Factors affecting the early post-operative prognosis in morbidly obese surgical patients after laparoscopic sleeve gastrectomy – a retrospective cohort study

BACKGROUND: The number of morbidly obese patients who have undergone bariatric surgery has been gradually increasing in Japan. These obese patients are often complicated with metabolic, cardiac, respiratory, and other diseases. The aim of this study was to analyze the perioperative clinical course in a retrospective cohort with respect to the utility of anesthesia management in order to prevent longer hospital stays after surgery. FINDINGS: Sixty-seven morbidly obese patients who had undergone sleeve gastrectomy were divided into two groups, based upon the duration of postoperative hospital stay; group S was comprised of the patients who were discharged within 5 days after surgery (n = 57) and group L was comprised of those who were discharged after 6 days or more (n = 10). The mean duration of the hospital stay was 4.8 ± 0.4 days and 7.8 ± 1.4 days in groups S and L, respectively. Multivariate logistic regression analysis showed that prolonged anesthesia was a predictor of a longer postoperative hospital stay (p < 0.05). While the difference in BMI was not significantly different, the percentage of patients with BMI ≥ 50 was 12 and 30% in groups S and L, respectively. CONCLUSIONS: Longer duration of anesthesia affected the duration of postoperative hospital stay in morbidly obese patients undergoing sleeve gastrectomy. In addition, patients with BMI ≥ 50 might be at risk of longer hospitalization after surgery.