Marine Benois1, Lionel Sebastianelli1, Adeline Morisot2, Imed Ben Amor1, Jean Gugenheim1, Laurent Bailly2, Antonio Iannelli3,4,5,6. 1. Digestive Unit, Archet 2 Hospital, University Hospital of Nice, F-06202, Nice, France. 2. Department of Public Health, University Hospital of Nice, Nice, France. 3. Digestive Unit, Archet 2 Hospital, University Hospital of Nice, F-06202, Nice, France. iannelli.a@chu-nice.fr. 4. Inserm, U1065, Team 8 "Hepatic Complications of Obesity", F-06204, Nice, France. iannelli.a@chu-nice.fr. 5. University of Nice Sophia-Antipolis, F-06107, Nice, France. iannelli.a@chu-nice.fr. 6. Service de Chirurgie Digestive et Centre de Transplantation Hépatique, Hôpital Archet 2, 151 Route Saint Antoine de Ginestière, BP 3079, Nice Cedex3, France. iannelli.a@chu-nice.fr.
Abstract
INTRODUCTION: Nowadays, surgeons are dealing more and more with patients experiencing failure of a previous bariatric procedure after the worldwide exponential increase of bariatric surgery. Only a few and contradictory studies investigated both outcomes and complications risk factors in this subset population of bariatric patients. We aimed to study a homogeneous population of patients undergoing redo bariatric surgery (REDO-BS) resulting in bypass anatomy to evaluate early postoperative outcomes and identify risk factors of postoperative complications and mortality. MATERIAL AND METHODS: In this study, we compared the outcomes of patients undergoing REDO-BS from another former bariatric procedure into Roux-en-Y gastric bypass (RYGP) to those undergoing primary RYGP. Data were extracted from a prospectively maintained database. RESULTS: One hundred thirty-eight conversional bariatric surgery (CBS) cases resulting in RYGP anatomy and 38 RBS cases of pouch resizing (PR) were compared with 756 primary RYGP. There were no statistical significant difference in outcomes between the primary and CBS groups but patients undergoing PR had a significant higher risk of developing a leak than others. CBS complication risk factors were age (OR = 1.05; p = 0.04), operative time, and T2DM (OR = 4.11; p = 0.03). CONCLUSIONS: CBS is safe and leads to similar early postoperative outcomes as primary RYGP whereas the indication for revisional surgery such as PR should be carefully evaluated as it is associated with an increased risk of leak.
INTRODUCTION: Nowadays, surgeons are dealing more and more with patients experiencing failure of a previous bariatric procedure after the worldwide exponential increase of bariatric surgery. Only a few and contradictory studies investigated both outcomes and complications risk factors in this subset population of bariatric patients. We aimed to study a homogeneous population of patients undergoing redo bariatric surgery (REDO-BS) resulting in bypass anatomy to evaluate early postoperative outcomes and identify risk factors of postoperative complications and mortality. MATERIAL AND METHODS: In this study, we compared the outcomes of patients undergoing REDO-BS from another former bariatric procedure into Roux-en-Y gastric bypass (RYGP) to those undergoing primary RYGP. Data were extracted from a prospectively maintained database. RESULTS: One hundred thirty-eight conversional bariatric surgery (CBS) cases resulting in RYGP anatomy and 38 RBS cases of pouch resizing (PR) were compared with 756 primary RYGP. There were no statistical significant difference in outcomes between the primary and CBS groups but patients undergoing PR had a significant higher risk of developing a leak than others. CBS complication risk factors were age (OR = 1.05; p = 0.04), operative time, and T2DM (OR = 4.11; p = 0.03). CONCLUSIONS: CBS is safe and leads to similar early postoperative outcomes as primary RYGP whereas the indication for revisional surgery such as PR should be carefully evaluated as it is associated with an increased risk of leak.
Authors: Andreas Rohner; Jeannette D Widmer; Jennifer Klasen; Anita Scheiwiller; Dominik Muller; Markus K Muller Journal: Surg Obes Relat Dis Date: 2016-09-14 Impact factor: 4.734
Authors: Ioannis I Lazaridis; Romano Schneider; Jennifer M Klasen; Tarik Delko; Roman Stocker; Marko Kraljević Journal: Obes Surg Date: 2022-10-15 Impact factor: 3.479