LAUSR

Background The exact impact of smoking within the last 12 months on the safety outcome of sleeve gastrectomy and Roux-Y gastric bypass is not well known. The study aimed to assess the effects of smoking on 30-day surgical outcomes. Methods Preoperative characteristics and outcomes from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program dataset 2015–2018 were selected for all patients who underwent primary sleeve gastrectomy or Roux-Y gastric bypass. 30-day postoperative outcomes were assessed. We used propensity score matching to control for potential confounding. Results In laparoscopic sleeve gastrectomy group, 29 165 pairs were included in the analysis. Smoking increased risk for inpatients readmission rate (3.67% vs. 3.10%; RR, 1.18; 95%CI 1.08–1.29, p  < 0.001), intervention rate (1.03% vs. 0.84%; RR, 1.22; 95%CI 1.00–1.24, p  = 0.020), reoperation rate (0.99% vs. 0.79%; RR, 1.25; 95%CI 1.05–1.48, p  = 0.010), and leak rate (0.59% vs. 0.32%; RR, 1.83; 95%CI 1.43–2.37, p  < 0.001). In laparoscopic Roux-Y gastric bypass cohort,11 895 pairs were included in the ultimate analysis. Smoking increased risk for inpatients readmission rate (7.54% vs. 5.88%; RR, 1.28; 95%CI 1.16–1.41, p  < 0.001), intervention rate (3.53% vs. 2.30%; RR, 1.54; 95%CI 1.32–1.80, p  < 001), reoperation rate (3.17% vs. 1.86%; RR, 1.70; 95%CI 1.45–2.00, p  < 0.001), leak rate (1.05% vs. 0.59%; RR, 1.78; 95%CI 1.33–2.39, p  < 0.001), bleed rate (2.03% vs. 1.45%; RR, 1.39; 95%CI 1.15–1.69, p  < 0.001), and morbidity (4.20% vs. 3.38%; RR, 1.24; 95%CI 1.09–1.41, p  = 0.001). Conclusion Smoking cigarettes at any point within the 12 months before admission for surgery increased the risk for surgical short-term complications in bariatric patients. The effect was the most significant regarding leaks.