Association between operative position and postoperative nausea and vomiting in patients undergoing laparoscopic sleeve gastrectomy

doi:10.4240/wjgs.v16.i7.2088

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Jul 27, 2024; 16(7): 2088-2095
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2088

Association between operative position and postoperative nausea and vomiting in patients undergoing laparoscopic sleeve gastrectomy

Zhao-Peng Li, Yan-Cheng Song, Ya-Li Li, Dong Guo, Dong Chen, Yu Li

Zhao-Peng Li, Yan-Cheng Song, Dong Guo, Dong Chen, Yu Li, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266033, Shandong Province, China

Ya-Li Li, Department of Operation Room, The Affiliated Hospital of Qingdao University, Qingdao 266033, Shandong Province, China

Author contributions: Chen D and Li Y conceived the review; Li ZP conducted the literature search and drafted the manuscript; YL Li, Guo D, and Chen D collected the related article; Song YC and Li Y revised the manuscript; and all authors have read and approved the article.

Institutional review board statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Affiliated Hospital of Qingdao University (Ethical Approval Number: QYFY WZLL27397).

Informed consent statement: Informed consent was obtained from all individual participants included in the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Corresponding author: Yu Li, Doctor, Surgeon, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266033, Shandong Province, China. liyu11920@hotmail.com

Received: March 2, 2024
Revised: May 18, 2024
Accepted: June 18, 2024
Published online: July 27, 2024
Processing time: 141 Days and 21.7 Hours

Abstract

BACKGROUND

Bariatric surgery is one of the most effective ways to treat morbid obesity, and postoperative nausea and vomiting (PONV) is one of the common complications after bariatric surgery. At present, the mechanism of the high incidence of PONV after weight-loss surgery has not been clearly explained, and this study aims to investigate the effect of surgical position on PONV in patients undergoing bariatric surgery.

AIM

To explore the effect of the operative position during bariatric surgery on PONV.

METHODS

Data from obese patients, who underwent laparoscopic sleeve gastrectomy (LSG) in the authors’ hospital between June 2020 and February 2022 were divided into 2 groups and retrospectively analyzed. Multivariable logistic regression analysis and the t-test were used to study the influence of operative position on PONV.

RESULTS

There were 15 cases of PONV in the supine split-leg group (incidence rate, 50%) and 11 in the supine group (incidence rate, 36.7%) (P = 0.297). The mean operative duration in the supine split-leg group was 168.23 ± 46.24 minutes and 140.60 ± 32.256 minutes in the supine group (P < 0.05). Multivariate analysis revealed that operative position was not an independent risk factor for PONV (odds ratio = 1.192, 95% confidence interval: 0.376-3.778, P = 0.766).

CONCLUSION

Operative position during LSG may affect PONV; however, the difference in the incidence of PONV was not statistically significant. Operative position should be carefully considered for obese patients before surgery.

Keywords: Postoperative nausea and vomiting; Bariatric surgery; Laparoscopic sleeve gastrectomy; Operative positions; Obesity

Core Tip: Laparoscopic sleeve gastrectomy is associated with a high incidence of postoperative nausea and vomiting (PONV). The incidence of PONV was higher in those who underwent the procedure in the supine split-leg position vs those who were supine; however, the difference was not statistically significant. Operative position may affect operative duration, although it is not a risk factor for PONV.