IBC-Oxford University2023_BJSPoster_11Early Results and Postoperative Complications in Bariatric International Centers of Reference for Weight Loss Surgery
Authors: Barriga Fong J A , Ramos A C , Verboonen Sotelo S , de León Palomares J Ponce , Rodríguez López C , Pérez Corzo H J , Almanza Reyes M A , Ortiz Gómez E , Álvarez Malo ÓO , Guzmán Barba J A , Esparza Estrada I 
Published: December 2023

Abstract

Background
Metabolic/Bariatric Surgery (MBS) is worldwide recognized as the best treatment option for obesity. Medical insurance restrictions, better financing conditions and social media easy access make persons with obesity look for international centers of reference to make possible their access to weight loss surgery. These kinds of surgeries are frequently performed in Tijuana, Baja California, Mexico, where there are dedicated specialized high-volume hospital centres. Like any major surgery, bariatric procedures are not exempt from complications, which need to be considered and adequately treated as they can compromise the patient's well-being. Will be presented here the early results and complications from 4 centres of excellence as part of Baja California College of Bariatric and Metabolic Surgeons.

Methods
This is an observational, descriptive, and retrospective study based on medical records of patients who underwent primary MBS in specialized high-volume hospital centres in Tijuana, Baja California, Mexico, from March to September 2022. The following information of interest will be collected: age, gender, comorbidities, BMI, type of surgery performed, surgical time, length of stay, trans/postoperative complications, and hospital readmission in a 30-day postoperative observational time. Once the data collection process is completed, a descriptive analysis will be conducted using SPSS version 26 software for MacOS. Means and standard deviations will be obtained for quantitative variables, while frequencies and percentages will be calculated for qualitative variables.

Results
A total of 3906 patients were included, with 85.8% being female and 14.2% being male. The average weight and BMI in females and males were 113.6 kg and 138.8 kg, and 42.3 kg/m2 and 44.7 kg/m2, respectively. Hypertension was reports in 961 individuals (31%), while 383 reported type-2 diabetes (12%). Sleeve gastrectomy (LSG) was performed in 90% of the patients, 5.1% were Roux-en-Y gastric bypass (RYGB), and 3.6% were one anastomosis gastric bypass (OAGB). The average surgical time per procedure was 59 minutes in general with 40 (± 9) min, 94 (± 19) min and 70 (± 27) min respectively for LSG, RYGB and OAGB. A total of 15 patients (0.38%) experienced some form of early postoperative complication, with the majority (8 cases) being postoperative bleeding. Additionally, there were 4 leaks, 1 sleeve migration, 1 sleeve obstruction, and 1 intestinal obstruction. Out of these, 13 patients (0.33%) required a surgical reintervention before discharge (7 cases of bleeding, 4 cases of leaks, sleeve migration, and sleeve obstruction). 12 out of the 13 reinterventions occurred following sleeve gastrectomy, while the remaining reintervention was a result of intestinal obstruction in a RYGB patient. Length of stay varies from 2 to 4 days with an average of 2.2 days.

Conclusion
Complications are very low in international MBS centres of excellence in Tijuana, Mexico. The experience and skill of the bariatric surgeon are directly related to the number of surgeries performed in their professional practice, which, in turn, helps prevent the occurrence of short-term postoperative complications and to allow the early diagnosis and prompt treatment adoption.