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https://hdl.handle.net/2440/51576
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Type: | Journal article |
Title: | Revisional bariatric surgery for failed restrictive procedures |
Author: | Coakley, B. Deveney, C. Spight, D. Thompson, S. Le, D. Jobe, B. Wolfe, B. McConnell, D. O'Rourke, R. |
Citation: | Surgery for Obesity and Related Diseases, 2008; 4(5):581-586 |
Publisher: | Elsevier Inc. |
Issue Date: | 2008 |
ISSN: | 1550-7289 1878-7533 |
Statement of Responsibility: | Brian A., Coakley B.A., Clifford W. Deveney, Donn H. Spight, Sarah K. Thompson, David Le, Blair A. Jobe, Bruce M. Wolfe, Donald B. McConnell and Robert W. O'Rourke |
Abstract: | Background Revisional bariatric surgery is increasing in frequency, but the morbidity and efficacy have not been well defined. The primary aim of this study was to determine the clinical efficacy with respect to weight loss, and associated morbidity, of revisional bariatric surgery in an academic university hospital bariatric surgery program. Methods A retrospective review of all patients who underwent revisional bariatric surgery for failed primary restrictive procedures, including gastroplasty and gastric bypass, but not including gastric banding or malabsorptive procedures, during a 10-year period at a single university hospital was performed. The perioperative morbidity and long-term weight loss and clinical results were determined from the medical charts. Results A total of 41 patients met the inclusion criteria. The primary bariatric procedures included vertical banded gastroplasty in 20 and Roux-en-Y gastric bypass in 21. The indications for revisional surgery included poor weight loss, weight regain, and various technical problems, including anastomotic stenosis and ulcer. The major morbidity rate was 17%. No patients died. The weight loss results varied depending on the indication for the revisional surgery and reoperative solution applied. The resolution of technical problems was achieved in all patients. Conclusion Revisional bariatric surgery can be performed with minimal mortality, albeit significant morbidity. The efficacy with respect to weight loss appeared acceptable, although the results were not as good as those after primary bariatric surgery. The analysis of patient subsets stratified by surgical history and revisional strategy provided important insights into the mechanisms of failure and efficacy of different revisional strategies. |
Keywords: | Revisional surgery Bariatric surgery Gastric bypass Restrictive procedures |
Description: | Copyright © 2008 American Society for Metabolic and Bariatric Surgery Published by Elsevier Inc. |
DOI: | 10.1016/j.soard.2007.10.004 |
Published version: | http://dx.doi.org/10.1016/j.soard.2007.10.004 |
Appears in Collections: | Aurora harvest 5 Medicine publications |
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