La prise en charge ambulatoire de la sleeve gastrectomie : étude préliminaire prospective

Abstract

Epidemiological evidence suggests that obesity has become a global pandemic with significant implications to public health. Laparoscopic sleeve gastrectomy (LSG) has proved highly effective in alleviating type 2 diabetes and other comorbidities compared with traditional medical treatment. The purpose of this study is to evaluate the feasibility of laparoscopic sleeve gastrectomy in ambulatory.MethodsThis prospective study was conducted from May 2011 to April 2012. The data of 30 patients undergoing LSG were analyzed. Standard anesthetic, surgical, analgesic, and antiemetic protocols were used.ResultsOf the 30 obese patients, 7% were male and 93% were female. Mean age was 34 years (22–55). Mean preoperative BMI was 42.7 kg/m2. 5 patients (16.6%) had HTN; 3 (10%) had dyslipidemia and 1 (3,3%) had diabetes not requiring treatment. 1 patient required two attempts and use of Eschmann tracheal tube introducer for successful intubation. The mean operating time was 60 minutes (range, 45–95) and there were no conversions to open surgery. No intraoperative anaesthetic complications occurred. Postoperative Analgesic medication was administered with a combination of nefopam, tramadol and paracetamol. 20% patients developed nausea and vomiting in the recovery room and 97% of patients have no pain or low output recovery room. They were successfully treated before the release of the hospital. Mean time in the recovery room was 86.5 minutes (35–240). The overall satisfaction rate was 90%. No patients were admitted because of nausea or inadequated pain control. No patient presented postoperatively any thrombo-embolic complication.ConclusionsLaparoscopic sleeve gastrectomy in ambulatory is feasible and well tolerated in selected patients. However, further studies are necessary to assess its safety and acceptability.