in our patient population was 1.1 days (range, 1-14 days), and 824 (98.3 %) patients were discharged on postoperative day 1. Readmissions within 30 days after the index RYGB was observed in 31 (3.7 %) patients. Reasons included abdominal pain (n = 14), nausea/vomiting (n = 6), gastrostomy tube-related complications (n = 5), chest pain (n = 3), allergic reaction (n = 1), urinary tract infection (n = 1), and dehydration (n = 1). Of these readmitted patients, nine (1.1 %) patients required reoperations due to small bowel obstruction (n = 5), perforated anastomotic ulcer (n = 1), anastomotic leak (n = 1), subphrenic abscess (n = 1), and appendicitis (n = 1).
  
  
  CONCLUSIONS
  Routine gastrostomy tube placement in the gastric remnant at the time of RYGB seems to have contributed to our short LOS and low 30-day readmission rate.
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Bariatric and Laparoscopy Center, Orlando Health, 89 Copeland Ave, 1st Floor, Orlando, FL 32806, USA.
authors.forename: Rena
authors.initials: R
authors.lastname: Moon
authors.forename: Andre
authors.initials: A
authors.lastname: Teixeira
authors.forename: Kelly
authors.initials: K
authors.lastname: Potenza
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Jawad
mesh_terms: D015746:Abdominal Pain / Q000150:complications / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D002404:Catheterization / Q000379:methods*; D003681:Dehydration / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D018530:Gastric Stump / Q000601:surgery*; D005774:Gastrostomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D010149:Postoperative Pain / Q000453:epidemiology / Q000601:surgery; D010359:Patient Readmission / Q000706:statistics & numerical data*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult