Relationship between surgeon volume and adverse outcomes after RYGB in Longitudinal Assessment of Bariatric Surgery (LABS) study
Surgery for Obesity and Related DiseasesPublished 27 September 2009Open access
Mark D. Smith, Emma Patterson, Abdus S. Wahed, Steven H. Belle, Marc Bessler, Anita P. Courcoulas
Citations67
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
In the LABS, the patient's risk of an adverse outcome after RYGB decreased significantly with the increase in surgeon RY GB volume (cases performed annually), such that for each 10-case/yr increase in volume, the risk of a composite event decreased by 10%.
Abstract
In the LABS, the patient's risk of an adverse outcome after RYGB decreased significantly with the increase in surgeon RYGB volume (cases performed annually).
Keywords
Medicine
Annals of Internal MedicineGastrointestinal Surgery for Severe Obesity
2,159 Citations1991Consensus Development Conference Panel
Annals of Internal MedicineMeta-Analysis: Surgical Treatment of Obesity
1,574 Citations2005Melinda A. Maggard, Lisa R. Shugarman +11 more
The increasing numbers of obese individuals have led to intensified interest in surgical treatments to achieve weight loss, and a variety of surgical procedures have been used (Figure 1), which generates weight loss primarily through malabsorption.
New England Journal of MedicinePerioperative Safety in the Longitudinal Assessment of Bariatric Surgery
1,399 Citations2009David Reed Flum, David Reed Flum +14 more
The overall risk of death and other adverse outcomes after bariatric surgery was low and varied considerably according to patient characteristics, andExtreme values of body-mass index were significantly associated with an increased risk of the composite end point, whereas age, sex, race, ethnic group, and other coexisting conditions were not.
JAMATrends in Bariatric Surgical Procedures
946 Citations2005Heena P. Santry
Findings suggest that use of bariatric surgical procedures increased substantially from 1998 to 2003, while rates of in-hospital complications were stable and length of stay decreased.
NutritionGastrointestinal surgery for severe obesity
639 Citations1996Robert E. Brolin
The panel recommended that patients seeking therapy for severe obesity for the first time should be considered for treatment in a nonsurgical program with integrated components of a dietary regimen, appropriate exercise, and behavioral modification and support.
JAMAEarly Mortality Among Medicare Beneficiaries Undergoing Bariatric Surgical Procedures
629 Citations2005David R. Flum
Among Medicare beneficiaries, the risk of early death after bariatric surgery is considerably higher than previously suggested and associated with advancing age, male sex, and lower surgeon volume of bariatric procedures.
Annals of SurgeryThe Relationship Between Hospital Volume and Outcome in Bariatric Surgery at Academic Medical Centers
426 Citations2004Ninh T. Nguyen, Mahbod Paya +4 more
Bariatric surgery performed at hospitals with more than 100 cases annually is associated with a shorter length of stay, lower morbidity and mortality, and decreased costs, which may be related in part to formalization of the structures and processes of care.
Annals of SurgeryMortality After Bariatric Surgery
271 Citations2007Mario Morino, Mauro Toppino +4 more
Mortality after bariatric surgery is a rare event influenced by different risk factors including type of surgery, open surgery, prolonged operative time, comorbidities, and volume of activity.
Surgery for Obesity and Related DiseasesSafety and efficacy of bariatric surgery: Longitudinal Assessment of Bariatric Surgery
244 Citations2007Steven H. Belle, Paul D. Berk +7 more
The goal of the LABS consortium is to accelerate clinical research and understanding of extreme obesity and its complications by evaluating the risks and benefits of bariatric surgery.
SurgeryThe relationship of surgeon and hospital volume to outcome after gastric bypass surgery in Pennsylvania: A 3-year summary
188 Citations2003Anita P. Courcoulas, Matthew J. Schuchert +2 more
Risk-adjusted in-hospital adverse outcome is significantly lower when gastric bypass is performed by higher-volume surgeons, and the same trend was observed for deaths.
The American Journal of SurgeryLaparoscopic sleeve gastrectomy for morbid obesity
183 Citations2008Jason Moy, Alfons Pomp +3 more
LSG has been shown in initial studies to produce excellent excess weight loss comparable with laparoscopic Roux-en-Y gastric bypass in many series with a very low incidence of major complications and death.
Annals of SurgerySurgeon Volume Impacts Hospital Mortality for Pancreatic Resection
169 Citations2009Robert W. Eppsteiner, Nicholas G. Csikesz +3 more
After controlling for patient demographics and factors, pancreatic resection by a HV surgeon in this case-controlled cohort was independently associated with a 51% reduction in in-hospital mortality.
