Comparison of postoperative nausea and vomiting after laparoscopic sleeve gastrectomy and single anastomosis sleeve ileal bypass: a randomized control study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Xia ¹ , XIE Xiutao ¹ , YUAN Peiwen ¹ , WANG Jian ¹ , HONG Jian ² , LI Chao ² , ZHU Xiaocheng ² ,  YAO Libin ²

1. Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu 221004, P. R. China;
2. Department of Bariatric Metabolic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P. R. China;

Corresponding author：

YAO Libin, Email: yaolibin_123@126.com

Keywords：

postoperative nausea and vomiting; laparoscopic sleeve gastrectomy; single-anastomosis sleeve ileal bypass; Rhodes index

DOI：

10.7507/1007-9424.202402063

Video：

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Objective To compare the postoperative nausea and vomiting (PONV) after laparoscopic sleeve gastrectomy (LSG) and single-anastomosis sleeve ileal bypass (SASI), and to explore the risk factors for PONV. Method A total of 220 patients at the Affiliated Hospital of Xuzhou Medical University from June 2022 to December 2022 were prospectively collected, and were randomly divided into the LSG group and the SASI group; the general condition of the patients was recorded. PONV was assessed on the POD0, POD1, POD2, POD30, POD60, POD90, using the Rhodes index score.Results The total Rhodes index score in the LSG group was higher than that in the SASI group [(25.56±13.54) vs. (16.06±11.28), P＜0.05]. The results of multiple linear regression analysis showed that female (P=0.014), LSG (P＜0.001), young age (P=0.050), and low BMI (P=0.019) were risk factors for PONV. Conclusions Compared with LSG, the Rhodes index score after SASI is low. For young women with low BMI, special attention should be paid to the prevention and treatment of PONV after LSG.

Citation： SUN Xia, XIE Xiutao, YUAN Peiwen, WANG Jian, HONG Jian, LI Chao, ZHU Xiaocheng, YAO Libin. Comparison of postoperative nausea and vomiting after laparoscopic sleeve gastrectomy and single anastomosis sleeve ileal bypass: a randomized control study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(8): 945-951. doi: 10.7507/1007-9424.202402063 Copy

