Is Revisional Bariatric Surgery Effective as Primary Surgery?

Abstract

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.

Giá trị tiên lượng tử vong của thang điểm qsofa ở bệnh nhân nhiễm trùng hô hấp cấp nặng

“…[9][10][11][12] Trên bệnh nhân SARI, nghiên cứu của chúng tôi cho kết quả tương đồng với một nghiên cứu trên 159 bệnh nhân tại Thổ Nhĩ Kỳ (AUROC = 0,683). 13 Nghiên cứu này cũng cho thấy giá trị tiên lượng tử vong của thang điểm qSOFA thấp hơn các thang điểm CURB-65, PSI, và APACHE II (AUROC lần lượt là 0,717; 0,712; và 0,748). Với kết quả này, chúng tôi nhận thấy giá trị của thang điểm qSOFA trong việc tiên lượng tử vong ở bệnh nhân SARI là không cao, với AUROC = 0,6253.…”

Comparing weight loss outcomes after conversion to Roux-en-Y gastric bypass versus duodenal switch from sleeve gastrectomy in a community hospital

“…Because of this, revisional bariatric surgery has increased in recent years from 6.0% in 2013 to 16.7% in 2019 [3]. Revisional RYGB, BPD-DS, and the newer single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) have all demonstrated to be effective techniques for further weight reduction [8][9][10], with revisional bariatric procedures on average showing lower excess body weight loss compared to initial bariatric procedures [9,10]. However, there have been few studies directly comparing revisional bariatric surgeries regarding excess body weight loss, specifically SG converted to RYGB and SG converted to DS, and thus the optimal revisional procedure is still under investigation.…”