PMID- 28477245
OWN - NLM
STAT- MEDLINE
DCOM- 20180418
LR  - 20220408
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 27
IP  - 10
DP  - 2017 Oct
TI  - Systematic Review and Meta-Analysis of Outcomes After Revisional Bariatric 
      Surgery Following a Failed Adjustable Gastric Band.
PG  - 2522-2536
LID - 10.1007/s11695-017-2677-7 [doi]
AB  - INTRODUCTION: Laparoscopic adjustable gastric band (LAGB)-related complications 
      have been reported in significant numbers of patients often leading to band 
      removal. Increasingly revisional bariatric surgery (RBS) is offered, most 
      commonly either band to Roux-en-Y gastric bypass (B-RYGB) or band to sleeve 
      gastrectomy (B-SG). OBJECTIVES: We conducted a systematic review and 
      meta-analysis of studies to evaluate the efficacy of RBS following failed LAGB. 
      METHODS: Medline, Embase, The Cochrane Library and NHS Evidence were searched for 
      English language studies assessing patients who had undergone LAGB and who 
      subsequently underwent either B-RYGB or B-SG. RESULTS: Thirty-six studies met the 
      inclusion criteria. There were 2617 patients. B-RYGB was performed in 60.5% 
      (n = 1583). There was one death within 30 days (0.0004%). The overall pooled 
      morbidity rate was 13.2%. There was no difference between the B-RYGB and B-SG 
      groups in morbidity, leak rate or return to theatre. Percentage excess weight 
      loss (%EWL) following the revisional procedure for all patients combined at 6, 12 
      and 24 months was 44.5, 55.7 and 59.7%, respectively. There was no statistical 
      difference in %EWL between B-RYGB and B-SG at any time point. The rates of 
      remission of diabetes, hypertension and obstructive sleep apnoea were 46.5, 35.9 
      and 80.8%, respectively. CONCLUSIONS: Randomised controlled trials (RCTs) do not 
      exist on this issue but the available observational evidence does suggest that 
      RBS is associated with generally good outcomes similar to those experienced after 
      primary surgery. Further, high-quality research, particularly RCTs, is required 
      to assess long-term weight loss, comorbidity and quality of life outcomes.
FAU - Sharples, Alistair J
AU  - Sharples AJ
AD  - Department of Upper GI Surgery, Heart of England NHS Foundation Trust, 
      Birmingham, UK. alsharples@yahoo.co.uk.
FAU - Charalampakis, Vasileios
AU  - Charalampakis V
AD  - Department of Upper GI Surgery, Heart of England NHS Foundation Trust, 
      Birmingham, UK.
FAU - Daskalakis, Markos
AU  - Daskalakis M
AD  - Department of Upper GI Surgery, Heart of England NHS Foundation Trust, 
      Birmingham, UK.
FAU - Tahrani, Abd A
AU  - Tahrani AA
AD  - Department of Diabetes and Endocrinology, Heart of England NHS Foundation Trust, 
      Birmingham, UK.
AD  - Institute of Metabolic and Systems Research, University of Birmingham, 
      Birmingham, UK.
AD  - Centre of Endocrinology Diabetes and Metabolism, Birmingham Health Partners, 
      Birmingham, UK.
FAU - Singhal, Rishi
AU  - Singhal R
AD  - Department of Upper GI Surgery, Heart of England NHS Foundation Trust, 
      Birmingham, UK.
LA  - eng
GR  - CS-2013-13-029/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
SB  - IM
MH  - Comorbidity
MH  - *Gastrectomy/methods/statistics & numerical data
MH  - Gastroplasty/*adverse effects/methods/statistics & numerical data
MH  - Humans
MH  - Laparoscopy/adverse effects/methods/statistics & numerical data
MH  - Obesity, Morbid/epidemiology/*surgery
MH  - Quality of Life
MH  - Reoperation/*methods/statistics & numerical data
MH  - Treatment Failure
MH  - Weight Loss/physiology
OTO - NOTNLM
OT  - Adjustable gastric band
OT  - Revisional bariatric surgery
EDAT- 2017/05/10 06:00
MHDA- 2018/04/19 06:00
CRDT- 2017/05/07 06:00
PHST- 2017/05/10 06:00 [pubmed]
PHST- 2018/04/19 06:00 [medline]
PHST- 2017/05/07 06:00 [entrez]
AID - 10.1007/s11695-017-2677-7 [pii]
AID - 10.1007/s11695-017-2677-7 [doi]
PST - ppublish
SO  - Obes Surg. 2017 Oct;27(10):2522-2536. doi: 10.1007/s11695-017-2677-7.