{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:00:16Z","timestamp":1754154016175,"version":"3.41.2"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Postoperative hemorrhage (POH) is a life-threatening complication, occurring in 1.3\u20131.7% of bariatric surgeries and still constitutes a recognized challenge. This study examined the effect of intraoperative mean arterial pressure (MAP) on the development of POH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective observational study with a case\u2013control design was conducted on adult patients who underwent bariatric surgery between 2015 and 2023 at a high-volume academic center. Intraoperative MAP (including MAP in the last 10 and 30\u00a0min) was collected in patients who developed POH. Cases were matched with controls by sex, gender, type of procedure, and ASA classification.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>From 204 participants, 102 patients with POH were matched with 102 controls. The most common procedure performed was Roux-en-Y gastric bypass (<jats:italic>n<\/jats:italic>\u2009=\u200998, 48%), followed by sleeve gastrectomy (<jats:italic>n<\/jats:italic>\u2009=\u200977, 37.7%). Patients with POH had statistically significant lower intraoperative MAP during the last 10\u00a0min (92.41\u2009\u00b1\u200914.25 vs 97.44\u2009\u00b1\u200914.64, <jats:italic>p<\/jats:italic>\u2009=\u20090.014) and 30\u00a0min (87.93\u2009\u00b1\u200912.32 vs 91.93\u2009\u00b1\u200911.26, p\u2009=\u20090.016) of surgery compared to controls. An intraoperative MAP lower than 90\u00a0mmHg in the last 10\u00a0min (OR\u2009=\u20092.067, 95% CI\u2009=\u20091.156\u20133.695), 30\u00a0min (OR\u2009=\u20092.231, 95% CI\u2009=\u20091.27\u20133.919), and whole procedure (OR\u2009=\u20091.834, 95% CI\u2009=\u20091.024\u20133.285) was associated with increased risk of POH. No significant differences were found in comorbidities, smoking, preoperative laboratory results, history of antiplatelet therapy or anticoagulation use, and operative time between the two groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our study demonstrates that patients with POH had lower intraoperative MAP during the last 10 and 30\u00a0min of surgery. An intraoperative MAP\u2009&lt;\u200990\u00a0mmHg was identified as a risk factor for developing POH.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11841-y","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T11:56:52Z","timestamp":1750075012000},"page":"4815-4821","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of reduced intraoperative mean arterial pressure on postoperative hemorrhage in bariatric surgery"],"prefix":"10.1007","volume":"39","author":[{"given":"Arturo","family":"Estrada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeisson","family":"Rivero-Moreno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasson","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Zamata-Ovalle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Velez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Humberto","family":"Rodriguez-Quintero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Moran-Atkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4917-7099","authenticated-orcid":false,"given":"Diego","family":"Camacho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"11841_CR1","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.2337\/dc18-S007","volume":"41","author":"American Diabetes Association","year":"2018","unstructured":"American Diabetes Association (2018) 7. 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No funding or external support was received for this work. Dr. Arturo Estrada, Yeisson Rivero-Moreno, Jasson Xia, Diego Ovalle, Karen Velez, Jorge Humberto Rodriquez-Quintero, Jenny Choi, Erin Moran-Atkin, and Diego Camacho have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}