Safety and short-term outcomes of sleeve gastrectomy and Roux-en-Y gastric bypass following removal of adjustable gastric banding
1 Department of Surgery, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625 Herne, Germany.
2 StatConsult Society for Clinical and Health Services Research mbH, Am Fuchsberg 11, 39112 Magdeburg, Germany.
3 Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Straße des Friedens 122, 07548 Gera, Germany.
Research Article
World Journal of Advanced Research and Reviews, 2021, 10(03), 358–369
Article DOI: 10.30574/wjarr.2021.10.3.0293
Publication history:
Received on 23 May 2021; revised on 25 June 2021; accepted on 27 June 2021
Abstract:
Background: The practice of bariatric surgery was studied using the German Bariatric Surgery Registry (GBSR). The focus of the study was to evaluate whether revision sleeve gastrectomy (R-SG) or Roux-en-Y Gastric Bypass (R-RYGB) has a major benefit in terms of perioperative risk in patients after failed Adjustable Gastric Banding (AGB).
Methods: The data collection includes patients who underwent SG or RYGB as revision surgery after failed AGB between 2005 and 2019. Outcome criteria were perioperative complications, comorbidities, 30-day mortality, and operative time.
Results: The study analyzed data from 1395 patients after revision SG and RYGB. 907 patients after R-RYGB, and 488 after R-SG. Intraoperative and overall postoperative complication rates were not significantly different between the two groups (p=0.321 and 0.621). The specific postoperative complication rate was significantly lower in R-SG than in R-RYGB (p=0.049). The mean operative time differed significantly between the two groups in favor of R-SG (160.3 min vs. 128.3 min; p<0.001). There was no significant difference in 30-day mortality between the two groups (p=0.952).
Conclusion: The study shows that R-SG and R-RYGB are safe and feasible as revision procedures and have acceptable complication and mortality rates. However, in our study, we cannot make a recommendation in favor of any of the surgical methods. Proper patient selection is essential to avoid possible adverse effects. Concerning the long-term results, further studies with higher methodological quality are necessary.
Keywords:
Bariatric surgery; Sleeve gastrectomy; Gastric bypass; Gastric banding; Complications; Comorbidities
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