Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?
<h2>Background</h2> <p>Revisional gastric bypass (R-RYGB) surgery is utilized for the management of inadequate weight loss or weight regain observed after some cases of bariatric surgeries. Data on the mid-term effectiveness of primary gastric bypass (P-RYGB) compared with R-RYGB (...
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2019
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| Summary: | <h2>Background</h2> <p>Revisional gastric bypass (R-RYGB) surgery is utilized for the management of inadequate weight loss or weight regain observed after some cases of bariatric surgeries. Data on the mid-term effectiveness of primary gastric bypass (P-RYGB) compared with R-RYGB (e.g., post sleeve gastrectomy/gastric banding) are controversial.</p> <h2>Methods</h2> <p>Retrospective chart review of all patients who received P-RYGB and R-RYGB (January 2011–June 2015) at our center. One hundred twenty patients who underwent P-RYGB and 34 R-RYGB who completed 18 months follow-up were included. We compared the effectiveness of P-RYGB with R-RYGB by assessing four anthropometric, two glycemic, and four lipid parameters, as well as the control of type 2 diabetes (T2DM), hypertension, dyslipidemia (remission, improvement, persistence, relapse, de novo), mortality and complications rates.</p> <h2>Results</h2> <p>A comparison of the effectiveness of P-RYGB with R-RYGB at 18 months revealed no significant differences in patients’ age, gender, and preoperative BMI between groups. However, patients who received P-RYGB had lower mean weight (P= 0.001) and BMI (P< 0.001), reflected by a higher mean delta BMI (P= 0.02), total weight loss percentage (TWL%) (P< 0.0001) and excess weight loss percentage (EWL%) (P< 0.0001). No differences in glycemic parameters, lipid profiles, control of T2DM, hypertension, and dyslipidemia were observed. No death is reported and complication rates were comparable.</p> <h2>Conclusions</h2> <p>Although R-RYGB effectively addressed inadequate weight loss, weight regain, and recurrence of comorbidities after restrictive bariatric surgery, R-RYGB resulted in inferior weight loss compared with P-RYGB. Neither procedure differed in their clinical control of T2DM, hypertension, and dyslipidemia. Both procedures exhibited comparable complication rates.</p><h2>Other Information</h2> <p> Published in: Obesity Surgery<br> License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s11695-019-04280-x" target="_blank">http://dx.doi.org/10.1007/s11695-019-04280-x</a></p> |
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