Abstract
Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery. Both laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) represent viable options, but the long-term results are still lacking. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG after failed LAGB. Evaluate the long-term follow-up (median 9.3 years) of the same cohort of patients. University and primary-care hospitals, Italy. We retrospectively examined a prospectively maintained database of the previously published multicenter cohort of 56 patients who underwent LSG after failed LAGB between 2008–2011. The control group included cross-matched non-revisional LSGs. The primary endpoint was weight loss, secondary endpoints co-morbidities, and the need for further bariatric surgery. The study group included 44 patients and the control group 56. We found %EWL 53% Vs. 67% (p = .021), %EBMIL (54 Vs. 68%, p = .018), %TWL (26 Vs. 34%, p = .002). We also found more severe GERD (gastroesophageal reflux disease) symptoms in the revisional than in the primary group (9.0 vs. 1.8% mild and 23.0 vs. 3.0% severe). Ten patients from the revisional group (22.7%) vs. eight in the primary group (13%) underwent further bariatric surgery (LRYGB). Our results showed less favorable weight loss in revisional than primary LSG after LABG, higher prevalence of GERD, and a more frequent need for further revisional surgery. Despite the study’s limitations, the present data suggest that the long-term outcomes may offset the possible reduced short-term complication rate after revisional sleeve gastrectomy for a failed LABG.
Highlights
Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery [1]
The choice for laparoscopic sleeve gastrectomy (LSG) as a revisional procedure was based on the multidisciplinary re-evaluation of the alimentary and lifestyle behavior and absence of gastroesophageal reflux disease (GERD)
LSG and Roux-en-Y Gastric Bypass (RYGB) have been proposed as effective revisional procedures after failed LAGB
Summary
Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery [1]. Despite good short-term outcomes in weight loss and postoperative complications, it is associated with over 50%. Updates in Surgery cohort studies with a long-term follow-up after revisional LSG following LAGB [7]. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG in a “2-step” approach after failed LAGB. In 56 patients, we reported excess weight loss (%EWL) of 78.5% without major complications. The results were not statistically different from those obtained in our primary (not revisional) sleeve gastrectomy series [8]. The present, multicenter, retrospective cohort study aimed to update the long-term results of LAGB patients converted to LSG, providing a 9-year follow-up of that series
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