BLEND STUDY
30-Day MorBidity and MortaLity of Primary Bariatric SurgEry combiNed with Another ProceDure (cholecystectomy and/or ventral hernia repair and/or hiatal hernia repair): A TUGS Multinational Audit
STUDY OBJECTIVES
1) The primary objective is to find out the 30-day mortality and morbidity of any primary bariatric surgery combined with a cholecystectomy and/or ventral hernia repair and/or hiatal hernia repair.
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2) The secondary objective is to find out the factors associated with 30-day morbidity and mortality of such surgical procedures.
INCLUSION CRITERIA
1)All consecutive patients undergoing any primary bariatric surgery combined with a cholecystectomy and/or ventral hernia repair and/or hiatal hernia repair between 1st January 2022 and 30th June 2022 at your centre (The study date may be extended depending on the numbers recruited)
2)Only include primary bariatric surgery
3)Adults (>/=18 years)
EXCLUSION CRITERIA
1)Patients who fall outside the above dates
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2)Patients undergoing revisional bariatric surgery or endoscopic bariatric procedure
3)Patients <18 years of age.
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4)Patients undergoing surgery other than cholecystectomy or ventral hernia repair or hiatal hernia repair with primary bariatric surgery
Abstract
Background
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No robust data are available on the safety of primary bariatric and metabolic surgery (BMS) alone compared to primary BMS combined with other procedures.
Objectives
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.SettingThis is as an international, multicenter, prospective, and observational audit of patients undergoing primary BMS combined with one or more additional procedures.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.
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Results
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%).
Conclusion
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.
