PMID- 26809671
OWN - NLM
STAT- MEDLINE
DCOM- 20171214
LR  - 20220408
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 26
IP  - 9
DP  - 2016 Sep
TI  - Management of Complications and Outcomes After Revisional Bariatric Surgery: 
      3-Year Experience at a Bariatric Center of Excellence.
PG  - 2144-2149
LID - 10.1007/s11695-016-2071-x [doi]
AB  - BACKGROUND: Laparoscopic revisional bariatric surgery (RBS) is increasingly 
      common. A tailored decision-making process is advocated. In this retrospective 
      study, we reviewed the RBS experience of a single center, analyzing perioperative 
      complications to provide insight into management options and midterm outcomes. 
      METHODS: Records from November 2011 to March 2015 were reviewed from 
      prospectively maintained database. Six hundred eighteen patients underwent 
      laparoscopic bariatric procedures; of these, 81 (13.1 %) underwent RBS. Patients 
      with a minimum follow-up of 6 months (n = 77) were evaluated. Fifty-nine 
      underwent revised laparoscopic sleeve gastrectomy, and 18 underwent revised 
      Roux-en-Y gastric bypass. Indications for RBS were inadequate weight loss or 
      weight regain in 42 cases (54.5 %) and gastroesophageal reflux disease (GERD), 
      procedure-related complications, or technical failure in 35 cases (45.5 %). 
      RESULTS: There were no deaths or conversions to open surgery. After a mean 
      follow-up of 22 months, body mass index (BMI) decreased from 40.9 +/- 6.7 to 
      31.9 +/- 4.8 kg/m(2), mean % excess weight loss (%EWL) was 58 +/- 24.3 %, and 55.3 % 
      of patients had resolution of comorbidities. Eight major complications (10.4 %) 
      occurred: five leaks and three intra-abdominal hematomas. Non-surgical management 
      succeeded in 50 % of complications. CONCLUSIONS: This study confirms that RBS is 
      challenging; a complication rate of 10 % is expected. Major surgery can be 
      avoided when devoted endoscopists and radiologists are available. Intensive 
      follow-up after complications allows early diagnosis and treatment of unfavorable 
      sequelae. RBS induced a mean %EWL of 58 % at 2 years and resolution of 
      comorbidities in 50 % of cases. However, the durability of these effects remains 
      questionable.
FAU - Abdelgawad, Mohamed
AU  - Abdelgawad M
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Division of General 
      Surgery and Bariatric Center of Excellence IFSO EU, "La Sapienza", University of 
      Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
AD  - Gastroenterology Surgical Center, Faculty of medicine, Mansoura University, 
      Mansoura, Egypt.
FAU - De Angelis, Francesco
AU  - De Angelis F
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Division of General 
      Surgery and Bariatric Center of Excellence IFSO EU, "La Sapienza", University of 
      Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
FAU - Iossa, Angelo
AU  - Iossa A
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Division of General 
      Surgery and Bariatric Center of Excellence IFSO EU, "La Sapienza", University of 
      Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
FAU - Rizzello, Mario
AU  - Rizzello M
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Division of General 
      Surgery and Bariatric Center of Excellence IFSO EU, "La Sapienza", University of 
      Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
FAU - Cavallaro, Giuseppe
AU  - Cavallaro G
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Division of General 
      Surgery and Bariatric Center of Excellence IFSO EU, "La Sapienza", University of 
      Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
FAU - Silecchia, Gianfranco
AU  - Silecchia G
AD  - Department of Medico-Surgical Sciences and Biotechnologies, Division of General 
      Surgery and Bariatric Center of Excellence IFSO EU, "La Sapienza", University of 
      Rome, Via F. Faggiana 1668, 04100, Latina, Italy. 
      gianfranco.silecchia@uniroma1.it.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
SB  - IM
MH  - Adult
MH  - *Bariatric Surgery/adverse effects/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/surgery
MH  - Postoperative Complications/*epidemiology
MH  - *Reoperation/adverse effects/statistics & numerical data
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Complications
OT  - Fistula
OT  - Laparoscopic surgery
OT  - Leak
OT  - Morbid obesity
OT  - Revisional bariatric surgery
EDAT- 2016/01/27 06:00
MHDA- 2017/12/15 06:00
CRDT- 2016/01/27 06:00
PHST- 2016/01/27 06:00 [entrez]
PHST- 2016/01/27 06:00 [pubmed]
PHST- 2017/12/15 06:00 [medline]
AID - 10.1007/s11695-016-2071-x [pii]
AID - 10.1007/s11695-016-2071-x [doi]
PST - ppublish
SO  - Obes Surg. 2016 Sep;26(9):2144-2149. doi: 10.1007/s11695-016-2071-x.