Bronchoplastic procedures for central tumors and sleeve pneumonectomies are associated with poor survival. Careful selection of these patients, as well as of patients with impaired lung function and cardiovascular risk factors, is mandatory.

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Purpose: Dumping syndrome (DS) is an important but often underreported problem occurring after bariatric surgery. It is believed that gastric bypass procedures like Roux-en-Y Gastric By-pass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) are more likely to cause DS than the pylorus-preserving Sleeve Gastrectomy (SG). The aim of this study was to evaluate the incidence of DS in patients undergoing SG, RYGB and OAGB. Materials and Methods: A retrospective clinical study with 180 patients undergoing SG (n=50), RYGB (n=53) and OAGB (n=77) between 2016-2018 was performed. All clinical and demo-graphic data were assessed. The percentage of excess weight loss (%EWL) was used to evaluate weight reduction. 127/180 (70.6%) patients took part in an additional phone interview. The incidence of DS was evaluated using validated Sigstad Score. Results: Information about the occurrence of dumping symptoms and patient satisfaction was obtained from 127 patients. Median follow-up was 20.0±11.4 months. Significant differences between the surgical procedures were found for the duration of surgery, complications, weight loss, incidence of DS and satisfaction postoperatively. DS occurred in 15.6% after SG, 56.4% after RYGB and 42.9% after OAGB. A higher weight loss was observed in patients who experienced dumping symptoms. Conclusion: The present results show a clear superiority of SG regarding both perioperative results and incidence of DS compared to RYGB and OAGB and may impact clinicians and patients in their choice of procedure.

Background: Dumping syndrome (DS) is an important but often missed problem occurring after bariatric surgery. It is believed that gastric bypass procedures like Roux-en-Y Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) are more likely to cause DS than the pylorus-preserving Sleeve Gastrectomy (SG). The aim of this study was to evaluate the incidence of DS in patients undergoing SG, RYGB and OAGB. Methods: A retrospective clinical study with additional phone interviews of 180 morbidly obese patients (130 females; 72.2%) undergoing SG (n=50), RYGB (n=53) and OAGB (n=77) in our clinic during 2016 - 2018 was performed. Clinical and demographic data were assessed. The incidence of dumping syndrome was evaluated using validated Sigstad Score. Results: Information about the occurrence of dumping symptoms and patient satisfaction was obtained from 127 patients; 53 could not be reached by phone. Median follow-up was 20.0 ± 11.4 months. Significant differences between the surgical procedures were found for the duration of surgery, complications, incidence of DS and satisfaction postoperatively. DS occurred in 15.6% after SG, in 56.4% after RYGB and in 42.9% after OAGB. While SG showed the shortest operative time with 66.5 ± 25.3 minutes and highest patient satisfaction, the lowest complication rate was observed after OAGB with 5.2%. The RYGB group reported the longest duration of surgery with 121.0 ± 28.9 minutes, most complications (17.0%), and lowest patient satisfaction. Conclusion: The present results showed a clear superiority of SG regarding both perioperative results and incidence of DS compared to RYGB and OAGB and may impact clinicians and patients in their choice of procedure.

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