Midterm results of revisional bariatric surgery postsleeve gastrectomy: resleeve versus bypass |
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| Institution: | 1. Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait;2. Department of Surgery, Al Amiri Hospital, Kuwait City, Kuwait;1. Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait;2. Thunayan Al-Ghanim Gastroenterology Center, Al-Amiri Hospital, Kuwait City, Kuwait;3. Department of Surgery, Faculty of Medicine, Kuwait University, Safat, Kuwait;4. Department of Surgery, Al-Amiri Hospital, Kuwait City, Kuwait;1. Department of General Surgery, Assuta Ashdod Public Hospital, Ashdod, Israel (Affiliated to the Faculty of Health and Science, Ben-Gurion University, Beer-Sheba, Israel);2. Department of General and Oncological Surgery-Surgery C, Chaim Sheba Medical Center, Tel-Hashomer, Israel (Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel);3. St George & Sutherland Clinical School, University of New South Wales, Sydney, Australia;1. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;2. Division of Pediatric Endocrinology, Mass General Hospital for Children and Harvard Medical School, Boston, Massachusetts;3. MGH Weight Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;4. Department of Surgery, Boston Medical Center, Boston, Massachusetts;5. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;1. Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia;2. Department of Counseling Psychology, West Virginia University, Morgantown, West Virginia;3. Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia |
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| Abstract: | BackgroundBariatric surgery has been shown to produce the most predictable weight loss results, with laparoscopic sleeve gastrectomy (SG) being the most performed procedure as of 2014. However, inadequate weight loss may present the need for a revisional procedure.ObjectivesThe aim of this study is to compare the efficacy of laparoscopic resleeve gastrectomy (LRSG) and laparoscopic Roux-en-Y gastric bypass in attaining successful weight loss.SettingPublic hospital following SG.MethodsA retrospective analysis was performed on all patients who underwent SG from 2008–2019. A list was obtained of those who underwent revisional bariatric surgery after initial SG, and their demographic characteristics were analyzed.ResultsA total of 2858 patients underwent SG, of whom 84 patients (3%) underwent either a revisional laparoscopic Roux-en-Y gastric bypass (rLRYGB) or LRSG. A total of 82% of the patients were female. The mean weight and body mass index (BMI) before SG for the LRSG and rLRYGB patients were 136.7 kg and 49.9 kg/m2 and 133.9 kg and 50.5 kg/m2, respectively. The mean BMI showed a drop from 42.0 to 31.7 (P < .001) 1 year post revisional surgery for the LRSG group and 42.7 to 34.5 (P < .001) for the rLRYGB group, correlating to an excess weight loss (EWL) of 61.7% and 48.1%, respectively. At 5 years post revisional surgery, LRSG patients showed an increase in BMI to 33.8 (EWL = 45.3%), while those who underwent rLRYGB showed a decrease to 34.3 (EWL = 49.2%). Completeness of follow-up at 1, 3, and 5 years for rLRYGB and LRSG were 67%, 35%, and 24% and 45%, 21%, and 18%, respectively.ConclusionsRevisional bariatric surgery is a safe and effective method for the management of failed primary SG. LRSG patients tended to do better earlier on; however, it leveled off with those who underwent rLRYGB by 5 years. |
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| Keywords: | Bariatric surgery Sleeve gastrectomy Resleeve Bypass |
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