Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP
Introduction Bariatric surgery is an evidence-based approach for sustained weight loss in patients with severe obesity. The most common procedures in North America are the laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). The Edmonton Obesity Staging System (EO...
Gespeichert in:
| Veröffentlicht in: | Surgical endoscopy 2021-12, Vol.35 (12), p.7163-7173 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 7173 |
|---|---|
| container_issue | 12 |
| container_start_page | 7163 |
| container_title | Surgical endoscopy |
| container_volume | 35 |
| creator | Skulsky, Samuel L. Dang, Jerry T. Switzer, Noah J. Sharma, Arya M. Karmali, Shahzeer Birch, Daniel W. |
| description | Introduction
Bariatric surgery is an evidence-based approach for sustained weight loss in patients with severe obesity. The most common procedures in North America are the laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). The Edmonton Obesity Staging System (EOSS) is a tool that assigns patients a score of 0 to 4 according to their obesity-related comorbidities and functional status. Previous research demonstrates that increasing EOSS score is associated with overall non-operative mortality risk.
Objective
We sought to assess the association of the EOSS with major 30-day postoperative complications following LSG or LRYGB.
Methods
Primary LSG or LRYGB patients were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Patients were assigned EOSS scores according to their comorbidities and functional limitations extracted from the database. Multivariable logistic regression analysis was conducted to evaluate the relationship between EOSS score, age, sex, BMI, type of procedure, or operative time with 30-day major complications.
Results
From 2015 to 2017, 430,238 patients (79.4% female) who underwent primary LSG or LRYGB were identified. The relative frequencies of patients by EOSS score were: 0 and 1 (23.9%), 2 (62.8%), 3 (10.5%), and 4 (2.9%). Mean preoperative BMI was 45.4 (SD 7.9) kg/m
2
and mean age was 44.6 (SD 12.0) years. The overall 30-day major complication rate was 3.5%. EOSS 2, 3, and 4 were significantly associated with major complications. The strongest associations with major complications were EOSS 4 (OR 2.30; 95% CI 2.11–2.51,
p
|
| doi_str_mv | 10.1007/s00464-020-08138-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2458039062</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2458039062</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-7066c3efd12e9498288a9e4dac23e9d54c2f0a2138240490dc3b043f2629218c3</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS0EokvhD3BAlrhwCUxsZ5NwK1WhlYoKWjhHXmey6yqJg8ehys_iHzLLFpA4IFm2LH_znvWeEM9zeJ0DlG8IwKxNBgoyqHJdZeUDscqNVplSefVQrKDWkKmyNifiCdEtMF_nxWNxonVeFFCalfhx6Xd7jPKiHcKYwihvtkg-LXKT7M6PO7lZKOEgyYWIJG1E6ccWJ-RtTP0iLVFw3iZs5Z1PezkFSmHCaJP_jtKFYeq940sYeXps5RBisv3BoQt9H-4OHlsbWSF6J2mOO4zLW0Z52X4hTzJ0Mu1Rfny3Oft89empeNTZnvDZ_Xkqvr6_-HJ-mV3ffLg6P7vOnC6LlJWwXjuNXZsrrE1dqaqyNZrWOqWxbgvjVAdWcWzKcCzQOr0Fozu1VjWn5_SpeHXUnWL4NiOlZvDksO_tiGGmRpmiAl3DWjH68h_0NsyRv89UwdZ1WUHFlDpSLgaiiF0zRT_YuDQ5NIdCm2OhDRfa_Cq0KXnoxb30vB2w_TPyu0EG9BEgfho5vL_e_5H9Ca-orow</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2598297808</pqid></control><display><type>article</type><title>Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Skulsky, Samuel L. ; Dang, Jerry T. ; Switzer, Noah J. ; Sharma, Arya M. ; Karmali, Shahzeer ; Birch, Daniel W.</creator><creatorcontrib>Skulsky, Samuel L. ; Dang, Jerry T. ; Switzer, Noah J. ; Sharma, Arya M. ; Karmali, Shahzeer ; Birch, Daniel W.</creatorcontrib><description>Introduction
Bariatric surgery is an evidence-based approach for sustained weight loss in patients with severe obesity. The most common procedures in North America are the laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). The Edmonton Obesity Staging System (EOSS) is a tool that assigns patients a score of 0 to 4 according to their obesity-related comorbidities and functional status. Previous research demonstrates that increasing EOSS score is associated with overall non-operative mortality risk.
Objective
We sought to assess the association of the EOSS with major 30-day postoperative complications following LSG or LRYGB.
Methods
Primary LSG or LRYGB patients were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Patients were assigned EOSS scores according to their comorbidities and functional limitations extracted from the database. Multivariable logistic regression analysis was conducted to evaluate the relationship between EOSS score, age, sex, BMI, type of procedure, or operative time with 30-day major complications.
