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Is a One-Step Sleeve Gastrectomy Indicated as a Revision Procedure After Gastric Banding? Data Analysis from a Quality Assurance Study of the Surgical Treatment of Obesity in Germany

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Abstract

Background

Since 1 January 2005, the outcomes of bariatric surgeries have been examined in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg.

Methods

Data are collected in an online data bank. Data collection began in 2005 for the results of gastric banding (GB) and in 2006 for sleeve gastrectomies (SGs). In addition to primary bariatric operations, data regarding the complications of revision procedures and redo operations have been analyzed. Participation in the quality assurance study is required for all certified centers in Germany.

Results

SGs are a popular redo operation after failed gastric banding. Using the German Bariatric Surgery Registry, we analyzed data from 137 SGs that were used in a one-step approach after GB and 37 SGs that were used in a two-step approach. Leakage rates for primary SGs dropped to 1.9 %. The incidence of leakage after a one-step SG after GB is significantly higher (4.4 %) than for a two-step approach (0 %).

Conclusion

SGs are popular procedures after failed GB in Germany, but the complication rates for one-step band removal are higher than for a two-step approach. After examining the data, we suggest performing band removal and SG as a two-step procedure. Further analysis is necessary to evaluate the optimal time period between band removal and SG. Follow-up investigations must be performed to determine if SG is an effective and safe option after GB.

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Acknowledgments

The German Nationwide Survey on Bariatric Surgery is supported by the Ministry of Research and Education Germany (BMBF) grant number 01GI1124. The responsible investigator is Christine Stroh. We thank all of the hospitals that participated in the study for their active engagement.

Conflict of Interest

There is no conflict of interest. Christine Stroh, Diana Benedix, Rudolf Weiner, Frank Benedix, Stefanie Wolff, Christian Knoll, and Thomas Manger confirm that there are no links to firms whose products are mentioned in the article or to firms marketing a competing product. The topic is presented in an independent light, and the information outlined is product-neutral. The following firms support the GBSR without any relation to their products: Johnson & Johnson MEDICAL GmbH, Ethicon Endo-Surgery Deutschland, Norderstedt and Covidien Deutschland GmbH, Neustadt/Donau.

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Authors and Affiliations

  1. SRH Municipal Hospital, Gera, Germany

    Christine Stroh & T. Manger

  2. University Hospital, Magdeburg, Germany

    D. Benedix & F. Benedix

  3. Sachsenhausen Hospital, Frankfurt am Main, Germany

    R. Weiner

  4. StatConsult, Magdeburg, Germany

    C. Knoll

  5. Institute for Quality Assurance in Surgical Medicine at the University Hospital, Magdeburg, Germany

    Christine Stroh, S. Wolff & T. Manger

  6. Department of General, Abdominal and Pediatric Surgery, SRH Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany

    Christine Stroh & S. Wolff

Authors
  1. Christine Stroh
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  2. D. Benedix
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  3. R. Weiner
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  4. F. Benedix
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  5. S. Wolff
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  6. C. Knoll
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  7. T. Manger
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Consortia

Obesity Surgery Working Group, Competence Network Obesity

Corresponding author

Correspondence to Christine Stroh.

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Stroh, C., Benedix, D., Weiner, R. et al. Is a One-Step Sleeve Gastrectomy Indicated as a Revision Procedure After Gastric Banding? Data Analysis from a Quality Assurance Study of the Surgical Treatment of Obesity in Germany. OBES SURG 24, 9–14 (2014). https://doi.org/10.1007/s11695-013-1068-y

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  • DOI: https://doi.org/10.1007/s11695-013-1068-y

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