Revisional surgery after sleeve gastrectomy

Sleeve gastrectomy is currently considered as a primary bariatric surgery. This is due to its relative simplicity and satisfactory results. As observed with other bariatric procedures, surgeons are confronted with insufficient weight loss or weight regain, insufficient resolution of metabolic disord...

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Autores principales:	O.Y. Usenko, I.M. Todurov, O.V. Perekhrestenko, O.O. Kalashnikov, S.V. Kosiukhno, O.I. Plehutsa, O.A. Potapov, O.V. Shchytov, I.V. Marievskiy
Formato:	article
Lenguaje:	EN UK
Publicado:	Danylo Halytsky Lviv National Medical University 2018
Materias:	morbid obesity, sleeve gastrectomy, revisional surgery, roux-en-y gastric bypass, weight loss failure, biliopancreatic diversion with duodenal switch Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/5315499e3a194eeea732708b21995eff
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spelling	oai:doaj.org-article:5315499e3a194eeea732708b21995eff2021-11-10T19:50:04ZRevisional surgery after sleeve gastrectomy1029-42442415-330310.25040/aml2018.02.021https://doaj.org/article/5315499e3a194eeea732708b21995eff2018-06-01T00:00:00Zhttps://amljournal.com/index.php/journal/article/view/109https://doaj.org/toc/1029-4244https://doaj.org/toc/2415-3303Sleeve gastrectomy is currently considered as a primary bariatric surgery. This is due to its relative simplicity and satisfactory results. As observed with other bariatric procedures, surgeons are confronted with insufficient weight loss or weight regain, insufficient resolution of metabolic disorders and intractable severe reflux. Aim. The aim of this study was to analyze the indications for and the outcomes of revisional surgery after sleeve gastrectomy. Material and Methods. From 2011 to 2017, 11 (5%) patients underwent revision surgery after sleeve gastrectomy procedure for insufficient weight loss and/or severe reflux. All patients with failure after primary sleeve gastrectomy underwent endoscopic and radiologic evaluation. The patients were subdivided into groups: group 1, undergoing revision as part of a two-step procedure; group 2 with failure of a primary sleeve gastrectomy (insufficient weight loss and/or severe reflux). Results and Discussion. Mean initial body mass index and excess weight were 47,7±10,1 (35-81,5) kg/m2 and 76,8±32,6 (46-169) kg, respectively, before primary sleeve gastrectomy. The mean interval between the two procedures was almost 23±9,2 months in group 1 and 43±27,4 months in group 2. The mean body mass index and % excess weight loss was 49,7±7,1 kg/m2 and 34,2±15,7 % for group 1 and 37,2±3,0 kg/m2 and 18,9±11,9% for group 2, before revisional surgery. Five patients underwent a two-step procedure because of extreme obesity in grou p 1. In group 2: three patients underwent conversion to Roux-en-Y gastric bypass for insufficient weight loss and severe reflux, and three patients underwent re-sleeve gastrectomy for insufficient weight loss and severe reflux. All reflux symptoms were resolved postoperatively without medication. The mean body mass index and % excess weight loss was 30,4±4 kg/m2 and 68,8±11,3 % for group 1 and 27,7±5,4 kg/m2 and 62,1±20,6% for group 2, respectively. The only postoperative complication observed was a staple line leakage. Revision-related mortality was 0 %. Conclusion. The revision rate was 5%. Revision of a sleeve gastrectomy is safe, feasible and effective in the short term follow-up in patients who do not achieve sufficient weight loss and in those patients who have sever reflux after the initial sleeve gastrectomy.O.Y. UsenkoI.M. TodurovO.V. PerekhrestenkoO.O. KalashnikovS.V. KosiukhnoO.I. PlehutsaO.A. PotapovO.V. ShchytovI.V. MarievskiyDanylo Halytsky Lviv National Medical Universityarticlemorbid obesity, sleeve gastrectomy, revisional surgery, roux-en-y gastric bypass, weight loss failure, biliopancreatic diversion with duodenal switchMedicine (General)R5-920ENUKActa Medica Leopoliensia, Vol 24, Iss 2, Pp 21-27 (2018)
institution	DOAJ
collection	DOAJ
language	EN UK
topic	morbid obesity, sleeve gastrectomy, revisional surgery, roux-en-y gastric bypass, weight loss failure, biliopancreatic diversion with duodenal switch Medicine (General) R5-920