Results
From 2015 to 2017, 430,238 patients (79.4% female) who underwent primary LSG or LRYGB were identified. The relative frequencies of patients by EOSS score were: 0 and 1 (23.9%), 2 (62.8%), 3 (10.5%), and 4 (2.9%). Mean preoperative BMI was 45.4 (SD 7.9) kg/m
2
and mean age was 44.6 (SD 12.0) years. The overall 30-day major complication rate was 3.5%. EOSS 2, 3, and 4 were significantly associated with major complications. The strongest associations with major complications were EOSS 4 (OR 2.30; 95% CI 2.11–2.51,
p
< 0.001) and LRYGB versus LSG (OR 2.03; 95% CI 1.97–2.11,
p
< 0.001). EOSS 3 and 4 were most strongly associated with death.
Conclusion
Higher EOSS scores are independently associated with 30-day major postoperative complications and mortality. The EOSS provides utility in staging patients and identifying those at greater risk of postoperative complications.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-020-08138-7</identifier><identifier>PMID: 33155074</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>2020 SAGES Oral ; Abdominal Surgery ; Adult ; Bariatric Surgery - adverse effects ; Female ; Gastrectomy - adverse effects ; Gastric Bypass ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Male ; Medicine ; Medicine & Public Health ; Mortality ; Obesity ; Obesity, Morbid - surgery ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Postoperative period ; Proctology ; Surgery ; Treatment Outcome ; Weight control</subject><ispartof>Surgical endoscopy, 2021-12, Vol.35 (12), p.7163-7173</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>2020. Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-7066c3efd12e9498288a9e4dac23e9d54c2f0a2138240490dc3b043f2629218c3</citedby><cites>FETCH-LOGICAL-c375t-7066c3efd12e9498288a9e4dac23e9d54c2f0a2138240490dc3b043f2629218c3</cites><orcidid>0000-0002-6799-8632</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-020-08138-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-020-08138-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33155074$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Skulsky, Samuel L.</creatorcontrib><creatorcontrib>Dang, Jerry T.</creatorcontrib><creatorcontrib>Switzer, Noah J.</creatorcontrib><creatorcontrib>Sharma, Arya M.</creatorcontrib><creatorcontrib>Karmali, Shahzeer</creatorcontrib><creatorcontrib>Birch, Daniel W.</creatorcontrib><title>Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
Bariatric surgery is an evidence-based approach for sustained weight loss in patients with severe obesity. The most common procedures in North America are the laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). The Edmonton Obesity Staging System (EOSS) is a tool that assigns patients a score of 0 to 4 according to their obesity-related comorbidities and functional status. Previous research demonstrates that increasing EOSS score is associated with overall non-operative mortality risk.
Objective
We sought to assess the association of the EOSS with major 30-day postoperative complications following LSG or LRYGB.
Methods
Primary LSG or LRYGB patients were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Patients were assigned EOSS scores according to their comorbidities and functional limitations extracted from the database. Multivariable logistic regression analysis was conducted to evaluate the relationship between EOSS score, age, sex, BMI, type of procedure, or operative time with 30-day major complications.
Results
From 2015 to 2017, 430,238 patients (79.4% female) who underwent primary LSG or LRYGB were identified. The relative frequencies of patients by EOSS score were: 0 and 1 (23.9%), 2 (62.8%), 3 (10.5%), and 4 (2.9%). Mean preoperative BMI was 45.4 (SD 7.9) kg/m
2
and mean age was 44.6 (SD 12.0) years. The overall 30-day major complication rate was 3.5%. EOSS 2, 3, and 4 were significantly associated with major complications. The strongest associations with major complications were EOSS 4 (OR 2.30; 95% CI 2.11–2.51,
p
< 0.001) and LRYGB versus LSG (OR 2.03; 95% CI 1.97–2.11,
p
< 0.001). EOSS 3 and 4 were most strongly associated with death.
