Abstract | BACKGROUND: Patients having previous bariatric surgery are at risk for weight regain and return of co-morbidities. If an anatomic basis for the failure is identified, many surgeons advocate revision or conversion to a Roux-en-Y gastric bypass. The aim of this study was to determine whether revisional bariatric surgery leads to sufficient weight loss and co-morbidity remission. PATIENTS AND METHODS: From 2005-2012, patients undergoing revision were entered into a prospectively maintained database. Perioperative outcomes, including complications, weight loss, and co-morbidity remission, were examined for all patients with a history of a previous vertical banded gastroplasty (VBG) or Roux-en-Y gastric bypass (RYGB). RESULTS: Twenty-two patients with a history of RYGB and 56 with a history of VBG were identified. Following the revisional procedure, the RYGB group experienced 35.8% excess weight loss (%EWL) and a 31.8% morbidity rate. For the VBG group, patients experienced a 46.2% %EWL from their weight before the revisional operation with a 51.8% morbidity rate. Co-morbidity remission rate was excellent. Diabetes (VBG:100%, RYGB: 85.7%), gastroesophageal reflux disease (VBG: 94.4%, RYGB: 80%), and hypertension (VBG: 74.2%, RYGB:60%) demonstrated significant improvement. CONCLUSION: Revision of a failed RYGB or conversion of a VBG to a RYGB provides less weight loss and a higher complication rate than primary RYGB but provides an excellent opportunity for co-morbidity remission.
|
Authors | Daniel McKenna, Don Selzer, Michael Burchett, Jennifer Choi, Samer G Mattar |
Journal | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
(Surg Obes Relat Dis)
2014 Jul-Aug
Vol. 10
Issue 4
Pg. 654-9
ISSN: 1878-7533 [Electronic] United States |
PMID | 24708909
(Publication Type: Journal Article)
|
Copyright | Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Body Mass Index
- Female
- Gastric Bypass
(adverse effects)
- Gastroesophageal Reflux
(etiology, prevention & control)
- Gastroplasty
(adverse effects)
- Humans
- Hypertension
(etiology, prevention & control)
- Male
- Middle Aged
- Obesity, Morbid
(complications, surgery)
- Reoperation
- Retrospective Studies
- Sleep Apnea, Obstructive
(etiology, prevention & control)
- Treatment Outcome
- Weight Loss
|