1.	郭沛, 刘朋朋, 侯栋升, 等. 腹腔镜袖状胃切除术治疗不同肥胖程度单纯性肥胖症的疗效分析. 中国普外基础与临床杂志, 2021, 28(2): 208-211.
2.	Ferraz-Bannitz R, Kashyap S, Patti ME. Bariatric surgery: It's not just incretins! J Clin Endocrinol Metab, 2022, 107(2): e883-e885.
3.	de Moura DTH, Barrichello S Jr, de Moura EGH, et al. Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy. Endoscopy, 2020, 52(3): 202-210.
4.	Uhe I, Douissard J, Podetta M, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials. Obesity (Silver Spring), 2022, 30(3): 614-627.
5.	Surve A, Cottam D, Richards C, et al. A matched cohort comparison of long-term outcomes of Roux-en-Y gastric bypass (RYGB) versus single-anastomosis Duodeno-ileostomy with sleeve gastrectomy (SADI-S). Obes Surg, 2021, 31(4): 1438-1448.
6.	Mahdy T, Al Wahedi A, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg, 2016, 34: 28-34.
7.	Mui WL, Lee DW, Lam KK. Laparoscopic sleeve gastrectomy with loop bipartition: a novel metabolic operation in treating obese type Ⅱ diabetes mellitus. Int J Surg Case Rep, 2014, 5(2): 56-58.
8.	Zheng XZ, Cheng B, Luo J, et al. The characteristics and risk factors of the postoperative nausea and vomiting in female patients undergoing laparoscopic sleeve gastrectomy and laparoscopic gynecological surgeries: a propensity score matching analysis. Eur Rev Med Pharmacol Sci, 2021, 25(1): 182-189.
9.	Halliday TA, Sundqvist J, Hultin M, et al. Post-operative nausea and vomiting in bariatric surgery patients: an observational study. Acta Anaesthesiol Scand, 2017, 61(5): 471-479.
10.	Tarnowski W, Barski K, Jaworski P, et al. Single anastomosis sleeve ileal bypass (SASI): a single-center initial report. Wideochir Inne Tech Maloinwazyjne, 2022, 17(2): 365-371.
11.	Mahdy T, Gado W, Alwahidi A, et al. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg, 2021, 31(4): 1579-1589.
12.	Kushner BS, Freeman D, Sparkman J, et al. Assessment of postoperative nausea and vomiting after bariatric surgery using a validated questionnaire. Surg Obes Relat Dis, 2020, 16(10): 1505-1513.
13.	Fathy M, Abdel-Razik MA, Elshobaky A, et al. Impact of pyloric injection of magnesium sulfate-lidocaine mixture on postoperative nausea and vomiting after laparoscopic sleeve gastrectomy: a randomized-controlled trial. Obes Surg, 2019, 29(5): 1614-1623.
14.	Mion F, Tolone S, Garros A, et al. High-resolution impedance manometry after sleeve gastrectomy: increased intragastric pressure and reflux are frequent events. Obesity surgery, 2016, 26(10): 2449-2456.
15.	Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg, 2012, 256(1): 104-110.
16.	Salama TMS, Sabry K, Ghamrini YE. Single anastomosis sleeve ileal bypass: new step in the evolution of bariatric surgeries. J Invest Surg, 2017, 30(5): 291-296.
17.	Apfel CC, Heidrich FM, Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth, 2012, 109(5): 742-753.
18.	Apfel CC, Greim CA, Haubitz I, et al. A risk score to predict the probability of postoperative vomiting in adults. Acta Anaesthesiol Scand, 1998, 42(5): 495-501.
19.	中国研究型医院学会糖尿病与肥胖外科专业委员会. 腹腔镜胃袖状切除术后恶心呕吐预防与处理中国专家共识 (2022版). 中华消化外科杂志, 2022, 21(11): 1395-1402.
20.	Song Y, Zhu J, Dong Z, et al. Incidence and risk factors of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy and its relationship with Helicobacter pylori: a propensity score matching analysis. Front Endocrinol (Lausanne), 2023, 14: 1102017. doi: 10.3389/fendo.2023.1102017.
21.	Kim JH, Hong M, Kim YJ, et al. Effect of body mass index on postoperative nausea and vomiting: propensity analysis. J Clin Med, 2020, 9(6): 1612. doi: 10.3390/jcm9061612.
22.	Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet, 2010, 49(2): 71-87.
23.	Blouin RA, Warren GW. Pharmacokinetic considerations in obesity. J Pharm Sci, 1999, 88(1): 1-7.
24.	Jain R, Chung SM, Jain L, et al. Implications of obesity for drug therapy: limitations and challenges. Clin Pharmacol Ther, 2011, 90(1): 77-89.
25.	Khalil BNM, Elderh MSH, Khaja MAR, et al. Perioperative use of ketamine infusionversus dexmedetomidine infusion for analgesia in obese patients undergoing bariatric surgery: a double-blinded three-armed randomized controlled trial. BMC Anesthesiol, 2023, 23(1): 108. doi: 10.1186/s12871-023-02059-3.

