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One-Stage vs Two-Stage Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients with Body Mass Index >55 Kg/m2; 5-YEAR FOLLOW UP

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Abstract

Background

Surgical strategies in patients with BMI > 55 kg/m2 are not well established.

Objectives

The objective of this study is to compare the long term results and complications of 1- vs. 2-stage laparoscopic “Roux-en-Y″ gastric bypass (LRYGB) for patients with BMI > 55 kg/m2.

Methods

Retrospective review of the complications and outcomes, between January 2007 and January 2010, for patients with a BMI > 55 kg/m2 who underwent directly a LRYGB (1-stage) or a LRYGB as a 2nd stage of a laparoscopic sleeve gastrectomy (LSG).

Results

Twenty-four patients were enrolled (no patient was lost during the 5-year follow-up). In the 1-stage LRYGB group, two patients had grade II complications according to Clavien-Dindo classification. In the 2-stage LRYGB group, complications of the first and the second surgery were summed. There were no differences between the two groups despite being heterogenous (more men with a higher BMI in the 2-stage group). There was a statistically significant difference in the final BMI in 1-stage LRYGB group compared to the 2-stage LRYGB group (34.46 ± 6.29 vs. 40.40 ± 3.47; p = 0.01, respectively) and in percentage of excess of BMI loss (%EBMIL; 69.80 ± 19.96 vs. 54.54 ± 13.93; p = 0.04, respectively).

Conclusions

In patients with a BMI > 55 kg/m2, both 1- and 2-stage LRYGB give good long-term results. If feasible, a 1-stage LRYGB obtains a better percentage of excess of BMI loss but if not possible, the strategy of initially performing a laparoscopic sleeve gastrectomy followed by a LRYGB is safe and there were no differences in complications.

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Authors and Affiliations

  1. Bariatric and Metabolic Surgery Unit, Hospital Clínico Universitario, Valencia, Spain

    María Díaz-Tobarra, Norberto Cassinello Fernández, Pablo Jordá Gómez, Mohammad Nebih Nofal, Raquel Alfonso Ballester & Joaquín Ortega Serrano

  2. Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario, Avda Blasco Ibañez, 17, 46010, Valencia, Spain

    Norberto Cassinello Fernández

Authors
  1. María Díaz-Tobarra
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  2. Norberto Cassinello Fernández
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  3. Pablo Jordá Gómez
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  4. Mohammad Nebih Nofal
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  5. Raquel Alfonso Ballester
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  6. Joaquín Ortega Serrano
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Corresponding author

Correspondence to Norberto Cassinello Fernández.

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Conflict of Interest. Disclosure Statement

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent Statement

As data were retrospectively collected from medical records and our anonymized own database, this type of study does not require formal consent apart from surgical informed consent, according to the institutional Ethical and Clinical Investigation Committee.

Additional information

Each co-author has participated sufficiently in the work to take public responsibility for appropriate portions of the content. All authors disclose any conflict of interest with funds, grants, institutions or products mentioned in the manuscript. Checklist has been fulfilled and an official interpreter has reviewed spelling and grammar.

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Díaz-Tobarra, M., Cassinello Fernández, N., Jordá Gómez, P. et al. One-Stage vs Two-Stage Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients with Body Mass Index >55 Kg/m2; 5-YEAR FOLLOW UP. OBES SURG 27, 955–960 (2017). https://doi.org/10.1007/s11695-016-2411-x

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  • DOI: https://doi.org/10.1007/s11695-016-2411-x

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