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- Title
Predictors of Length of Hospital Stay After Reduction of Internal Hernia in Patients With a History of Roux-en-Y Gastric Bypass.
- Authors
Sohail, Amir H.; Hurwitz, Joshua C.; Silverstein, Jeffrey; Hakmi, Hazim; Sajan, Abin; Ye, Ivan B.; Pacheco, Tulio Brasileiro Silva; Zielinski, Gregory R.; Gangwani, Manesh Kumar; Petrone, Patrizio; Levine, Jun; Kella, Venkata; Brathwaite, Collin E. M.; Goparaju, Anirudha
- Abstract
Background: Postoperative internal hernias after Roux-en-Y gastric bypass (RYGB) have an incidence of 2%-9% and are a surgical emergency. Evidence on factors associated with length of stay (LOS) after emergent internal hernia reduction in RYGB patients is limited. Methods: This is a retrospective review of patients who underwent internal hernia reduction after RYGB at our tertiary care center over a 5 year period from 2015 to 2020. Demographics, comorbidities, and intra- and postoperative hospital course were collected. Univariate and multivariate linear regressions were used to investigate factors associated with LOS. Results: We identified 38 patients with internal hernia after RYGB. These patients with mean age 44.1 years were majority female (71.1%) and white race (60.5%). Of the 24 patients where the RYGB was done at our institution, the mean RYGB to IH interval was 43 months. Petersen's defect (57.8%) followed by jejuno-jejunal mesenteric defect (31.6%) were the most common locations for IH. Both Petersen's and jejuno-jejunal mesenteric hernias were found in 4 cases (10.5%). Revision of bypass and small bowel resection were required in 13.2% and 5.3% of cases, respectively. The median (interquartile range) length of stay (LOS) was 2 days. On the multivariate analysis, male sex (P =.019), conversion to exploratory laparotomy (P =.005), and resection of small bowel (P <.001) were independent risk factors for increased LOS. Conclusion: The most common location of IH after RYGB is Petersen's defect, followed by jejuno-jejunal mesenteric defect. LOS was significantly associated with male sex, exploratory laparotomy, and resection of small bowel.
- Subjects
GASTRIC bypass; LENGTH of stay in hospitals; HERNIA; SURGICAL emergencies; SMALL intestine; RACE; MORBID obesity; INGUINAL hernia
- Publication
American Surgeon, 2024, Vol 90, Issue 6, p1255
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/00031348241227215