PMID- 20702147
OWN - NLM
STAT- MEDLINE
DCOM- 20110404
LR  - 20101129
IS  - 1878-7533 (Electronic)
IS  - 1550-7289 (Linking)
VI  - 6
IP  - 6
DP  - 2010 Nov-Dec
TI  - Revisional bariatric surgery: who, what, where, and when?
PG  - 635-42
LID - 10.1016/j.soard.2010.04.005 [doi]
AB  - BACKGROUND: Revisional bariatric surgery (RBS) outcomes have been poorly 
      characterized. We compared the RBS and primary bariatric surgery (PBS) outcomes 
      at the Penn State Milton S. Hershey Medical Center in the United States. METHODS: 
      A total of 72 RBS cases from 2000 to 2007 were reviewed and grouped by 
      indication: failure of weight loss, gastrojejunal complications, or other. The 
      RBS patients were compared with the 856 PBS patients who underwent Roux-en-Y 
      gastric bypass. The mean follow-up time was 12.6 +/- 1.2 months for the RBS group 
      and 16 +/- 0.5 months for the PBS group. Weight loss was analyzed as the kilograms 
      lost and patients with >/= 50% excess body weight loss (EBWL). Outcomes included 
      mortality, leaks, surgical site infections, and length of stay. RESULTS: The 
      weight loss was 23 +/- 2.8 kg after RBS and 41.3 +/- 0.7 kg after PBS (P <.05 versus 
      PBS). The post-RBS weight loss varied by surgical indication: failure of weight 
      loss, 27.1 +/- 2 kg; gastrojejunal complications, 8.7 +/- 3.4 kg; and other 23.5 +/- 
      10.6 kg. Also, 29% of the RBS patients had >/= 50% excess body weight loss (versus 
      the prerevision weight) and 61% (versus the initial weight) compared with 52.7% 
      after PBS. Only age </= 50 years was associated with >/= 50% excess body weight loss 
      after RBS for the failure of weight loss group. No RBS patients died. However, 
      leaks, surgical site infections, and length of stay were increased after RBS. 
      CONCLUSION: The results of our study have shown that weight loss after RBS varies 
      with the surgical indication and is affected by age >50 years. Although the RBS 
      patients had decreased weight loss and increased complications compared with the 
      PBS patients, >/= 50% EBWL was achieved by a significant number of RBS patients.
CI  - Copyright (c) 2010 American Society for Metabolic and Bariatric Surgery. Published 
      by Elsevier Inc. All rights reserved.
FAU - Radtka, John F 3rd
AU  - Radtka JF 3rd
AD  - Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania 
      17033, USA.
FAU - Puleo, Frances J
AU  - Puleo FJ
FAU - Wang, Li
AU  - Wang L
FAU - Cooney, Robert N
AU  - Cooney RN
LA  - eng
GR  - GM-55639/GM/NIGMS NIH HHS/United States
GR  - T32-GM64332/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20100504
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
SB  - IM
MH  - Adult
MH  - Bariatric Surgery/mortality/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Gastric Bypass
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/epidemiology/surgery
MH  - Postoperative Complications/epidemiology/mortality
MH  - Reoperation/mortality/statistics & numerical data
MH  - Treatment Outcome
MH  - Weight Loss
EDAT- 2010/08/13 06:00
MHDA- 2011/04/05 06:00
CRDT- 2010/08/13 06:00
PHST- 2009/11/10 00:00 [received]
PHST- 2010/02/05 00:00 [revised]
PHST- 2010/04/21 00:00 [accepted]
PHST- 2010/08/13 06:00 [entrez]
PHST- 2010/08/13 06:00 [pubmed]
PHST- 2011/04/05 06:00 [medline]
AID - S1550-7289(10)00441-7 [pii]
AID - 10.1016/j.soard.2010.04.005 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2010 Nov-Dec;6(6):635-42. doi: 10.1016/j.soard.2010.04.005. 
      Epub 2010 May 4.