Early postoperative complications after gastric bypass revisional surgery in patients with previous sleeve gastrectomy versus primary gastric bypass.
Por:
Campo-Betancourth CF, Ortiz Sebastián S, Estrada Caballero JL, Llopis Torremocha C, Villodre Tudela C, Ruiz de la Cuesta García-Tapia E, Gracia Alegría E, Carbonell Morote S, Salas Rezola E, Cárdenas Jaén K, Zapater P, Bernabéu Aguirre C and Ramia Ángel JM
Publicada:
1 oct 2022
Ahead of Print:
4 jun 2022
Resumen:
BACKGROUND: Revisional bariatric surgery (RS) is indicated if there is weight regain or insufficient weight loss, no improvement or reappearance of co-morbidities, or previous bariatric surgery complications. It has been associated with higher postoperative morbidity. OBJECTIVE: To evaluate the early postoperative complications (<30 d) of Roux-en-Y gastric bypass RS (RYGB-RS) after primary sleeve gastrectomy (SG-1) compared with primary RYGB (RYGB-1) at a bariatric surgery referral center. SETTING: Department of General and Digestive Surgery of General Universitary Hospital of Alicante, Spain. METHODS: Retrospective cohort study comparing RYGB-RS after SG-1 and RYGB-1 between January 2008 and March 2021. Postoperative complications, hospital stay, mortality, and readmissions were analyzed. RESULTS: Six hundred and twenty-eight RYGB surgeries (48 RYGB-RS, 580 RYGB-1) were studied. The mean age of patients undergoing RYGB-RS was 50 years, compared with 46 years in the RYGB-1 group (P = .017). Mean initial body mass index was 44.2 kg/m(2) (RYGB-RS) versus 47.6 kg/m(2) (RYGB-1; P = .004). Cardiovascular risk factors were higher in the RYGB-1 group (P < .05). Indications for RS were weight regain or insufficient weight loss (72.9%), weight regain or insufficient weight loss plus gastroesophageal reflux disease (14.6%), and gastroesophageal reflux disease (12.5%). There were no differences in the frequency of complications (RYGB-RS 22.9% vs RYGB-1 20.5%) or in their severity (Clavien-Dindo =IIIa; RYGB-RS 10.4% vs RYGB-1 6.4%; P > .05). There were no differences in emergency room visits (RYGB-RS at 12.5% vs RYGB-1 at 14.9%) or in readmissions (RYGB-RS at 12.5% vs RYGB-1 at 9.4%). CONCLUSION: No differences were observed between primary RYGB and revisional RYGB in early morbidity, mortality, emergencies, or readmissions. Revisional bariatric surgery is a safe procedure at referral centers and must be done by expert hands.
Filiaciones:
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
Salas Rezola E:
Department of Anesthesiology and Resuscitation, General Universitary Hospital of Alicante, Alicante, Spain
Cárdenas Jaén K:
Department of Digestive Medicine, General Universitary Hospital of Alicante, Alicante, Spain
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Department of Clinical Pharmacology, General Universitary Hospital of Alicante, Alicante, Spain
Bernabéu Aguirre C:
Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
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Department of General and Digestive Surgery, General Universitary Hospital of Alicante, Alicante, Spain
Institute and Health and Biomedical Research of Alicante, ISABIAL, General Universitary Hospital of Alicante, Alicante, Spain
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