Stacy A Brethauer1, Shanu Kothari2, Ranjan Sudan3, Brandon Williams4, Wayne J English5, Matthew Brengman6, Marina Kurian7, Matthew Hutter8, Lloyd Stegemann9, Kara Kallies2, Ninh T Nguyen10, Jaime Ponce11, John M Morton12. 1. Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: brethas@ccf.org. 2. Department of Surgery, Gunderson Health System, La Crosse, Wisconsin. 3. Department of Surgery, Duke University Medical Center, Durham, North Carolina. 4. Vanderbilt Center for Surgical Weight Loss, Nashville, Tennessee. 5. Department of Surgery, Marquette General Hospital, Marquette, Michigan. 6. Advanced Surgical Partners of Virginia, Richmond, Virginia. 7. Department of Surgery, New York University Bariatric Surgery Associates, New York, New York. 8. Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts. 9. Better Weigh Center, Corpus Christi, Texas. 10. Department of Surgery, University of California Irvine Medical Center, Orange, California. 11. Dalton Surgical Group, Dalton, Georgia. 12. Department of Surgery, Stanford University, Palo Alto, California.
Abstract
BACKGROUND: Reoperative bariatric surgery has become a common practice in many bariatric surgery programs. There is currently little evidence-based guidance regarding specific indications and outcomes for reoperative bariatric surgery. A task force was convened to review the current evidence regarding reoperative bariatric surgery. The aim of the review was to identify procedure-specific indications and outcomes for reoperative procedures. METHODS: Literature search was conducted to identify studies reporting indications for and outcomes after reoperative bariatric surgery. Specifically, operations to treat complications, failed weight loss, and weight regain were evaluated. Abstract and manuscript reviews were completed by the task force members to identify, grade, and categorize relevant studies. RESULTS: A total of 819 articles were identified in the initial search. After review for inclusion criteria and data quality, 175 articles were included in the systematic review and analysis. The majority of published studies are single center retrospective reviews. The evidence supporting reoperative surgery for acute and chronic complications is described. The evidence regarding reoperative surgery for failed weight loss and weight regain generally demonstrates improved weight loss and co-morbidity reduction after reintervention. Procedure-specific outcomes are described. Complication rates are generally reported to be higher after reoperative surgery compared to primary surgery. CONCLUSION: The indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, co-morbid disease, and complications.
BACKGROUND: Reoperative bariatric surgery has become a common practice in many bariatric surgery programs. There is currently little evidence-based guidance regarding specific indications and outcomes for reoperative bariatric surgery. A task force was convened to review the current evidence regarding reoperative bariatric surgery. The aim of the review was to identify procedure-specific indications and outcomes for reoperative procedures. METHODS: Literature search was conducted to identify studies reporting indications for and outcomes after reoperative bariatric surgery. Specifically, operations to treat complications, failed weight loss, and weight regain were evaluated. Abstract and manuscript reviews were completed by the task force members to identify, grade, and categorize relevant studies. RESULTS: A total of 819 articles were identified in the initial search. After review for inclusion criteria and data quality, 175 articles were included in the systematic review and analysis. The majority of published studies are single center retrospective reviews. The evidence supporting reoperative surgery for acute and chronic complications is described. The evidence regarding reoperative surgery for failed weight loss and weight regain generally demonstrates improved weight loss and co-morbidity reduction after reintervention. Procedure-specific outcomes are described. Complication rates are generally reported to be higher after reoperative surgery compared to primary surgery. CONCLUSION: The indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, co-morbid disease, and complications.
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