TY  - JOUR
T1  - Laparoscopic vs open gastric bypass surgery: Differences in patient demographics, safety, and outcomes
AU  - Banka G, Woodard G, Hernandez-Boussard T, Morton JM
Y1  - 2012/06/01
N1  - 10.1001/archsurg.2012.195
JO  - Archives of Surgery
SP  - 550
EP  - 556
VL  - 147
IS  - 6
N2  - Objective 
                  To determine national outcome differences between laparoscopic Roux-en-Y gastric bypass (LRYGB) and open Roux-en-Y gastric bypass (ORYGB).Design 
                  Retrospective cohort study.Setting 
                  The Nationwide Inpatient Sample.Patients 
                  Patients undergoing ORYGB and LRYGB.Main Outcome Measures 
                  Outcome measures were number of procedures performed, patient and hospital characteristics, patient complications, mortality, length of stay, resource use, and Agency for Healthcare Research and Quality Patient Safety Indicators. Both demographic and outcomes variables were compared by either t test or χ2 analysis, with regression analysis adjusting for confounding variables.Results 
                  The ORYGB and LRYGB cohorts consisted of 41 094 and 115 177 cases, respectively. From 2005 to 2007, LRYGB was more commonly performed than ORYGB (72% vs 28%; P &lt; .001) and at high-volume hospitals (69% vs 61%; P &lt; .001). A higher percentage of ORYGB compared with LRYGB patients were Medicare (9.3% vs 7.1%) and Medicaid (10.4% vs 5.9%; P &lt; .01) beneficiaries. More ORYGB patients compared with LRYGB patients were discharged with nonroutine dispositions (7.7% vs 2.4%; P = .005), died (0.2% vs 0.1%; P &lt; .001), and had 1 or more complications (18.7% vs 12.3%; P &lt; .001). All Patient Safety Indicator rates were higher for ORYGB. Patients who had ORYGB compared with LRYGB also had longer median lengths of stay (3.5 vs 2.4 days; P &lt; .001) and higher total charges ($35 018 vs $32 671; P &lt; .001). Patients who had LRYGB had a lower odds ratio than patients who had ORYGB for both mortality (odds ratio, 0.54; P &lt; .001) and having 1 or more complications (odds ratio, 0.66; P &lt; .001) even after adjusting for confounding variables.Conclusion 
                  In this population-based study, LRYGB provided greater safety than ORYGB even after adjusting for patient-level socioeconomic and comorbidity differences.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2012.195
UR  - http://dx.doi.org/10.1001/archsurg.2012.195
ER  -