Compliance with a multidisciplinary team meeting’s decision prior to bariatric surgery protects against major postoperative complications

Abstract Background Good surgical practice guidelines in France state that patients eligible for bariatric surgery must always be discussed at a multidisciplinary team (MDT) meeting. Objective Describe MDT meetings and assess their possible impact on the post-operative course. Setting University Hospital, France, public practice. Methods From April 2009 to March 2013, we included all patients reviewed in an MDT meeting prior to bariatric surgery. The primary endpoint was the case validation rate. The secondary endpoints were the number of MDT meetings, the number of submissions discussed or refused, outcomes in patients who underwent surgery in another centre after refusal or deferral in our MDT meeting. Results 49 MDT meetings were held representing 1,099 case files (816 patients) were discussed. 84.5% of the case files concerned first-line surgery, 14% concerned second-line surgery and 1.4% concerned third-line surgery. Overall, 776 (70.6%) of these submissions were approved, accounting for 95% of the patients. Further investigation prior to a decision was required in 13.3%. Surgery was definitively refused in 1% (n=11). For the 776 patients having undergone surgery, complication rate was 10.1%, major complication rate was 6% and reoperation rate was 3.2%. For the 11 patients for whom bariatric surgery was refused, 7 patients underwent surgery in another centre (without MDT meetings). There were 4 post-operative complications (57.1%; 3 major and 1 minor). Conclusion The MDT meeting’s decision is important for standardizing the management of obese patients prior to bariatric surgery. MDT meetings might help to reduce complication by optimizing patient selection and preoperative care.