Primary Sleeve Gastrectomy Compared to Sleeve Gastrectomy as Revisional Surgery: Weight Loss and Complications at Intermediate Follow-up
- 402 Downloads
The laparoscopic adjustable gastric band (LAGB) can be revised to sleeve gastrectomy (LSG) for various reasons. Data are limited on the safety and efficacy of single-stage removal of LAGB and creation of LSG.
A retrospective review of cases was performed from 2010 to 2013. From the primary LSG group, a control group was matched in a 2:1 ratio.
Thirty-two patients underwent single-stage revision from LAGB to LSG, with a control group of 64. The most common indication for revision was insufficient weight loss (62.5 %). Operative time for revision and control groups was 134 and 92 min, respectively (p < 0.0001). Hospital stay was 3.22 and 2.59 days, respectively (p = 0.02). Overall, the 30-day complication rate for revision and control patients was 14.71 and 6.25 %, respectively (p = 0.20). There were no leaks, one stricture (3.13 %) in the revision group, and one reoperation for bleeding in the control group (1.56 %). For patients with BMI >30 at surgery, change in BMI at 12 months for revision and control was 8.77 and 11.58, respectively (p = 0.02).
Single-stage revision can be performed safely, with minimal increases in hospital stay and 30-day complications. Weight loss is greater in those who undergo primary LSG compared to those who undergo LSG as revision.
KeywordsBariatric Gastric band Laparoscopy Obesity Sleeve gastrectomy
- 4.Scozzari G, Farinella E, Bonnet G, Toppino M, Morino M. Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial. Obes Surg 2009;19:1108–1115.PubMedCrossRefGoogle Scholar
- 9.Metropolitan Life Height & Weight Tables. Statistical Bulletin 1983; 64(1):2–9.Google Scholar
- 14.Lanthaler M, Strasser S, Aigner F, Margreiter R, Nehoda H. Weight loss and quality of life after gastric band removal or deflation. ObesSurg 2009;19:1401–1408.Google Scholar
- 15.Aarts EO, Dogan K, Koehestanie P, Janssen I, Berends FJ. What happens after gastric band removal without additional bariatric surgery? Surgery Obesity Rel Dis 2013: ePub ahead of print 25 Oct 2013.Google Scholar
- 25.Burgmer R, Grigutsch K, Zipfel S, Wolf AM, de Zwaan M, Husemann B, Albus C, Senf W, Herpertz S. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. ObesSurg 2005;15:684–691.Google Scholar