Cureus | Timing of Smoking Cessation Affects Outcomes After Laparoscopic Gastric Bypass

Timing of Smoking Cessation Affects Outcomes After Laparoscopic Gastric Bypass


Abstract

With the growth of bariatric surgery and the inevitable need for conversion/revision to other weight loss procedures, there exists a clear need to identify those characteristics that can help to guide beneficent  decision making. Among gastric bypass patients, marginal ulcers are a common complication and are thought to be predisposed by a number of factors, including smoking. To date, no study has focused on whether smoking status of a patient at the time of gastric bypass is related to later marginal ulcer formation and other complications.

A meta-analysis of prior studies was performed with the addition of new data to determine the correlation between common postoperative complications (marginal ulcers, nausea/vomiting, bleeding, stricture), need for reintervention, weight loss and patient smoking habits at the time of laparoscopic gastric bypass. Trends and Relative Risks among smokers, former smokers and never smokers were calculated using this data.

Results demonstrate that current smokers have a statistically significant higher incidence (within the first year after surgery) of marginal ulcers, overall postoperative complications, percent excess weight loss, need for reintervention and postop pain with nausea/vomiting as compared to never smokers and smokers who have undergone at least six weeks of smoking cessation prior to surgery. in this regard, never smokers and former smokers were nearly equivocal in outcomes.

The results of this study support current recommendations for smoking cessation among patients who are undergoing a laparoscopic gastric bypass whether as a primary procedure or as a revision surgery. This analysis supports at least 6-8 weeks of cessation which can provide significantly improved outcomes in gastric bypass patients, particularly in regards to initial postoperative complications and later marginal ulcer development.

Poster
non-peer-reviewed

Timing of Smoking Cessation Affects Outcomes After Laparoscopic Gastric Bypass


Author Information

Edward Skicki Corresponding Author

Surgery, Lancaster General Hospital, Lancaster, USA

Gary Aghazarian

Surgery, University of Pittsburgh Medical Center P, Harrisburg, USA

Matthew Kalliath

Surgery, University of Pittsburgh Medical Center Pinnacle, Harrisburg, USA

Cory Kutruff

Surgery, University of Pittsburgh Medical Center Pinnacle, Harrisburg, USA

John Mills

Surgery, University of Pittsburgh Medical Center Pinnacle, Harrisburg, USA

Justin Rosenberger

Surgery, Central Pa Surgical Associates, Harrisburg, USA

Luciano DiMarco

Surgery, Central Pa Surgical Associates, Harrisburg, USA


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