Global 30-Day Morbidity and Mortality of Primary Bariatric Surgery Combined with Another Procedure: The BLEND Study

• Published in: Obesity surgery
• Main Authors: Nanayakkara, Kushan D. L., Abouelazayem, Mohamed, Pereira, Juan Pablo Scarano, Balasubaramaniam, Vignesh, Al-Shami, Khayry, Alqahtan, Awadh Robaan, Askari, Alan, Chowdhury, Sharfuddin, Cristin, Luca, Elgazar, Amr, Elhadi, Muhammed, Graham, Yitka, Kalmoush, Abd-Elfattah Morsi, Lisi, Giorgio, Mier, Fernando, O’Malley, William Edward, Poghosyan, Tigran, Ribeiro, Rui, Sakran, Nasser, Sawaftah, Khaled Ahmad, Tokocin, Merve, Türkçapar, Ahmet Gökhan, Verras, Georgios -Ioannis, Wei, Zhuoqi, Zerrweck, Carlos, Gkoutos, Georgios V., Cardoso, Victor Roth, Singhal, Rishi, Mahawar, Kamal, Abdulwahed, Eman Ali, Ahmed, Fuad, AL Hamoud, Mohammad A., Al-Qazakzeh, Hamzeh Ibrahim, Al-Shami, Manar, Al-Taan, Omer, Allawgalli, Aiman Nuri, Alrayes, Bourhan Mohammad Hassan, Alshareea, Entisar Ahmed, Arraf, Jabra, Bakeer, Hibah Bileid, Baksi, Aditya, Balescu, Irina, Bani Hani, Zeina M, Bani Hani, Leen M, Berardi, Giovanna, Bhasker, Aparna Govil, Boligo, Sofia L., Borges, Nuno, Cano Busnelli, Virginia Margarita, Caruana, Clifford, Cethorth Fonseca, Roland Kevin, Chia, Daryl K. A., Daskalakis, Markos, De Leon Ballesteros, Guillermo Ponce, Diaz, Angel, Dogjani, Agron, Dulac, Anne Sophie, Duro, Agustin, Elghrieb, Ahmed E, Erdene, Sarnai, Erginöz, Ergin, Frattini, Francesco, Ghazal, Ahmad, Gil, Isabela, Viswanath, Nakul Gokhare, Gunawardene, Ashok, Hazebroek, Eric, Houssem, Ammar, Inam, Aatif, Kapiris, Stylianos, Kasi, Shahbaz Khan, Kassir, Radwan, Khan, Shahzeb, Klib, Mohamad, Di Pangrazio, Marco, Kraljik, Darko, Liakopulos, Nicolas Juan, Magnani, Riccardo, Masri, Ruqaya, Özçelik, Mehmet Faik, Petkov, Plamen, Rajeev, Yashasvi, Ramu, Gopi, Saleh, Fahd S, Salvi, Prashant H, Sarodaya, Varun, Sawaftah, Marah Ahmad, Sawas, Mohamad Nabhan, Shabbir, Azhar, Thapar, Pinky M, Tidjane, Anisse, Ulhaq, Muhammad Burhan, Viveiros, Octavio, Voon, Kelvin, Walędziak, Maciej, Yeoh, Bryan, Yüksel, Sercan, Zayat, Hussein, Zengin, Kağan, Pinto, Federico
• Format: Journal Article
• Language: English
• Published: 13.06.2024
• ISSN: 0960-8923; 1708-0428; 1708-0428
• DOI: 10.1007/s11695-024-07296-0

No robust data are available on the safety of primary bariatric and metabolic surgery (BMS) alone compared to primary BMS combined with other procedures.BACKGROUNDNo robust data are available on the safety of primary bariatric and metabolic surgery (BMS) alone compared to primary BMS combined with other procedures.The objective of this study is to collect a 30-day mortality and morbidity of primary BMS combined with cholecystectomy, ventral hernia repair, or hiatal hernia repair.OBJECTIVESThe objective of this study is to collect a 30-day mortality and morbidity of primary BMS combined with cholecystectomy, ventral hernia repair, or hiatal hernia repair.This is as an international, multicenter, prospective, and observational audit of patients undergoing primary BMS combined with one or more additional procedures.SETTINGThis is as an international, multicenter, prospective, and observational audit of patients undergoing primary BMS combined with one or more additional procedures.The audit took place from January 1 to June 30, 2022. A descriptive analysis was conducted. A propensity score matching analysis compared the BLEND study patients with those from the GENEVA cohort to obtain objective evaluation between combined procedures and primary BMS alone.METHODSThe audit took place from January 1 to June 30, 2022. A descriptive analysis was conducted. A propensity score matching analysis compared the BLEND study patients with those from the GENEVA cohort to obtain objective evaluation between combined procedures and primary BMS alone.A total of 75 centers submitted data on 1036 patients. Sleeve gastrectomy was the most commonly primary BMS (N = 653, 63%), and hiatal hernia repair was the most commonly concomitant procedure (N = 447, 43.1%). RYGB accounted for the highest percentage (20.6%) of a 30-day morbidity, followed by SG (10.5%). More than one combined procedures had the highest morbidities among all combinations (17.1%). Out of overall 134 complications, 129 (96.2%) were Clavien-Dindo I-III, and 4 were CD V. Patients who underwent a primary bariatric surgery combined with another procedure had a pronounced increase in a 30-day complication rate compared with patients who underwent only BMS (12.7% vs. 7.1%).RESULTSA total of 75 centers submitted data on 1036 patients. Sleeve gastrectomy was the most commonly primary BMS (N = 653, 63%), and hiatal hernia repair was the most commonly concomitant procedure (N = 447, 43.1%). RYGB accounted for the highest percentage (20.6%) of a 30-day morbidity, followed by SG (10.5%). More than one combined procedures had the highest morbidities among all combinations (17.1%). Out of overall 134 complications, 129 (96.2%) were Clavien-Dindo I-III, and 4 were CD V. Patients who underwent a primary bariatric surgery combined with another procedure had a pronounced increase in a 30-day complication rate compared with patients who underwent only BMS (12.7% vs. 7.1%).Combining BMS with another procedure increases the risk of complications, but most are minor and require no further treatment. Combined procedures with primary BMS is a viable option to consider in selected patients following multi-disciplinary discussion.CONCLUSIONCombining BMS with another procedure increases the risk of complications, but most are minor and require no further treatment. Combined procedures with primary BMS is a viable option to consider in selected patients following multi-disciplinary discussion.