World Journal of GastroenterologyLaparoscopic sleeve gastrectomy for morbid obesity
168 Citations2008Antonio Iannelli
The Laparoscopic Sleeve Gastrectomy has increased in popularity and is currently very "trendy" among laparoscopic surgeons involved in bariatric surgery, and it has been proposed by some as a sole bariatric procedure.
Surgical EndoscopyImpact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer
143 Citations2005COLOR Study Group
Laroscopic operation for colon cancer at hospitals with high caseloads appears to be associated with improved short-term results, and a higher number of lymph nodes were harvested at high case volume hospitals.
Surgery for Obesity and Related DiseasesNational trends in use and outcome of laparoscopic adjustable gastric banding
104 Citations2008Marcelo W. Hinojosa, J. Esteban Varela +4 more
The increasing popularity of the laparoscopic adjustable gastric band procedure could in part be related to the lower cost and lower morbidity compared with Laparoscopic gastric bypass.
Journal of the American College of SurgeonsRelationship Between Hospital Volume, System Clinical Resources, and Mortality in Pancreatic Resection
99 Citations2009Bellal Joseph, John M. Morton +4 more
System clinical resources were more influential in operative mortality for pancreatic resection and might help explain why high- volume hospitals, low-volume surgeons in high-volume institutions, and some lower-volume hospitals with excellent clinical resources have lower perioperative mortality rates.
New England Journal of MedicineSurgical Treatment of Obesity — Weighing the Facts
96 Citations2009Malcolm K. Robinson
There has been an explosion in the number of bariatric surgical procedures performed worldwide, and the number is still rising, with the number in the United States more than 10 times as great as the number performed in 1994.
Journal of the American College of SurgeonsRelationship Between Surgeon and Hospital Volume and Readmission after Bariatric Operation
84 Citations2007Wendy E. Weller, Carl Rosati +1 more
There is an important relationship between surgeon and hospital volume and short-term readmission after bariatric operation.
The American SurgeonNational Study of the Effect of Patient and Hospital Characteristics on Bariatric Surgery Outcomes
80 Citations2005Alfredo M. Carbonell, Amy E. Lincourt +4 more
Male gender, increased age, and large hospital size were predictors of increased morbidity, having had a complication predicted increased mortality, while female gender had a protective effect, and hospital volume influenced patient outcomes.
The American SurgeonCharacterizing the Performance and Outcomes of Obesity Surgery in California
80 Citations2003Jerome H. Liu, David S. Zingmond +6 more
The quality of care for obesity surgery has improved between 1996 and 2000 and despite operating on patients with more comorbidity, rates of cardiac and respiratory complications have decreased.
Annals of SurgerySurgeon Volume Does Not Predict Outcomes in the Setting of Technical Credentialing
70 Citations2008David W. Larson, Peter W. Marcello +10 more
European Journal of Vascular and Endovascular SurgeryThe Relationship Between Volume and Outcome Following Elective Open Repair of Abdominal Aortic Aneurysms (AAA) in 131 German Hospitals
69 Citations2007Hans‐Henning Eckstein, T. Brückner +7 more
Patient's age, ASA classification, AAA diameter, length of procedure, suprarenal clamping and blood transfusion are predictive variables for an increased perioperative mortality in elective open AAA repair.
The American Journal of GastroenterologyTrends of Heller Myotomy Hospitalizations for Achalasia in the United States, 1993-2005: Effect of Surgery Volume on Perioperative Outcomes
58 Citations2008Y. Richard Wang, Daniel T. Dempsey +2 more
A larger volume of Heller myotomy in a hospital was associated with better perioperative outcomes in terms of shorter length of stay and lower total charges, and these findings were robust in alternative statistical models, specifications, and subgroup analyses.
Nature Clinical Practice Gastroenterology & HepatologyComplications of antiobesity surgery
45 Citations2007Ninh T. Nguyen, Samuel E. Wilson
The indications for bariatric surgery and the early and late complications associated with these two procedures are discussed.
Archives of SurgeryWhen Policy Meets Statistics
43 Citations2007Edward H. Livingston
Despite the weak evidence for a volume-outcome relationship for bariatric surgery, a 125-case per year threshold has been set for center-of-excellence status, which eliminates most hospitals currently providing these services and disproportionately restricts access for the poor and underinsured.
