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Comparison of Repeat Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Case of Weight Loss Failure After Sleeve Gastrectomy

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Abstract

Background

Few series are available on the results of repeat sleeve gastrectomy (re-SG) and Roux-en-Y gastric bypass (RYGB) performed to manage the failure of primary sleeve gastrectomy (SG). The objective of this study was to compare the short- and medium-term outcomes of re-SG and RYGB after SG.

Material & Methods

Between January 2010 and December 2017, patients undergoing re-SG (n = 61) and RYGB (n = 83) for failure of primary SG were included in this study. Revisional surgery was proposed for patients with insufficient excess weight loss (EWL ≤ 50%) or weight regain. The primary endpoint was the comparison of weight loss in the re-SG group and the RYGB group at the 1-year follow-up. The secondary endpoints were overall mortality and morbidity, specific morbidity, length of stay, weight loss, and correction of comorbidities.

Results

The mean interval between SG and re-SG was 41.5 vs. 43.2 months between SG and RYGB (p = 0.32). The mean operative time was 103 min (re-SG group) vs. 129.4 min (RYGB group). One death (1.7%; re-SG group) and 25 complications (17.4%; 9 in the re-SG group, 16 in the RYGB group) were observed. At the 1 year, mean body mass index was 31.6 in the re-SG group and 32.5 in the RYGB group (p = 0.61) and excess weight loss was 69.5 vs. 61.2, respectively (p = 0.05).

Conclusion

Re-SG and RYGB as revisional surgery for SG are feasible with acceptable outcomes and similar results on weight loss on the first postoperative year.

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Abbreviations

SG:

Sleeve gastrectomy

Re-SG:

Re-sleeve gastrectomy

RYGB:

Roux-en-Y gastric bypass

RS:

Revisional surgery

GERD:

Gastroesophageal reflux disease

OSA:

Obstructive sleep apnea

T2DM:

Type 2 diabetes mellitus

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Authors and Affiliations

  1. Department of Digestive, Esogastric and Bariatric Surgery, Bichat Claude Bernard University Hospital, 46 rue Henri Huchard, F-75018, Paris, France

    Christos Antonopulos, Lionel Rebibo, Lara Ribeiro-Parenti, Konstantinos Arapis, Jean-Pierre Marmuse & Simon Msika

  2. Department of Medical and Oral Sciences and Biotechnologies, “G.d’Annunzio” University, Via dei Vestini 31, 66100, Chieti, Italy

    Christos Antonopulos

  3. SSPC (Simplification des Soins des Patients Complexes) - Clinical Research Unit, University of Picardie Jules Verne, 80054, Amiens Cedex 01, France

    Lionel Rebibo & Jean-Marc Regimbeau

  4. Department of Digestive Surgery, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France

    Lionel Rebibo, Abdennaceur Dhahri & Jean-Marc Regimbeau

  5. Department of Digestive and General Surgery, Louis Mourier University Hospital, 178 rue des Renouillers, F-92700, Colombes, France

    Daniela Calabrese & Simon Msika

  6. Explorations Fonctionnelles Department, Louis Mourier Hospital, 178 rue des Renouillers, F-92700, Colombes, France

    Muriel Coupaye

  7. Department of Diabetes and Nutrition, Bichat Claude Bernard University Hospital, 46 rue Henri Huchard, F-75018, Paris, France

    Boris Hansel

Authors
  1. Christos Antonopulos
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  2. Lionel Rebibo
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  10. Jean-Marc Regimbeau
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Corresponding author

Correspondence to Simon Msika.

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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.

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Informed consent was obtained by all individual participants included in the study.

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Antonopulos, C., Rebibo, L., Calabrese, D. et al. Comparison of Repeat Sleeve Gastrectomy and Roux-en-Y Gastric Bypass in Case of Weight Loss Failure After Sleeve Gastrectomy. OBES SURG 29, 3919–3927 (2019). https://doi.org/10.1007/s11695-019-04123-9

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