Conclusion
Higher EOSS scores are independently associated with 30-day major postoperative complications and mortality. The EOSS provides utility in staging patients and identifying those at greater risk of postoperative complications.</description><subject>2020 SAGES Oral</subject><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Bariatric Surgery - adverse effects</subject><subject>Female</subject><subject>Gastrectomy - adverse effects</subject><subject>Gastric Bypass</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Obesity, Morbid - surgery</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Postoperative period</subject><subject>Proctology</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Weight control</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUFv1DAQhS0EokvhD3BAlrhwCUxsZ5NwK1WhlYoKWjhHXmey6yqJg8ehys_iHzLLFpA4IFm2LH_znvWeEM9zeJ0DlG8IwKxNBgoyqHJdZeUDscqNVplSefVQrKDWkKmyNifiCdEtMF_nxWNxonVeFFCalfhx6Xd7jPKiHcKYwihvtkg-LXKT7M6PO7lZKOEgyYWIJG1E6ccWJ-RtTP0iLVFw3iZs5Z1PezkFSmHCaJP_jtKFYeq940sYeXps5RBisv3BoQt9H-4OHlsbWSF6J2mOO4zLW0Z52X4hTzJ0Mu1Rfny3Oft89empeNTZnvDZ_Xkqvr6_-HJ-mV3ffLg6P7vOnC6LlJWwXjuNXZsrrE1dqaqyNZrWOqWxbgvjVAdWcWzKcCzQOr0Fozu1VjWn5_SpeHXUnWL4NiOlZvDksO_tiGGmRpmiAl3DWjH68h_0NsyRv89UwdZ1WUHFlDpSLgaiiF0zRT_YuDQ5NIdCm2OhDRfa_Cq0KXnoxb30vB2w_TPyu0EG9BEgfho5vL_e_5H9Ca-orow</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Skulsky, Samuel L.</creator><creator>Dang, Jerry T.</creator><creator>Switzer, Noah J.</creator><creator>Sharma, Arya M.</creator><creator>Karmali, Shahzeer</creator><creator>Birch, Daniel W.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6799-8632</orcidid></search><sort><creationdate>20211201</creationdate><title>Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP</title><author>Skulsky, Samuel L. ; Dang, Jerry T. ; Switzer, Noah J. ; Sharma, Arya M. ; Karmali, Shahzeer ; Birch, Daniel W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-7066c3efd12e9498288a9e4dac23e9d54c2f0a2138240490dc3b043f2629218c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>2020 SAGES Oral</topic><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Bariatric Surgery - adverse effects</topic><topic>Female</topic><topic>Gastrectomy - adverse effects</topic><topic>Gastric Bypass</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Obesity</topic><topic>Obesity, Morbid - surgery</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Postoperative period</topic><topic>Proctology</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Skulsky, Samuel L.</creatorcontrib><creatorcontrib>Dang, Jerry T.</creatorcontrib><creatorcontrib>Switzer, Noah J.</creatorcontrib><creatorcontrib>Sharma, Arya M.</creatorcontrib><creatorcontrib>Karmali, Shahzeer</creatorcontrib><creatorcontrib>Birch, Daniel W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Skulsky, Samuel L.</au><au>Dang, Jerry T.</au><au>Switzer, Noah J.</au><au>Sharma, Arya M.</au><au>Karmali, Shahzeer</au><au>Birch, Daniel W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>35</volume><issue>12</issue><spage>7163</spage><epage>7173</epage><pages>7163-7173</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Introduction
Bariatric surgery is an evidence-based approach for sustained weight loss in patients with severe obesity. The most common procedures in North America are the laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). The Edmonton Obesity Staging System (EOSS) is a tool that assigns patients a score of 0 to 4 according to their obesity-related comorbidities and functional status. Previous research demonstrates that increasing EOSS score is associated with overall non-operative mortality risk.
Objective
We sought to assess the association of the EOSS with major 30-day postoperative complications following LSG or LRYGB.
Methods
Primary LSG or LRYGB patients were identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Patients were assigned EOSS scores according to their comorbidities and functional limitations extracted from the database. Multivariable logistic regression analysis was conducted to evaluate the relationship between EOSS score, age, sex, BMI, type of procedure, or operative time with 30-day major complications.
Results
From 2015 to 2017, 430,238 patients (79.4% female) who underwent primary LSG or LRYGB were identified. The relative frequencies of patients by EOSS score were: 0 and 1 (23.9%), 2 (62.8%), 3 (10.5%), and 4 (2.9%). Mean preoperative BMI was 45.4 (SD 7.9) kg/m
2
and mean age was 44.6 (SD 12.0) years. The overall 30-day major complication rate was 3.5%. EOSS 2, 3, and 4 were significantly associated with major complications. The strongest associations with major complications were EOSS 4 (OR 2.30; 95% CI 2.11–2.51,
p
< 0.001) and LRYGB versus LSG (OR 2.03; 95% CI 1.97–2.11,
p
< 0.001). EOSS 3 and 4 were most strongly associated with death.
Conclusion
Higher EOSS scores are independently associated with 30-day major postoperative complications and mortality. The EOSS provides utility in staging patients and identifying those at greater risk of postoperative complications.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33155074</pmid><doi>10.1007/s00464-020-08138-7</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6799-8632</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2021-12, Vol.35 (12), p.7163-7173 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2458039062 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | 2020 SAGES Oral Abdominal Surgery Adult Bariatric Surgery - adverse effects Female Gastrectomy - adverse effects Gastric Bypass Gastroenterology Gastrointestinal surgery Gynecology Hepatology Humans Laparoscopy Male Medicine Medicine & Public Health Mortality Obesity Obesity, Morbid - surgery Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - surgery Postoperative period Proctology Surgery Treatment Outcome Weight control |
| title | Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T20%3A49%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Higher%20Edmonton%20Obesity%20Staging%20System%20scores%20are%20independently%20associated%20with%20postoperative%20complications%20and%20mortality%20following%20bariatric%20surgery:%20an%20analysis%20of%20the%20MBSAQIP&rft.jtitle=Surgical%20endoscopy&rft.au=Skulsky,%20Samuel%20L.&rft.date=2021-12-01&rft.volume=35&rft.issue=12&rft.spage=7163&rft.epage=7173&rft.pages=7163-7173&rft.issn=0930-2794&rft.eissn=1432-2218&rft_id=info:doi/10.1007/s00464-020-08138-7&rft_dat=%3Cproquest_cross%3E2458039062%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2598297808&rft_id=info:pmid/33155074&rfr_iscdi=true |