Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome?
After a failed laparoscopic adjustable gastric band (LAGB), laparoscopic sleeve gastrectomy (LSG) has been proposed as revisional surgery. Those patients that receive a second restrictive procedure fall into a small subgroup of patients with more than one restrictive procedure (MRP). If also the sec...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/1/293 |
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| author | Federico Sista Sergio Carandina Antoine Soprani Emmanuel Rivkine Laura Montana Fabiana Fiasca Sonia Cappelli Antonella Grasso Marius Nedelcu Irene Tucceri Cimini Marco Clementi |
| author_facet | Federico Sista Sergio Carandina Antoine Soprani Emmanuel Rivkine Laura Montana Fabiana Fiasca Sonia Cappelli Antonella Grasso Marius Nedelcu Irene Tucceri Cimini Marco Clementi |
| author_sort | Federico Sista |
| collection | DOAJ |
| description | After a failed laparoscopic adjustable gastric band (LAGB), laparoscopic sleeve gastrectomy (LSG) has been proposed as revisional surgery. Those patients that receive a second restrictive procedure fall into a small subgroup of patients with more than one restrictive procedure (MRP). If also the second restrictive procedure fails, the correct surgical strategy is a challenge for the surgeon. Roux-en-Y gastric bypass (RYGB) may be an option but there is no evidence in the literature on whether the procedure is effective in treating failures after MRP. This study aims to evaluate the influence of the previous number of restrictive interventions (MRP vs single LSG) in the results of RYGB as revisional surgery. We have retrospectively analyzed patients who underwent conversion from laparoscopic sleeve gastrectomy (LSG), or from multiple restrictive procedures (MRP), to RYGB for weight regain (WR) or insufficient weight loss (IWL) between 2009 and 2019. The number of patients analyzed was 69 with conversion to RYGB after LSG and 44 after MRP. The reduction of excess weight (%TWL) at 3, 6, 12, 24 RYGB postoperative months was respectively of 11.03%, 16.39%, 21.43%, and 24.22% in the MRP group, and of 10.97%, 16.4%, 21.22%, and 22.71% in the LSG group. No significant difference was found in %TWL terms after RYGB for the MRP group and the LSG group with an overall %TWL, which was 11.00 ± 6.03, 16.40 ± 8.08, 21.30 ± 9.43, and 23.30 ± 9.91 respectively at 3, 6, 12, and 24 months. The linear regression model highlighted a positive relationship between the %EWL post-bypass at 24 months and the time elapsed only between the LSG and RYGB in the MRP group patients (<i>p</i> < 0.001). RYGB has proved to be a reliable technique with good results in terms of weight loss after failed bariatric surgery both in patients who previously underwent MRP and in those who underwent exclusively LSG. RYGB showed better results in patients who experienced WR than in those who had IWL from previous techniques. |
| first_indexed | 2024-03-08T15:03:31Z |
| format | Article |
| id | doaj.art-8c808a69db4b4be4b6ec1c4869283e6d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T15:03:31Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8c808a69db4b4be4b6ec1c4869283e6d2024-01-10T15:02:00ZengMDPI AGJournal of Clinical Medicine2077-03832024-01-0113129310.3390/jcm13010293Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome?Federico Sista0Sergio Carandina1Antoine Soprani2Emmanuel Rivkine3Laura Montana4Fabiana Fiasca5Sonia Cappelli6Antonella Grasso7Marius Nedelcu8Irene Tucceri Cimini9Marco Clementi10Hepatic Pancreatic and Biliary Surgical Unit, San Salvatore Hospital, Department of Biothecnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyELSAN, Clinique Saint Michel, Centre de Chirurgie de l’Obésité (CCO), 83100 Toulon, FranceClinique Geoffroy-Saint Hilaire, Générale de Santé (GDS), Department of Digestive and Bariatric Surgery, 75005 Paris, FranceDepartment of Digestive and Bariatric Surgery, Centre Hospitalier Universitaire de Martinique, 97261 Fort-de-France, FranceDepartment of Digestive and Metabolic Surgery, Groupe Hospitalier Diaconesses Croix Saint-Simon, 75012 Paris, FrancePublic Health Unit, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyDepartment of Surgery, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyGeneral Surgical Unit, San Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyELSAN, Clinique Saint Michel, Centre de Chirurgie de l’Obésité (CCO), 83100 Toulon, FranceGeneral Surgical Unit, San Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyGeneral Surgical Unit, San Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, ItalyAfter a failed laparoscopic adjustable gastric band (LAGB), laparoscopic sleeve gastrectomy (LSG) has been proposed as revisional surgery. Those patients that receive a second restrictive procedure fall into a small subgroup of patients with more than one restrictive procedure (MRP). If also the second restrictive procedure fails, the correct surgical strategy is a challenge for the surgeon. Roux-en-Y gastric bypass (RYGB) may be an option but there is no evidence in the literature on whether the procedure is effective in treating failures after MRP. This study aims to evaluate the influence of the previous number of restrictive interventions (MRP vs single LSG) in the results of RYGB as revisional surgery. We have retrospectively analyzed patients who underwent conversion from laparoscopic sleeve gastrectomy (LSG), or from multiple restrictive procedures (MRP), to RYGB for weight regain (WR) or insufficient weight loss (IWL) between 2009 and 2019. The number of patients analyzed was 69 with conversion to RYGB after LSG and 44 after MRP. The reduction of excess weight (%TWL) at 3, 6, 12, 24 RYGB postoperative months was respectively of 11.03%, 16.39%, 21.43%, and 24.22% in the MRP group, and of 10.97%, 16.4%, 21.22%, and 22.71% in the LSG group. No significant difference was found in %TWL terms after RYGB for the MRP group and the LSG group with an overall %TWL, which was 11.00 ± 6.03, 16.40 ± 8.08, 21.30 ± 9.43, and 23.30 ± 9.91 respectively at 3, 6, 12, and 24 months. The linear regression model highlighted a positive relationship between the %EWL post-bypass at 24 months and the time elapsed only between the LSG and RYGB in the MRP group patients (<i>p</i> < 0.001). RYGB has proved to be a reliable technique with good results in terms of weight loss after failed bariatric surgery both in patients who previously underwent MRP and in those who underwent exclusively LSG. RYGB showed better results in patients who experienced WR than in those who had IWL from previous techniques.https://www.mdpi.com/2077-0383/13/1/293obesitysleeve gastrectomymultiple restrictive proceduresRoux-en-Y gastric bypassbariatric surgery |
| spellingShingle | Federico Sista Sergio Carandina Antoine Soprani Emmanuel Rivkine Laura Montana Fabiana Fiasca Sonia Cappelli Antonella Grasso Marius Nedelcu Irene Tucceri Cimini Marco Clementi Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome? Journal of Clinical Medicine obesity sleeve gastrectomy multiple restrictive procedures Roux-en-Y gastric bypass bariatric surgery |
| title | Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome? |
| title_full | Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome? |
| title_fullStr | Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome? |
| title_full_unstemmed | Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome? |
| title_short | Roux-en-Y Gastric Bypass after Laparoscopic Sleeve Gastrectomy Failure: Could the Number of Previous Operations Influence the Outcome? |
| title_sort | roux en y gastric bypass after laparoscopic sleeve gastrectomy failure could the number of previous operations influence the outcome |
| topic | obesity sleeve gastrectomy multiple restrictive procedures Roux-en-Y gastric bypass bariatric surgery |
| url | https://www.mdpi.com/2077-0383/13/1/293 |
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