Background: To assess outcomes of laparoscopic sleeve gastrectomy (LSG) as primary surgery (PS) versus revisional surgery (RS) emphasizing weight loss, modification of comorbidities and complications. Methods: The study included randomly selected 350 PS patients for control group and 35 RS patients for study group. Prospectively-collected patient data were retrospectively reviewed. To measure the efficacy of the procedure, we calculated the excess weight loss percentage (EWL%). Effective weight loss was accepted as more than 50%. The changes in the status of the comorbid diseases, complications (leakage, bleeding and stenosis), weight loss, % excessive weight loss (EWL) and mortality were recorded. Results: Mean BMI before PS and RS were 47.59 ± 6.46 kg/m 2 and 44.52 ± 6.75 kg/m 2 (p = 0.07). The mean operation time was more in the RS group than in the PS group. The amount of weight given in the RS group was higher one year after surgery. Diabetes mellitus (DM) and Dyslipidemia (DL) remission rates were higher in revision surgery group. There was one mortality in RS group. Conclusions: To summarize the first to systematically discuss results of primary surgery versus revisional surgery from Turkey and we showed the evidence that revisional surgery can be successfully completed with acceptable postoperative morbidity risks comparing with primary surgery. There is a need for long-term follow-up outcomes of large randomized controlled studies to define the related to weight loss and delayed complications.
Purpose: With the increase in demand for bariatric surgery, increasing numbers of patients require revisional surgery due to unwanted outcomes of primary bariatric procedures. There is no ideal bariatric procedure for every patient and all bariatric surgeries have failure rates. We aimed to assess the indications for revisional bariatric surgery and short-term surgical outcomes in this study. Materials and methods:All patients who underwent revisional bariatric surgery from March 2012 to June 2018 were determined prospectively. The data were retrospectively reviewed.Results: Forty-four patients were included. Mean age was 42 years. The primary surgery of cases was distributed with 32 laparoscopic sleeve gastrectomy, 7 mini gastric bypass, 4 adjustable gastric band and 5 gastric plication. The most common indication for revisional surgery was insufficient weight loss or renewed weight gain. The mean operation duration was 150 (70-380) minutes and mean duration 4.7 (3-12) hospital stay days. The improvement rates for comorbid for diabetes mellitus (DM), hypertension (HT) and obstructive sleep apnea syndrome (OSAS) were 84.6% (n = 11), 70% (n = 7) and 83.3%. Mini gastric bypass was performed most frequently as revisional procedure. Seven patients developed complications after revision surgery. Conclusion:Revisional bariatric surgery performed using the laparoscopic approach can be successfully completed with acceptable postoperative morbidity risks and shows satisfactory short-term weight loss. There is a need for longterm outcomes.
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