The impact of severe postoperative complications on outcomes of bariatric surgery – multicenter case-matched study

Abstract Background Bariatric surgery has relatively low complication rates, especially severe postoperative complications (defined by Clavien-Dindo classification as type 3 and 4), but these rates cannot be ignored. In other than bariatric surgical disciplines, complications affect not only short-term but also long-term results. In the field of bariatric surgery this topic has not been extensively studied. Objectives The aim of the study was to assess the outcomes of bariatric treatment in patients with obesity and severe postoperative complications in comparison to patients with a noneventful perioperative course. Setting 6 surgical units at XXXXX public hospitals. Methods We performed a multicenter propensity score matched analysis of 206 patients from 6 XXXXX surgical units and assessed the outcomes of bariatric procedures. 103 patients with severe postoperative complications (70 laparoscopic Sleeve Gastrectomy (SG) and 33 laparoscopic Roux en Y Gastric Bypass (RYGB)) were compared to 103 patients with no severe complications in terms of peri- and postoperative outcomes. Results The outcomes of bariatric treatment did not differ between compared groups. Median percentage of total weight loss (%TWL) 12 months after the surgery was 28.8% in the group with complications and 27.9% in patients with no severe complications (p=0.993). Remission rates of both: type 2 diabetes mellitus and arterial hypertension, showed no significant difference, SG vs RYGB respectively: 36% vs 42%, p=0.927 and 41 vs 46%, p=0.575. Conclusions The study suggests that severe postoperative complications had no significant influence either on weight-loss effects or obesity-related diseases remission.