Thomas Malinka1, Jens Zerkowski1, Itskovich Katharina1, Yves Michael Borbèly1, Philipp Nett1, Dino Kröll2. 1. Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 2. Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Dino.Kroell@insel.ch.
Abstract
BACKGROUND: While previous studies suggest laparoscopic Roux-en-Y gastric bypass (LRYGB) as a reasonable treatment approach to address weight loss failure after laparoscopic sleeve gastrectomy (LSG), data focusing on long-term outcomes are still lacking. The purpose of this study was to evaluate weight and comorbidity outcomes comparing revisional LRYGB (rLRYGB) with primary LRYGB (pLRYGB). METHODS: Retrospective single-centre case-matched analysis was conducted at a bariatric tertiary referral centre. Between January 2009 and July 2013, 239 patients were entered into a prospective database, and 32 patients undergoing rLRYGB (cases) were matched with 32 patients undergoing pLRYGB (controls) for sex, age and BMI. The end point was data at 3 years of follow-up. Thirty-one patients (12.9%) were lost to follow-up during the study period. RESULTS: There were no significant differences in patient demographics or median BMI (kg/m2) for pLRYGB or rLRYGB (42.8 ± 12.1 vs. 42.3 ± 11.5, respectively; p = 0.748). Coexisting comorbidities were rated similarly in both groups. At 3 years, the percentage of excess weight loss (74.4 ± 23.3 vs 52.0 ± 26, respectively; p = 0.007) was higher for pLRYGB than rLRYGB, while similar improvements of coexisting comorbidities could be observed. CONCLUSION: rLRYGB is a feasible and practical surgical approach that allows effective weight loss at 3 years of follow-up and alleviates refractory reflux symptoms. Although weight loss is lower compared to pLRYGB, resolution or improvement of coexisting comorbidities appears similar. Therefore, rLRYGB seems to be a reliable procedure to address failure after LSG.
BACKGROUND: While previous studies suggest laparoscopic Roux-en-Y gastric bypass (LRYGB) as a reasonable treatment approach to address weight loss failure after laparoscopic sleeve gastrectomy (LSG), data focusing on long-term outcomes are still lacking. The purpose of this study was to evaluate weight and comorbidity outcomes comparing revisional LRYGB (rLRYGB) with primary LRYGB (pLRYGB). METHODS: Retrospective single-centre case-matched analysis was conducted at a bariatric tertiary referral centre. Between January 2009 and July 2013, 239 patients were entered into a prospective database, and 32 patients undergoing rLRYGB (cases) were matched with 32 patients undergoing pLRYGB (controls) for sex, age and BMI. The end point was data at 3 years of follow-up. Thirty-one patients (12.9%) were lost to follow-up during the study period. RESULTS: There were no significant differences in patient demographics or median BMI (kg/m2) for pLRYGB or rLRYGB (42.8 ± 12.1 vs. 42.3 ± 11.5, respectively; p = 0.748). Coexisting comorbidities were rated similarly in both groups. At 3 years, the percentage of excess weight loss (74.4 ± 23.3 vs 52.0 ± 26, respectively; p = 0.007) was higher for pLRYGB than rLRYGB, while similar improvements of coexisting comorbidities could be observed. CONCLUSION: rLRYGB is a feasible and practical surgical approach that allows effective weight loss at 3 years of follow-up and alleviates refractory reflux symptoms. Although weight loss is lower compared to pLRYGB, resolution or improvement of coexisting comorbidities appears similar. Therefore, rLRYGB seems to be a reliable procedure to address failure after LSG.
Authors: Franz X Felberbauer; Felix Langer; Soheila Shakeri-Manesch; Elisabeth Schmaldienst; Mathias Kees; Stephan Kriwanek; Manfred Prager; Gerhard Prager Journal: Obes Surg Date: 2008-04-08 Impact factor: 4.129
Authors: Torgeir T Søvik; Erlend T Aasheim; Osama Taha; My Engström; Morten W Fagerland; Sofia Björkman; Jon Kristinsson; Kare I Birkeland; Tom Mala; Torsten Olbers Journal: Ann Intern Med Date: 2011-09-06 Impact factor: 25.391
Authors: Viktoria L Gloy; Matthias Briel; Deepak L Bhatt; Sangeeta R Kashyap; Philip R Schauer; Geltrude Mingrone; Heiner C Bucher; Alain J Nordmann Journal: BMJ Date: 2013-10-22
Authors: Chetan Parmar; Kamal K Mahawar; William R J Carr; Norbert Schroeder; Shlok Balupuri; Peter K Small Journal: Obes Surg Date: 2017-12 Impact factor: 4.129
Authors: Daniel M Felsenreich; Lukas M Ladinig; Philipp Beckerhinn; Christoph Sperker; Katrin Schwameis; Michael Krebs; Julia Jedamzik; Magdalena Eilenberg; Christoph Bichler; Gerhard Prager; Felix B Langer Journal: Obes Surg Date: 2018-11 Impact factor: 4.129
Authors: Michał Pędziwiatr; Piotr Małczak; Mateusz Wierdak; Mateusz Rubinkiewicz; Magdalena Pisarska; Piotr Major; Michał Wysocki; W Konrad Karcz; Andrzej Budzyński Journal: Obes Surg Date: 2018-07 Impact factor: 4.129