@article{081f7edc25d84b09a9380fd5ac3bc017,
title = "30-Day Outcomes After Intraoperative Leak Testing for Bariatric Surgery Patients",
abstract = " Background: Intraoperative testing of anastomoses and staples lines is commonly performed to minimize the risk of postoperative leaks in bariatric surgery, but its impact is unclear. The aim of this study was to determine the association between leak testing and 30-d postoperative leak, bleed, reoperation, and readmission rates for patients undergoing laparoscopic sleeve gastrectomy (LSG)or Roux-en-Y gastric bypass (RYGB). Methods: This is a retrospective observational study utilizing 2015-2016 data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Postoperative outcomes were compared using χ 2 test. Multivariable logistic regression was used to identify factors associated with 30-d outcomes. Results: We included 237,081 patients. Leak testing was performed on 73.0% and 92.1% of LSG and RYGB patients, respectively. LSG was associated with lower rates of leak, bleed, reoperation, and readmission than RYGB. On multivariable analysis, intraoperative leak testing was associated with increased rates of postoperative leak for LSG and RYGB (OR 1.48 and 1.90, respectively)and lower rates of bleed for LSG (OR 0.76). There were no significant associations between leak testing and rates of reoperation or readmission. Conclusions: Use of intraoperative leak testing was not associated with improved outcomes for either LSG or RYGB. A prospective trial investigating leak testing is warranted to better elucidate its impact.",
keywords = "Anastomotic leak, Bariatric surgery, Bleed, Intraoperative provocative testing, Readmission, Reoperation",
author = "Natalie Liu and Cusack, {Meghan C.} and Manasa Venkatesh and Pontes, {Anisa L.} and Grace Shea and Svoboda, {Dillon C.} and Greenberg, {Jacob A.} and Lidor, {Anne O.} and Funk, {Luke M.}",
note = "Funding Information: Efforts on this study and article were made possible by an American College of Surgeons George H.A. Clowes Career Development Award and a VA Career Development Award to Luke Funk (CDA 015-060). The views represented in this article represent those of the authors and not those of the DVA or the U.S. Government. In addition, this study is funded through the NIH T32 Surgical Oncology Research Training Program ( T32 CA090217-17 ) and the NIH T35 Surgery Summer Research Experience for Medical Students Program (T35DK062709). Funding Information: Efforts on this study and article were made possible by an American College of Surgeons George H.A. Clowes Career Development Award and a VA Career Development Award to Luke Funk (CDA 015-060). The views represented in this article represent those of the authors and not those of the DVA or the U.S. Government. In addition, this study is funded through the NIH T32 Surgical Oncology Research Training Program (T32 CA090217-17)and the NIH T35 Surgery Summer Research Experience for Medical Students Program (T35DK062709). Author's contributions: L.M.F. N.L. M.C. and M.V. contributed to study design. N.L. M.C. M.V. A.L.P. G.S. D.C.S. and L.M.F. contributed to data collection and analysis. N.L. M.C. and L.M.F. contributed to manuscript composition. All coauthors participated in the data interpretation and manuscript revisions. All coauthors approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Publisher Copyright: {\textcopyright} 2019",
year = "2019",
month = oct,
doi = "10.1016/j.jss.2019.04.047",
language = "English (US)",
volume = "242",
pages = "136--144",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
}