title: Risk factors for complications of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Although bariatric procedures are considered safe, yet still they involve a risk of possible perioperative complications. Identification of risk factors for complications would allow for appropriate preoperative optimization of the patient, as well as reasonable postoperative care and early diagnosis and treatment of possible complications. The aim of this study was to determine the risk factors for perioperative complications after laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).
  
  
  METHODS
  A retrospective analysis of prospectively collected data of patients operated for morbid obesity. Regarding postoperative complications defined as adverse events occurring within 30 days of the procedure. Factors associated with patient characteristics and those related to the surgical procedure were determined. 408 patients met inclusion criteria and were submitted to surgical treatment. LSG and LRYGB were performed in 233 and 175 patients, respectively.
  
  
  RESULTS
  Complications were observed in 30 (7.3%) patients. The maximum preoperative body weight and BMI, as well as body weight and BMI on the day of surgery were associated with increased complication rate. The type of the procedure did not influence perioperative complications (LRYGB vs. LSG; OR: 1.14; CI: 0.53-2.44; p = 0.74). Although operative time statistically significantly increased the risk of complications, it did not seem clinically relevant (OR: 1.01; CI: 1.00-1.02; p = 0.003). An increase in the number of stapler firings used significantly increased complication rate only in LSG group.
  
  
  CONCLUSIONS
  Longer duration of LSG and the increase in the number of stapler firings used during LSG should alert a surgeon to an increased risk of postoperative complications. In patients submitted to LRYGB the risk of possible complications increases with BMI.
authors.affiliation: 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: majorpiotr@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Major
authors.affiliation: Students' Scientific Group at 2nd Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: michal92wysocki@gmail.com.
authors.forename: Michał
authors.initials: M
authors.lastname: Wysocki
authors.affiliation: 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: michal.pedziwiatr@uj.edu.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Pędziwiatr
authors.affiliation: 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: magdalenapisarska@interia.pl.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Pisarska
authors.affiliation: 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: jadwigadworak@gmail.com.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Dworak
authors.affiliation: 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: pmmalczak@gmail.com.
authors.forename: Piotr
authors.initials: P
authors.lastname: Małczak
authors.affiliation: 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: andrzej.budzynski@uj.edu.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Budzyński
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D017792:Surgical Stapling
keywords: Gastric bypass; Postoperative complications; Risk factors; Sleeve gastrectomy