Revisional versus primary Roux-en-Y gastric bypass: a case-matched analysis

Delko, Tarik; Köstler, Thomas; Peev, Miroslav P.; Esterman, Adrian; Oertli, Daniel; Zingg, Urs

doi:10.1007/s00464-013-3204-0

Cited by 32 publications

(13 citation statements)

References 40 publications

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“…The reason for this difference remains unclear, though some speculate that it is because the patients requiring revisional bariatric surgery for inadequate weight loss may have poor diet compliance that resulted in their need for secondary surgery. Another possibility may be that the physiologic change of energy metabolism may be different for a secondary bariatric surgery than primary bariatric surgery [22]. Brolin et al showed that percent weight loss is even dependent on the type of primary bariatric surgery performed [23].…”

Section: Discussionmentioning

confidence: 99%

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass

et al. 2014

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“…Though some studies have shown inferior weight loss with RBS [2][3][4], others have not. At the same time, some authors [5,6] have shown that inferior weight loss with RBS does not come at the cost of inferior comorbidity resolution.…”

Section: Introductionmentioning

confidence: 95%

Revisional Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: a Systematic Review of Comparative Outcomes with Respective Primary Procedures

et al. 2015

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Though primary bariatric surgery is now firmly established as the first-line treatment for morbid obesity, this is not the case with revisional bariatric surgery. Despite proven benefits and patient demand, revisional bariatric surgery continues to attract controversy. Even though it is widely believed to be riskier and less effective than primary bariatric surgery, there is currently no systematic review in literature addressing this point. This review aims to establish outcomes after revisional bariatric surgery in comparison with those after primary bariatric surgery. Since Roux-en-Y gastric bypass or sleeve gastrectomy is currently the commonest anatomy achieved after revisional bariatric surgery, this review focuses on the outcome of revisional Roux-en-Y gastric bypass and revisional sleeve gastrectomy in comparison with respective primary procedures.

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“…Most studies that assessed the effectiveness of P-RYGB and R-RYGB only examined the weight loss and surgical complications [12][13][14]. Moreover, these studies reported inconsistent findings, suggesting comparable weight loss and complications for patients who underwent P-RYGB and R-RYGB [12][13][14] or inferior weight loss and higher complications in patients who received R-RYGB [15,16]. Furthermore, few studies have assessed the evolution of comorbidities after P-RYGB and R-RYGB [8,17,18], despite the possibility of relapse of comorbidities after RYGB (e.g., T2DM, HTN, and dyslipidemia).…”

Section: Introductionmentioning

confidence: 99%

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

et al. 2019

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Background Revisional gastric bypass (R-RYGB) surgery is utilized for the management of inadequate weight loss or weight regain observed after some cases of bariatric surgeries. Data on the mid-term effectiveness of primary gastric bypass (P-RYGB) compared with R-RYGB (e.g., post sleeve gastrectomy/gastric banding) are controversial. Methods Retrospective chart review of all patients who received P-RYGB and R-RYGB (January 2011-June 2015) at our center. One hundred twenty patients who underwent P-RYGB and 34 R-RYGB who completed 18 months follow-up were included. We compared the effectiveness of P-RYGB with R-RYGB by assessing four anthropometric, two glycemic, and four lipid parameters, as well as the control of type 2 diabetes (T2DM), hypertension, dyslipidemia (remission, improvement, persistence, relapse, de novo), mortality and complications rates. Results A comparison of the effectiveness of P-RYGB with R-RYGB at 18 months revealed no significant differences in patients' age, gender, and preoperative BMI between groups. However, patients who received P-RYGB had lower mean weight (P = 0.001) and BMI (P < 0.001), reflected by a higher mean delta BMI (P = 0.02), total weight loss percentage (TWL%) (P < 0.0001) and excess weight loss percentage (EWL%) (P < 0.0001). No differences in glycemic parameters, lipid profiles, control of T2DM, hypertension, and dyslipidemia were observed. No death is reported and complication rates were comparable. Conclusions Although R-RYGB effectively addressed inadequate weight loss, weight regain, and recurrence of comorbidities after restrictive bariatric surgery, R-RYGB resulted in inferior weight loss compared with P-RYGB. Neither procedure differed in their clinical control of T2DM, hypertension, and dyslipidemia. Both procedures exhibited comparable complication rates.

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Revisional versus primary Roux-en-Y gastric bypass: a case-matched analysis

Abstract: Revisional laproscopic VVLL RYGB can be performed as a one-stage procedure by experienced bariatric surgeons but shows less effective EWL than primary RYGB procedures.

Cited by 32 publications

References 40 publications

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass

Revisional Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: a Systematic Review of Comparative Outcomes with Respective Primary Procedures

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

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