Key result
Revisional bariatric surgery linked to a ~39% lower rate of sufficient weight loss versus primary surgery.
Why the study?
Revisional bariatric surgery is increasing despite being technically challenging and linked to higher morbidity and mortality, necessitating systematic data on these patients.
What are the indications, preferred procedures, and outcomes of revisional bariatric surgery in patients with morbid obesity?
Observational (n=799)
Yes
What are the indications, preferred procedures, and outcomes of revisional bariatric surgery in patients with morbid obesity?
Revisional bariatric surgery is primarily indicated for weight regain and leads to further weight reduction, but is associated with a significant complication rate.
Answers are grounded in this paper and cite their sources.
Multicenter Polish RBS data extend observational experience; leaves open prospective trials before any practice change.
Introduction: Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. Aim: The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. Material and methods: This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. Results: The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) - 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) - 289 (36.17%) patients and sleeve gastrectomy (SG) - 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common - 117 (14.64%) patients. Conclusions: RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.
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Major et al. (2022) conducted an observational in Morbid obesity (n=799). Revisional bariatric surgery vs. Primary bariatric surgery was evaluated on Sufficient weight loss. Revisional bariatric surgery achieved sufficient weight loss in 38.87% of patients, compared to 63.58% after primary surgery, and was associated with a 27.78% complication rate.
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