spellingShingle	morbid obesity, sleeve gastrectomy, revisional surgery, roux-en-y gastric bypass, weight loss failure, biliopancreatic diversion with duodenal switch Medicine (General) R5-920 O.Y. Usenko I.M. Todurov O.V. Perekhrestenko O.O. Kalashnikov S.V. Kosiukhno O.I. Plehutsa O.A. Potapov O.V. Shchytov I.V. Marievskiy Revisional surgery after sleeve gastrectomy
description	Sleeve gastrectomy is currently considered as a primary bariatric surgery. This is due to its relative simplicity and satisfactory results. As observed with other bariatric procedures, surgeons are confronted with insufficient weight loss or weight regain, insufficient resolution of metabolic disorders and intractable severe reflux. Aim. The aim of this study was to analyze the indications for and the outcomes of revisional surgery after sleeve gastrectomy. Material and Methods. From 2011 to 2017, 11 (5%) patients underwent revision surgery after sleeve gastrectomy procedure for insufficient weight loss and/or severe reflux. All patients with failure after primary sleeve gastrectomy underwent endoscopic and radiologic evaluation. The patients were subdivided into groups: group 1, undergoing revision as part of a two-step procedure; group 2 with failure of a primary sleeve gastrectomy (insufficient weight loss and/or severe reflux). Results and Discussion. Mean initial body mass index and excess weight were 47,7±10,1 (35-81,5) kg/m2 and 76,8±32,6 (46-169) kg, respectively, before primary sleeve gastrectomy. The mean interval between the two procedures was almost 23±9,2 months in group 1 and 43±27,4 months in group 2. The mean body mass index and % excess weight loss was 49,7±7,1 kg/m2 and 34,2±15,7 % for group 1 and 37,2±3,0 kg/m2 and 18,9±11,9% for group 2, before revisional surgery. Five patients underwent a two-step procedure because of extreme obesity in grou p 1. In group 2: three patients underwent conversion to Roux-en-Y gastric bypass for insufficient weight loss and severe reflux, and three patients underwent re-sleeve gastrectomy for insufficient weight loss and severe reflux. All reflux symptoms were resolved postoperatively without medication. The mean body mass index and % excess weight loss was 30,4±4 kg/m2 and 68,8±11,3 % for group 1 and 27,7±5,4 kg/m2 and 62,1±20,6% for group 2, respectively. The only postoperative complication observed was a staple line leakage. Revision-related mortality was 0 %. Conclusion. The revision rate was 5%. Revision of a sleeve gastrectomy is safe, feasible and effective in the short term follow-up in patients who do not achieve sufficient weight loss and in those patients who have sever reflux after the initial sleeve gastrectomy.
format	article
author	O.Y. Usenko I.M. Todurov O.V. Perekhrestenko O.O. Kalashnikov S.V. Kosiukhno O.I. Plehutsa O.A. Potapov O.V. Shchytov I.V. Marievskiy
author_facet	O.Y. Usenko I.M. Todurov O.V. Perekhrestenko O.O. Kalashnikov S.V. Kosiukhno O.I. Plehutsa O.A. Potapov O.V. Shchytov I.V. Marievskiy
author_sort	O.Y. Usenko
title	Revisional surgery after sleeve gastrectomy
title_short	Revisional surgery after sleeve gastrectomy
title_full	Revisional surgery after sleeve gastrectomy
title_fullStr	Revisional surgery after sleeve gastrectomy
title_full_unstemmed	Revisional surgery after sleeve gastrectomy
title_sort	revisional surgery after sleeve gastrectomy
publisher	Danylo Halytsky Lviv National Medical University
publishDate	2018
url	https://doaj.org/article/5315499e3a194eeea732708b21995eff
work_keys_str_mv	AT oyusenko revisionalsurgeryaftersleevegastrectomy AT imtodurov revisionalsurgeryaftersleevegastrectomy AT ovperekhrestenko revisionalsurgeryaftersleevegastrectomy AT ookalashnikov revisionalsurgeryaftersleevegastrectomy AT svkosiukhno revisionalsurgeryaftersleevegastrectomy AT oiplehutsa revisionalsurgeryaftersleevegastrectomy AT oapotapov revisionalsurgeryaftersleevegastrectomy AT ovshchytov revisionalsurgeryaftersleevegastrectomy AT ivmarievskiy revisionalsurgeryaftersleevegastrectomy
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Revisional surgery after sleeve gastrectomy

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