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Revisional bariatric surgery is more effective for improving obesity-related co-morbidities than it is for reinducing major weight loss.

AbstractBACKGROUND:
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.
AuthorsDaniel McKenna, Don Selzer, Michael Burchett, Jennifer Choi, Samer G Mattar
JournalSurgery 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
PMID24708909 (Publication Type: Journal Article)
CopyrightCopyright © 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

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