1. 郭沛, 刘朋朋, 侯栋升, 等. 腹腔镜袖状胃切除术治疗不同肥胖程度单纯性肥胖症的疗效分析. 中国普外基础与临床杂志, 2021, 28(2): 208-211.
2. Ferraz-Bannitz R, Kashyap S, Patti ME. Bariatric surgery: It's not just incretins! J Clin Endocrinol Metab, 2022, 107(2): e883-e885.
3. de Moura DTH, Barrichello S Jr, de Moura EGH, et al. Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy. Endoscopy, 2020, 52(3): 202-210.
4. Uhe I, Douissard J, Podetta M, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials. Obesity (Silver Spring), 2022, 30(3): 614-627.
5. Surve A, Cottam D, Richards C, et al. A matched cohort comparison of long-term outcomes of Roux-en-Y gastric bypass (RYGB) versus single-anastomosis Duodeno-ileostomy with sleeve gastrectomy (SADI-S). Obes Surg, 2021, 31(4): 1438-1448.
6. Mahdy T, Al Wahedi A, Schou C. Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: gastric bipartition, a novel metabolic surgery procedure: a retrospective cohort study. Int J Surg, 2016, 34: 28-34.
7. Mui WL, Lee DW, Lam KK. Laparoscopic sleeve gastrectomy with loop bipartition: a novel metabolic operation in treating obese type Ⅱ diabetes mellitus. Int J Surg Case Rep, 2014, 5(2): 56-58.
8. Zheng XZ, Cheng B, Luo J, et al. The characteristics and risk factors of the postoperative nausea and vomiting in female patients undergoing laparoscopic sleeve gastrectomy and laparoscopic gynecological surgeries: a propensity score matching analysis. Eur Rev Med Pharmacol Sci, 2021, 25(1): 182-189.
9. Halliday TA, Sundqvist J, Hultin M, et al. Post-operative nausea and vomiting in bariatric surgery patients: an observational study. Acta Anaesthesiol Scand, 2017, 61(5): 471-479.
10. Tarnowski W, Barski K, Jaworski P, et al. Single anastomosis sleeve ileal bypass (SASI): a single-center initial report. Wideochir Inne Tech Maloinwazyjne, 2022, 17(2): 365-371.
11. Mahdy T, Gado W, Alwahidi A, et al. Sleeve gastrectomy, one-anastomosis gastric bypass (OAGB), and single anastomosis sleeve ileal (SASI) bypass in treatment of morbid obesity: a retrospective cohort study. Obes Surg, 2021, 31(4): 1579-1589.
12. Kushner BS, Freeman D, Sparkman J, et al. Assessment of postoperative nausea and vomiting after bariatric surgery using a validated questionnaire. Surg Obes Relat Dis, 2020, 16(10): 1505-1513.
13. Fathy M, Abdel-Razik MA, Elshobaky A, et al. Impact of pyloric injection of magnesium sulfate-lidocaine mixture on postoperative nausea and vomiting after laparoscopic sleeve gastrectomy: a randomized-controlled trial. Obes Surg, 2019, 29(5): 1614-1623.
14. Mion F, Tolone S, Garros A, et al. High-resolution impedance manometry after sleeve gastrectomy: increased intragastric pressure and reflux are frequent events. Obesity surgery, 2016, 26(10): 2449-2456.
15. Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent intervention for metabolic syndrome and obesity. Ann Surg, 2012, 256(1): 104-110.
16. Salama TMS, Sabry K, Ghamrini YE. Single anastomosis sleeve ileal bypass: new step in the evolution of bariatric surgeries. J Invest Surg, 2017, 30(5): 291-296.
17. Apfel CC, Heidrich FM, Jukar-Rao S, et al. Evidence-based analysis of risk factors for postoperative nausea and vomiting. Br J Anaesth, 2012, 109(5): 742-753.
18. Apfel CC, Greim CA, Haubitz I, et al. A risk score to predict the probability of postoperative vomiting in adults. Acta Anaesthesiol Scand, 1998, 42(5): 495-501.
19. 中国研究型医院学会糖尿病与肥胖外科专业委员会. 腹腔镜胃袖状切除术后恶心呕吐预防与处理中国专家共识 (2022版). 中华消化外科杂志, 2022, 21(11): 1395-1402.
20. Song Y, Zhu J, Dong Z, et al. Incidence and risk factors of postoperative nausea and vomiting following laparoscopic sleeve gastrectomy and its relationship with Helicobacter pylori: a propensity score matching analysis. Front Endocrinol (Lausanne), 2023, 14: 1102017. doi: 10.3389/fendo.2023.1102017.
21. Kim JH, Hong M, Kim YJ, et al. Effect of body mass index on postoperative nausea and vomiting: propensity analysis. J Clin Med, 2020, 9(6): 1612. doi: 10.3390/jcm9061612.
22. Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet, 2010, 49(2): 71-87.
23. Blouin RA, Warren GW. Pharmacokinetic considerations in obesity. J Pharm Sci, 1999, 88(1): 1-7.
24. Jain R, Chung SM, Jain L, et al. Implications of obesity for drug therapy: limitations and challenges. Clin Pharmacol Ther, 2011, 90(1): 77-89.
25. Khalil BNM, Elderh MSH, Khaja MAR, et al. Perioperative use of ketamine infusionversus dexmedetomidine infusion for analgesia in obese patients undergoing bariatric surgery: a double-blinded three-armed randomized controlled trial. BMC Anesthesiol, 2023, 23(1): 108. doi: 10.1186/s12871-023-02059-3.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of postoperative nausea and vomiting after laparoscopic sleeve gastrectomy and single anastomosis sleeve ileal bypass: a randomized control study

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