In a high-volume centre, complication rates for primary metabolic and bariatric surgery were 9.2% and 0.7% for readmission, consistently meeting or exceeding international benchmarks.
Do perioperative outcomes of primary and revisional RYGB and SG at a high-volume centre meet international benchmark standards?
A high-volume centre demonstrated perioperative outcomes for primary and revisional bariatric surgery that meet or exceed international benchmark standards, highlighting the value of structured outcome monitoring.
Absolute Event Rate: 0% vs 0%
Abstract Bariatric surgery, predominantly Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), is the mainstay of obesity treatment worldwide, accounting for over 80% of all bariatric procedures. As obesity is a chronic and relapsing disease, revisional surgery is often necessary due to weight regain or the recurrence of comorbidities after primary intervention. The establishment of outcome benchmarks is essential for quality assurance and monitoring of surgical performance, particularly in high-volume centres. This study aims to evaluate the perioperative outcomes of primary and revisional RYGB and SG performed at a high-volume centre of excellence over a five-year period, and to compare the results with recently published international benchmark standards. A retrospective observational study was conducted on all patients who underwent primary and revisional RYGB or SG between January 2019 and December 2023. A total of 2929 patients were included: 2578 underwent primary MBS (80.1% female; mean age 45.1 years; mean BMI 42.1 kg/m²), and 351 underwent revisional surgery (86.3% female; mean age 50.2 years; mean BMI after primary surgery 40.5 kg/m²). Perioperative outcomes within 90 days included operation duration, intensive care unit (ICU) admission, length of stay, readmission, reoperation, complication rates, and procedure-specific adverse events (for example, staple line leak, haemorrhage and dysphagia). These were analysed and compared against established international benchmarks. For primary procedures, the overall complication rate was 9.2%, with readmission and reoperation rates of 0.7% and 0.43%, respectively. The mortality rate was 0.08% (two cases). Specific complications included staple line leakage (0.35%), dysphagia/stenosis (0.24%), postoperative haemorrhage (2.17%), and surgical site infection (0.43%). For revisional procedures, the overall readmission and reoperation rates were both 3.4%, with a rate of any complication rate within 30 days of 11%. No mortality was reported. Specific complications included fistula/staple line leak (0.9%), haemorrhage (1.4%), and dysphagia/stenosis (0.9%). When compared to international benchmark values, the outcomes from our centre were consistently within or better than the acceptable global ranges. Our high-volume multidisciplinary centre demonstrates favourable outcomes in both primary and revisional metabolic and bariatric surgeries, with complication, readmission, and reoperation rates at or below the established international benchmarks. These results reinforce the value of structured outcome monitoring and continuous quality improvement in centres of excellence. Benchmarking not only allows for internal performance evaluation but also serves as an essential tool for quality assurance in metabolic and bariatric surgery, promoting transparency, safety, and efficiency across the global bariatric community.
Faria-Teixeira et al. (Thu,) reported a other. In a high-volume centre, complication rates for primary metabolic and bariatric surgery were 9.2% and 0.7% for readmission, consistently meeting or exceeding international benchmarks.