Long-Term Matched Comparison of Primary and Revisional Laparoscopic Sleeve Gastrectomy

Sakran, Nasser; Soued, Sharon; Hod, Keren; Buchwald, J. N.; Soifer, Kim; Kessler, Yafit; Adelson, Dana; Biton, Reut; Goitein, David; Raziel, Asnat

doi:10.1007/s11695-022-06436-8

Cited by 11 publications

(9 citation statements)

References 38 publications

(46 reference statements)

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“…A long-term retrospective cohort study [ 41 ] found significantly higher percent excess BMI lost in the RLSG group at 6 years and 9 years follow-up. In contrast, a recent cross-matched study [ 42 ] found significant higher %EWL in the PLSG group in the short-term but similar %EWL between both groups in the long-term. However, the long-term results may have been influenced by the significant differences in follow-up durations between both groups [ 42 ].…”

Section: Discussioncontrasting

confidence: 56%

“…In contrast, a recent cross-matched study [ 42 ] found significant higher %EWL in the PLSG group in the short-term but similar %EWL between both groups in the long-term. However, the long-term results may have been influenced by the significant differences in follow-up durations between both groups [ 42 ]. Regardless, the long-term differences in WL efficacy between RLSG after GB and PLSG are unknown due to the lack of large, long-term, matched studies.…”

Section: Discussioncontrasting

confidence: 56%

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Medium Term Outcomes of Revision Laparoscopic Sleeve Gastrectomy after Gastric Banding: A Propensity Score Matched Study

et al. 2023

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Purpose Revision bariatric surgery may be undertaken after weight loss failure and/or complications following primary bariatric surgery. This study aims to compare the efficacy and safety of revision laparoscopic sleeve gastrectomy (RLSG) after gastric banding (GB) to those of primary laparoscopic sleeve gastrectomy (PLSG). Materials and Methods A retrospective, propensity-score matched study was conducted to compare between PLSG (control) patients and RLSG after GB (treatment) patients. Patients were matched using 2:1 nearest neighbor propensity score matching without replacement. Patients were compared on weight loss outcomes and postoperative complications for up to five years. Results 144 PLSG patients were compared against 72 RLSG patients. At 36 months, PLSG patients had significantly higher mean %TWL than RLSG patients (27.4 ± 8.6 [9.3–48.9]% vs. 17.9 ± 10.2 [1.7–36.3]%, p < 0.01). At 60 months, both groups had similar mean %TWL (16.6 ± 8.1 [4.6–31.3]% vs. 16.2 ± 6.0 [8.8–22.4)]%, p > 0.05). Early functional complication rates were slightly higher with PLSG (13.9% vs. 9.7%), but late functional complication rates were comparatively higher with RLSG (50.0% vs. 37.5%). The differences were not statistically significant (p > 0.05). Both early (0.7% vs 4.2%) and late (3.5% vs 8.3%) surgical complication rates were lower in PLSG patients compared to RLSG patients but did not reach statistical significance (p > 0.05). Conclusion RLSG after GB has poorer weight loss outcomes than PLSG in the short-term. Although RLSG may carry higher risks of functional complications, the safety of RLSG and PLSG are overall comparable. Graphical abstract

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Section: Discussioncontrasting

confidence: 56%

Section: Discussioncontrasting

confidence: 56%

Medium Term Outcomes of Revision Laparoscopic Sleeve Gastrectomy after Gastric Banding: A Propensity Score Matched Study

et al. 2023

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“…Comparison of primary and revisional MBS has been reported in the literature. Sakran et al [27] evaluated the long-term outcomes (12 years) of patients undergoing primary versus revisional SG, and it was shown that mean TWL was comparable between groups (20.9 and 18.3; p = 0.165) and resolution of associated medical conditions was comparable as well. Despite showing these outcomes, Long-Term Outcomes of Primary versus Revisional One Anastomosis Gastric Bypass Obes Facts 2024;17:303-310 DOI: 10.1159/000538768 more than 50% had insufficient weight loss and the vast majority of patients in both groups had weight regain with a trend toward earlier weight regain in the revisional group (2.6 vs. 3.4 years).…”

Section: Discussionmentioning

confidence: 99%

Primary versus Revisional One Anastomosis Gastric Bypass: Outcomes of Patients with at Least 8-Year Follow-Up

