Abstract

Background

The decriminalization of marijuana and legalization of derived products requires investigation of their effect on healthcare-related outcomes. Unfortunately, little data are available on the impact of marijuana use on surgical outcomes. We aimed to determine the effect of marijuana use on 30-day complications and 1-year weight loss following laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG).

Methods

At a large academic center, 1176 consecutive patients undergoing primary bariatric surgery from 2012 to 2017 were identified and separated into cohorts according to marijuana use. The only exclusions were 19 patients lost to follow-up. Propensity score matching, using logistic regression according to preoperative age, gender, BMI, and comorbid conditions, yielded 73 patient pairs for the control and study arms. All patients were followed two years postoperatively.

Results

Excess BMI lost did not differ between marijuana users and controls at 3 weeks (23.0% vs 18.9%, p = 0.095), 3 months (42.0% vs 38.1%, p = 0.416), 6 months (60.6% vs 63.1%, p = 0.631), 1 year (78.2% vs 77.3%, p = 0.789), or 2 years (89.1% vs 74.5%, p = 0.604). No differences in the rate of major 30-day postoperative complications, including readmission, infection, thromboembolic events, bleeding events and reoperation rates, were found between groups. Follow-up rate at two years was lower in marijuana users (12.3% vs 27.4%, p = 0.023).

Conclusion

This study suggests marijuana use has no impact on 30-day complications or weight loss following bariatric surgery, and should not be a contraindication to bariatric surgery.

中文翻译：

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大麻的使用不会影响减肥手术的效果

摘要

背景

大麻的非刑事化和衍生产品的合法化需要调查其对医疗相关结果的影响。不幸的是，关于大麻对手术结果影响的数据很少。我们旨在确定使用大麻对腹腔镜Roux-en-Y胃搭桥术（LRYGB）和腹腔镜袖胃切除术（LSG）后30天并发症和1年体重减轻的影响。

方法

在一个大型学术中心，从2012年至2017年，连续鉴定了1176例接受了减肥手术的患者，并根据大麻的使用将其分为多个队列。唯一的排除是19例失访的患者。根据术前年龄，性别，BMI和合并症情况，采用logistic回归进行倾向得分匹配，得出了用于对照和研究组的73对患者。术后两年均随访。

结果

大麻使用者和对照组在3周（23.0％对18.9％，p  = 0.095），3个月（42.0％对38.1％，p  = 0.416），6个月（60.6％对63.1％，p）之间的过量BMI损失没有差异。 = 0.631），1年（78.2％vs 77.3％，p  = 0.789）或2年（89.1％vs 74.5％，p  = 0.604）。两组之间在术后30天的主要并发症发生率上没有差异，包括再次入院，感染，血栓栓塞事件，出血事件和再次手术率。大麻使用者两年的随访率较低（12.3％对27.4％，p  = 0.023）。

结论

这项研究表明，使用大麻对减肥手术后的30天并发症或体重减轻没有影响，并且不应成为减肥手术的禁忌症。