Kee Yuan Ngiam1, Valerie Yu Hui Khoo2, Lucy Kong3, Anton Kui Sing Cheng3. 1. Division of Surgery, University Surgical Cluster, National University Hospital Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 8, 119228, Singapore City, Singapore. kee_yuan_ngiam@nuhs.edu.sg. 2. Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore City, Singapore. 3. Department of Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore City, Singapore.
Abstract
BACKGROUND: Bariatric surgery is increasingly being carried out and revisional procedures have also risen in concert. A review of the complications and revisions might elucidate technical and patient factors that influence the outcomes of bariatric surgeries in Asian patients. The objective of this study is to review the safety and efficacy of revisional bariatric surgery in a single center in Singapore over a 10-year period. METHODS: The setting of this study is a single public hospital with a multidisciplinary bariatric service including a weight management center, specialized endocrinology services, and bariatric surgical team. Participants were selected for surgery based on body mass index (BMI) and comorbidities. All patients underwent primary laparoscopic adjustable gastric banding (LAGB). Patients were then analyzed according to the types of revisional surgeries. The primary outcome was the type of complications and revisional surgeries. Secondary outcomes include short-term excess weight loss and further complications. RESULTS: A total of 365 patients were analyzed. 9.6% had a secondary procedure. In particular, two groups of complications required revisional surgery: failure of sustained weight loss and complications related to the LAGB insertion and use. Revisional surgeries had equivalent major complication rates (5.7%) compared to primary bariatric surgeries (6.8%). Revisional surgeries such as revisional LAGB (4.9 ± 9.8 kg), laparoscopic sleeve gastrectomy (LSG; 6.9 ± 21.0 kg), Roux-en-Y gastric bypass (RYGB; 4.6 ± 13.0 kg), and bilio-pancreatic diversion (BPD; 3.5 ± 6.3 kg) had modest weight loss compared to primary weight loss (12.7 ± 9.5 kg). Primary LAGB had a greater percentage excess weight loss in the first and second years post-surgery compared to revisional surgeries. There was one mortality post-primary surgery and no post-revisional surgical mortalities. CONCLUSIONS: Revisional bariatric surgery for complications related to the primary surgery is safe but had reduced excess weight loss compared to the initial surgery.
BACKGROUND: Bariatric surgery is increasingly being carried out and revisional procedures have also risen in concert. A review of the complications and revisions might elucidate technical and patient factors that influence the outcomes of bariatric surgeries in Asian patients. The objective of this study is to review the safety and efficacy of revisional bariatric surgery in a single center in Singapore over a 10-year period. METHODS: The setting of this study is a single public hospital with a multidisciplinary bariatric service including a weight management center, specialized endocrinology services, and bariatric surgical team. Participants were selected for surgery based on body mass index (BMI) and comorbidities. All patients underwent primary laparoscopic adjustable gastric banding (LAGB). Patients were then analyzed according to the types of revisional surgeries. The primary outcome was the type of complications and revisional surgeries. Secondary outcomes include short-term excess weight loss and further complications. RESULTS: A total of 365 patients were analyzed. 9.6% had a secondary procedure. In particular, two groups of complications required revisional surgery: failure of sustained weight loss and complications related to the LAGB insertion and use. Revisional surgeries had equivalent major complication rates (5.7%) compared to primary bariatric surgeries (6.8%). Revisional surgeries such as revisional LAGB (4.9 ± 9.8 kg), laparoscopic sleeve gastrectomy (LSG; 6.9 ± 21.0 kg), Roux-en-Y gastric bypass (RYGB; 4.6 ± 13.0 kg), and bilio-pancreatic diversion (BPD; 3.5 ± 6.3 kg) had modest weight loss compared to primary weight loss (12.7 ± 9.5 kg). Primary LAGB had a greater percentage excess weight loss in the first and second years post-surgery compared to revisional surgeries. There was one mortality post-primary surgery and no post-revisional surgical mortalities. CONCLUSIONS: Revisional bariatric surgery for complications related to the primary surgery is safe but had reduced excess weight loss compared to the initial surgery.
Authors: Tarja Martikainen; Elina Pirinen; Esko Alhava; Eero Poikolainen; Matti Pääkkönen; Matti Uusitupa; Helena Gylling Journal: Obes Surg Date: 2004-05 Impact factor: 4.129
Authors: Davide Lomanto; Wei-Jei Lee; Rajat Goel; Jeannette Jen-Mai Lee; Asim Shabbir; Jimmy B Y So; Chih-Kun Huang; Pradeep Chowbey; Muffazal Lakdawala; Barlian Sutedja; Simon K H Wong; Seigo Kitano; Kin-Fah Chin; Chin Kin Fah; Hildegardes C Dineros; Andrew Wong; Anton Cheng; Shanker Pasupathy; Sang Kuon Lee; Paisal Pongchairerks; Tran Binh Giang Journal: Obes Surg Date: 2012-03 Impact factor: 4.129
Authors: N Scopinaro; G F Adami; G M Marinari; E Gianetta; E Traverso; D Friedman; G Camerini; G Baschieri; A Simonelli Journal: World J Surg Date: 1998-09 Impact factor: 3.352