Background The number of patients who need revisional bariatric surgery is increasing, and the dilemma for surgeons is how to treat the bariatric surgical patient who is experiencing recurring morbid obesity and/or complications after restrictive procedure. Revision of failed bariatric procedures is a significant challenge, expecially when the previous surgery was a gastric restrictive procedure, for the high probability of complications. Methods Of 132 patients undergoing bariatric redo-surgery from November 1998 until July 2007, 107 were followed in a retrospective cohort study. Revisional surgery after restrictive bariatric procedure failures was requested for staple line disruption, pouch dilatation and outlet stenosis, as well as weight regained. At reoperation, the overall mean age was 47 and the mean BMI was 36.1± 7.7 SD. 56 and 51 patients were undergoing respectively to re-VBG (1st group) and RYGB-on-VBG (2nd group) . Results The follow-up rate was 90%. In the 1st group, the mean BMI decrased to 30.5, 30.9, 31.2, 31.7, 32.5, 32.4, and 32.9 after 1,2,3,4,5,6 and 7 years, respectively. In the 2nd group, the mean BMI decrased to 28.6, 30.2, and 28.4 after 1,2, and 3 years, respectively. Early surgical complications rate was 14.8% in the 1st group and 3.8% in the 2nd, and late surgical complications rate was 3.7% and 0.7%, respectively. Conclusion Despite both the operations are effective in bariatric redo-surgery, at medium term the outcomes RYGB-on-VBG seem to be better, more in term of complications and quality of life.

REDO-SURGERY OF FAILURES AND COMPLICATIONS AFTER RESTRICTIVE PROCEDURES: 10 YEARS EXPERIENCE ON 132 PATIENTS.

CARIANI, STEFANO;AGOSTINELLI, LAURA;LEURATTI, LUCA;GIORGINI, ELEONORA;AMENTA, ENRICO
2008

Abstract

Background The number of patients who need revisional bariatric surgery is increasing, and the dilemma for surgeons is how to treat the bariatric surgical patient who is experiencing recurring morbid obesity and/or complications after restrictive procedure. Revision of failed bariatric procedures is a significant challenge, expecially when the previous surgery was a gastric restrictive procedure, for the high probability of complications. Methods Of 132 patients undergoing bariatric redo-surgery from November 1998 until July 2007, 107 were followed in a retrospective cohort study. Revisional surgery after restrictive bariatric procedure failures was requested for staple line disruption, pouch dilatation and outlet stenosis, as well as weight regained. At reoperation, the overall mean age was 47 and the mean BMI was 36.1± 7.7 SD. 56 and 51 patients were undergoing respectively to re-VBG (1st group) and RYGB-on-VBG (2nd group) . Results The follow-up rate was 90%. In the 1st group, the mean BMI decrased to 30.5, 30.9, 31.2, 31.7, 32.5, 32.4, and 32.9 after 1,2,3,4,5,6 and 7 years, respectively. In the 2nd group, the mean BMI decrased to 28.6, 30.2, and 28.4 after 1,2, and 3 years, respectively. Early surgical complications rate was 14.8% in the 1st group and 3.8% in the 2nd, and late surgical complications rate was 3.7% and 0.7%, respectively. Conclusion Despite both the operations are effective in bariatric redo-surgery, at medium term the outcomes RYGB-on-VBG seem to be better, more in term of complications and quality of life.
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S. Cariani; L. Agostinelli; L. Leuratti; E. Giorgini; E. Amenta.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/68335
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