Obesity Surgery

, Volume 20, Issue 12, pp 1627–1632 | Cite as

Revisional vs. Primary Roux-en-Y Gastric Bypass—a Case-matched Analysis

Less Weight Loss in Revisions
  • Urs Zingg
  • Alexander McQuinn
  • Dennis DiValentino
  • Steven Kinsey-Trotman
  • Philip Game
  • David Watson
Clinical Research

Abstract

With the increase in bariatric procedures performed, revisional surgery is now required more frequently. Roux-en-Y gastric bypass (RYGB) is considered to be the gold standard revision procedure. However, data comparing revisional vs. primary RYGB is scarce, and no study has compared non-resectional primary and revisional RYGB in a matched control setting. Analysis of 61 revisional RYGB that were matched one to one with 61 primary RYGB was done. Matching criteria were preoperative body mass index, age, gender, comorbidities and choice of technique (laparoscopic vs. open). After matching, the groups did not differ significantly. Previous bariatric procedures were 13 gastric bands, 36 vertical banded gastroplasties, 10 RYGB and two sleeve gastrectomies. The indication for revisional surgery was insufficient weight loss in 55 and reflux in 6. Intraoperative and surgical morbidity was not different, but medical morbidity was significantly higher in revisional procedures (9.8% vs. 0%, p = 0.031). Patients undergoing revisional RYGB lost less weight in the first two postoperative years compared with patients with primary RYGB (1 month, 14.9% vs. 29.7%, p = 0.004; 3 months, 27.4% vs. 51.9%, p = 0.002; 6 months, 39.4 vs. 70.4%, p < 0.001; 12 months, 58.5% vs. 85.9%, p < 0.001; 24 months, 60.7% vs. 90.0%, p = 0.003). Although revisional RYGB is safe and effective, excess weight loss after revisional RYGB is significantly less than following primary RYGB surgery. Weight loss plateaus after 12 months follow-up.

Keywords

Revisional surgery Roux-en-Y gastric bypass Weight loss Case-matched analysis 

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Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Urs Zingg
    • 1
  • Alexander McQuinn
    • 2
  • Dennis DiValentino
    • 2
  • Steven Kinsey-Trotman
    • 2
  • Philip Game
    • 1
  • David Watson
    • 2
  1. 1.Discipline of SurgeryUniversity of Adelaide, Royal Adelaide HospitalAdelaideAustralia
  2. 2.Flinders University Department of SurgeryFlinders Medical CentreBedford ParkAustralia

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