Abu-Abeid,

Bendayan,

Yuval

et al. 2024

Obes Facts

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Background: One anastomosis gastric bypass (OAGB) prevalence is increasing worldwide and shows good mid- to long-term results. Data on long-term outcomes of revisional OAGB (rOAGB) is limited. This study objective is to evaluate the long-term outcomes of patients undergoing primary OAGB (pOAGB) and rOAGB. Methods: A retrospective analysis of a prospectively maintained patient registry at a single-tertiary center. Patients undergoing OAGB from January 2015 to May 2016 were included and grouped to pOAGB and rOAGB. Results: There were 424 patients, of which 363 underwent pOAGB, and 61 underwent rOAGB. Baseline characteristics were insignificantly different between groups except for type 2 diabetes (T2D) rate which was higher in pOAGB (26% vs. 11.5%, p=0.01). The mean follow-up time was 98.5±3.9 months and long-term follow up data was available for 52.5% of patients. The mean total weight loss (TWL) was higher in the pOAGB group (31.3±14 vs. 24.1±17.6, p=0.006), however TWL was comparable when relating to the weight at primary surgery for rOAGB. The rate of T2D and hypertension resolution was 79% and 72.7% with no difference between groups. 13 patients (5.9%) underwent OAGB revision during follow-up, with no difference between groups. Two deaths occurred during follow-up, both non-related to OAGB. Conclusion: OAGB is effective as a primary and as a revisional procedure for severe obesity with good long-term results in terms of weight loss and resolution of associated diseases. In addition, the revisional surgery rates and chronic complications are acceptable. Further large prospective studies are required to clarify this data.

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“… 9 , 10 Some studies tend to show a positive effect of RBS on the treatment of T2DM, regardless of the surgical sequence. 9 , 11 , 12 However, this body of evidence mainly relies on studies compiling heterogeneous data or with a small sample size and would need to be strengthened.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Sleeve Gastrectomy and Gastric Bypass as Revisional Surgery on Antidiabetic Reimbursement: A Nationwide Cohort Study

Thereaux,

Bennani,

Khemis

et al. 2024

Annals of Surgery Open

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Objective: This study compared the effectiveness of 4 main revisional bariatric surgery (RBS) sequences after sleeve gastrectomy (SG) and adjustable gastric banding (AGB), on the reimbursement of antidiabetic treatments in France. Background: Few large-scale prospective cohort studies have assessed the changes in antidiabetic treatments after RBS. Method: This nationwide observational population-based cohort study analyzed data from the French National Health Insurance Database. All patients who underwent primary SG and AGB in France between January 2012 and December 2014 were included and followed up until December 31, 2020. The changes in categories and costs of reimbursed antidiabetic treatments across different RBS sequences were assessed (presented as follows: bariatric surgery (BS)-RBS). Results: Among the 107,088 patients who underwent BS, 6396 underwent RBS, 2400 SG-GBP (SG converted to gastric bypass [GBP] during follow-up), 2277 AGB-SG, 1173 AGB-GBP, and 546 SG-SG. Pre-RBS insulin was used in 10 (2.9%), 4 (0.9%), 8 (2.4%), and 10 (2.6%) patients, respectively. Two years after RBS, the treatment discontinuation or decrease (the change of treatment to a lighter one category rates [eg, insulin to bi/tritherapy]) was 47%, 47%, 49%, and 34%, respectively. Four years after RBS, the median annual cost per patient compared with baseline was lower (P < 0.01) for all sequences, except SG-SG (P = 0.24). The most notable effect concerned AGB-GBP (median of more than 220 euros to 0). Conclusions: This study demonstrated the positive impact of RBS over a 4-year follow-up period on antidiabetic treatments reimbursement, through the reduction or discontinuation of treatments and a significant decrease in costs per patient.

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Long-Term Matched Comparison of Primary and Revisional Laparoscopic Sleeve Gastrectomy

Cited by 11 publications

References 38 publications

Medium Term Outcomes of Revision Laparoscopic Sleeve Gastrectomy after Gastric Banding: A Propensity Score Matched Study

Medium Term Outcomes of Revision Laparoscopic Sleeve Gastrectomy after Gastric Banding: A Propensity Score Matched Study

Primary versus Revisional One Anastomosis Gastric Bypass: Outcomes of Patients with at Least 8-Year Follow-Up

Cost-Effectiveness of Sleeve Gastrectomy and Gastric Bypass as Revisional Surgery on Antidiabetic Reimbursement: A Nationwide Cohort Study

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