PMID- 37391349 OWN - NLM STAT- Publisher LR - 20231022 IS - 1878-7533 (Electronic) IS - 1550-7289 (Linking) VI - 19 IP - 11 DP - 2023 Nov TI - Trends and safety of bariatric revisional surgery in Italy: multicenter, prospective, observational study. PG - 1270-1280 LID - S1550-7289(23)00522-1 [pii] LID - 10.1016/j.soard.2023.05.009 [doi] AB - BACKGROUND: Revisional bariatric surgery (RBS) represents a further solution for patients who experience inadequate weight loss (IWL) following primary bariatric surgery (BS) or significant weight regain (WR) following initial satisfactory response. RBS guidelines are lacking; however, an increased trend in further BS offerings has been reported recently. OBJECTIVE: Analyze trend, mortality, complication, readmission, and reoperation rates for any reason at 30 days after RBS in Italy. SETTING: Ten Italian high-volume BS centers (university hospitals and private centers). METHODS: Prospective, observational, multicenter study enrolling patients undergoing RBS between October 1, 2021, and March 31, 2022, registering reasons for RBS, technique, mortality, intraoperative and perioperative complications, readmissions, and reinterventions for any reason. Patients undergoing RBS during the same calendar interval in 2016-2020 were considered control patients. RESULTS: A total of 220 patients were enrolled and compared with 560 control-group patients. Mortality was .45% versus .35% (n.s), with an overall mortality of .25%, while open surgery or conversion to open surgery was registered in 1%. No difference was found for mortality, morbidity, complications, readmission (1.3%), and reoperation rates (2.2%). IWL/WR was the most frequent cause, followed by gastroesophageal reflux disease; Roux-en-Y gastric bypass was the most used revisional procedure (56%). Sleeve gastrectomy was the most revised procedure in the study group, while gastric banding was the most revised in the control group. RBS represents up to 9% of the total BS in the Italian participating centers. CONCLUSIONS: Laparoscopy represents the standard approach for RBS, which appears safe. Current Italian trends show a shift toward sleeve gastrectomy being the most revised procedure and Roux-en-Y gastric bypass being the most frequent revisional procedure. CI - Copyright (c) 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved. FAU - Boru, Cristian E AU - Boru CE AD - General Surgery Division, Department of Medical Surgical Sciences and Biotechnologies and Department of Medical Surgical Sciences and Translational Medicine, University "La Sapienza" of Rome, Rome, Italy. Electronic address: cristian.boru@uniroma1.it. FAU - Marinari, Giuseppe M AU - Marinari GM AD - Bariatric Unit, Humanitas Clinical and Research Hospital, IRCCS Rozzano, Milan, Italy. FAU - Olmi, Stefano AU - Olmi S AD - General and Oncological Surgery Department, Center of Bariatric Surgery, Policlinico San Marco di Zingonia, Bergamo, Italy. FAU - Gentileschi, Paolo AU - Gentileschi P AD - Bariatric and Metabolic Surgery Department, San Carlo of Nancy Hospital and "Tor Vergata" University of Rome, Rome, Italy. FAU - Morino, Mario AU - Morino M AD - General Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy. FAU - Anselmino, Marco AU - Anselmino M AD - IRCCS San Raffaele Hospital, Milan, Italy. FAU - Foletto, Mirto AU - Foletto M AD - Bariatric Surgery Unit, Azienda Ospedaliera of University of Padova, Padova, Italy. FAU - Bernante, Paolo AU - Bernante P AD - Metabolic and Obesity Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Centre for the Study and Research of Treatment for Morbid Obesity, Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy. FAU - Piazza, Luigi AU - Piazza L AD - General Surgery and Emergency Department, ARNAS Garibaldi Nesima Hospital, Catania, Italy. FAU - Perrotta, Nicola AU - Perrotta N AD - General Surgery Department, Villa d'Agri Hospital, Potenza, Italy. FAU - Morganti, Riccardo AU - Morganti R AD - Section of Statistics, University Hospital of Pisa, Pisa, Italy. FAU - Silecchia, Gianfranco AU - Silecchia G AD - General Surgery Division, Department of Medical Surgical Sciences and Biotechnologies and Department of Medical Surgical Sciences and Translational Medicine, University "La Sapienza" of Rome, Rome, Italy. CN - Cooperative RESTART Group LA - eng PT - Journal Article DEP - 20230523 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 OTO - NOTNLM OT - Conversion OT - Perioperative morbidity and mortality OT - Readmission OT - Reoperation OT - Revisional bariatric surgery OT - Trends FIR - Di Biasio, Alberto IR - Di Biasio A FIR - Trotta, Manuela IR - Trotta M FIR - Di Capua, Francesco IR - Di Capua F FIR - Bianciardi, Emanuela IR - Bianciardi E FIR - Campanelli, Michela IR - Campanelli M FIR - Sensi, Bruno IR - Sensi B FIR - Arolfo, Simone IR - Arolfo S FIR - Salzano, Antonio IR - Salzano A FIR - Oldani, Alberto IR - Oldani A FIR - Mancini, Rudj IR - Mancini R FIR - Fiorello, Luigi IR - Fiorello L FIR - Filippone, Emanuela IR - Filippone E FIR - Rottoli, Matteo IR - Rottoli M FIR - Veroux, Gastone IR - Veroux G FIR - Celiento, Marta IR - Celiento M EDAT- 2023/07/01 11:41 MHDA- 2023/07/01 11:41 CRDT- 2023/06/30 21:55 PHST- 2023/01/05 00:00 [received] PHST- 2023/04/14 00:00 [revised] PHST- 2023/05/06 00:00 [accepted] PHST- 2023/07/01 11:41 [pubmed] PHST- 2023/07/01 11:41 [medline] PHST- 2023/06/30 21:55 [entrez] AID - S1550-7289(23)00522-1 [pii] AID - 10.1016/j.soard.2023.05.009 [doi] PST - ppublish SO - Surg Obes Relat Dis. 2023 Nov;19(11):1270-1280. doi: 10.1016/j.soard.2023.05.009. Epub 2023 May 23.