Michał Łabul1, Michał Wysocki2, Katarzyna Bartosiak3, Michał Orłowski4, Bartosz Katkowski5, Paweł Jaworski6, Piotr Małczak7, Piotr Major7. 1. Department of General Surgery, Specialist Hospital in Legnica, Legnica, Poland. 2. Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Cracow, Poland. dr.michal.wysocki@gmail.com. 3. Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland. 4. Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo, Poland. 5. Department of General and Vascular Surgery, Polanica Zdrój, Poland. 6. Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland. 7. 2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Abstract
INTRODUCTION: With continuously growing number of redo bariatric surgeries (RBS), it is necessary to look for factors determining success of redo-surgeries. PATIENTS AND METHODS: A retrospective cohort study analyzed consecutive patients who underwent RBS in 12 referral bariatric centers in Poland from 2010 to 2020. The study included 529 patients. The efficacy endpoints were percentage of excessive weight loss (%EWL) and remission of hypertension (HT) and/or type 2 diabetes (T2D). RESULTS: Group 1: weight regain Two hundred thirty-eight of 352 patients (67.6%) exceeded 50% EWL after RBS. The difference in body mass index (BMI) pre-RBS and lowest after primary procedure < 10.6 kg/m2 (OR 2.33, 95% CI: 1.43-3.80, p = 0.001) was independent factor contributing to bariatric success after RBS, i.e., > 50% EWL. Group 2: insufficient weight loss One hundred thirty of 177 patients (73.4%) exceeded 50% EWL after RBS. The difference in BMI pre-RBS and lowest after primary procedure (OR 0.76, 95% CI: 0.64-0.89, p = 0.001) was independent factors lowering odds for bariatric success. Group 3: insufficient control of obesity-related diseases Forty-three of 87 patients (49.4%) achieved remission of hypertension and/or type 2 diabetes. One Anastomosis Gastric Bypass (OAGB) as RBS was independent factor contributing to bariatric success (OR 7.23, 95% CI: 1.67-31.33, p = 0.008), i.e., complete remission of HT and/or T2D. CONCLUSIONS: RBS is an effective method of treatment for obesity-related morbidity. Greater weight regain before RBS was minimizing odds for bariatric success in patients operated due to weight regain or insufficient weight loss. OAGB was associated with greater chance of complete remission of hypertension and/or diabetes.
INTRODUCTION: With continuously growing number of redo bariatric surgeries (RBS), it is necessary to look for factors determining success of redo-surgeries. PATIENTS AND METHODS: A retrospective cohort study analyzed consecutive patients who underwent RBS in 12 referral bariatric centers in Poland from 2010 to 2020. The study included 529 patients. The efficacy endpoints were percentage of excessive weight loss (%EWL) and remission of hypertension (HT) and/or type 2 diabetes (T2D). RESULTS: Group 1: weight regain Two hundred thirty-eight of 352 patients (67.6%) exceeded 50% EWL after RBS. The difference in body mass index (BMI) pre-RBS and lowest after primary procedure < 10.6 kg/m2 (OR 2.33, 95% CI: 1.43-3.80, p = 0.001) was independent factor contributing to bariatric success after RBS, i.e., > 50% EWL. Group 2: insufficient weight loss One hundred thirty of 177 patients (73.4%) exceeded 50% EWL after RBS. The difference in BMI pre-RBS and lowest after primary procedure (OR 0.76, 95% CI: 0.64-0.89, p = 0.001) was independent factors lowering odds for bariatric success. Group 3: insufficient control of obesity-related diseases Forty-three of 87 patients (49.4%) achieved remission of hypertension and/or type 2 diabetes. One Anastomosis Gastric Bypass (OAGB) as RBS was independent factor contributing to bariatric success (OR 7.23, 95% CI: 1.67-31.33, p = 0.008), i.e., complete remission of HT and/or T2D. CONCLUSIONS: RBS is an effective method of treatment for obesity-related morbidity. Greater weight regain before RBS was minimizing odds for bariatric success in patients operated due to weight regain or insufficient weight loss. OAGB was associated with greater chance of complete remission of hypertension and/or diabetes.
Authors: Zong Jie Koh; Claire Alexandra Zhen Chew; John J Y Zhang; Nicholas Syn; Guowei Kim; Jimmy Bok Yan So; Asim Shabbir Journal: Surg Obes Relat Dis Date: 2020-06-06 Impact factor: 4.734
Authors: Kamal K Mahawar; Abdelrahman Nimeri; Marco Adamo; Cynthia-Michelle Borg; Rishi Singhal; Omar Khan; Peter K Small Journal: Obes Surg Date: 2018-09 Impact factor: 4.129
Authors: Benjamin Clapp; Brittany Harper; Christopher Dodoo; William Klingsporn; Ashtyn Barrientes; Michael Cutshall; Alan Tyroch Journal: Surg Obes Relat Dis Date: 2020-04-03 Impact factor: 4.734
Authors: Luigi Angrisani; A Santonicola; P Iovino; A Vitiello; K Higa; J Himpens; H Buchwald; N Scopinaro Journal: Obes Surg Date: 2018-12 Impact factor: 4.129