Mid-long-term Revisional Surgery After Sleeve Gastrectomy: a Systematic Review and Meta-analysis

Guan, Bingsheng; Chong, Tsz Hong; Peng, Juzheng; Chen, Yanya; Wang, Cunchuan; Yang, Jingge

doi:10.1007/s11695-019-03842-3

Cited by 67 publications

(41 citation statements)

References 53 publications

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“…All these series include a relatively low number of patients, and there is no evidence to recommend one procedure over the other after the failure of SG [11,[28][29][30][31][32]. A recent meta-analysis showed a revision rate of 10.4% after SG, rising to 22.6% for patients with follow-up longer than 10 years [33]. The most common revisional procedure was RYGB, even if the results of different procedures were not compared.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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“…72,96,97 When PPIs are ineffective in relieving GERD symptoms, and RYGB is considered the optimal treatment approach in the absence of a correctable anatomic factor. 98 In Guan's statistics, 99 the pooled rate of revision due to GERD was 3.1%. For postoperative patients with uncontrolled GERD, RYGB is the procedure of choice.…”

Section: Revisional Surgeries For Complications Of Lsg Revisional Surgeries For Gerdmentioning

confidence: 99%

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Li¹,

Jiao²,

Zhang³

et al. 2021

DMSO

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Bariatric surgery has become increasingly common due to the worldwide obesity epidemic. A shift from open to laparoscopic surgery, specifically, laparoscopic sleeve gastrectomy (LSG), has occurred in the last two decades because of the low morbidity and mortality rates of LSG. Although LSG is a promising treatment option for patients with morbid obesity due to restrictive and endocrine mechanisms, it requires modifications for a subset of patients because of weight regain and tough complications, such as gastroesophageal reflux, strictures, gastric leak, and persistent metabolic syndrome., Revision surgeries have become more and more indispensable in bariatric surgery, accounting for 7.4% in 2016. Mainstream revisional bariatric surgeries after LSG include Roux-en-Y gastric bypass, repeated sleeve gastrectomy, biliopancreatic diversion, duodenal switch, duodenal-jejunal bypass, one-anastomosis gastric bypass, single anastomosis duodeno-ileal bypass (SAID) and transit bipartition. This review mainly describes the revisional surgeries of LSG, including the indication, choice of surgical method, and subsequent effect.

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“…43,44 Studies have shown that up to 28% of patients experience weight regain after SG, and 20% of patients can undergo a revision surgery. 45,46 The most frequent indications for revision are gastroesophageal reflux disease (GERD) and weight regain. 47…”

Section: Revisional Alternatives After Sleeve Gastrectomymentioning

confidence: 99%

Interventions for Weight Regain after Bariatric Surgery

Muñóz

Soto

2021

Digestive Disease Interventions

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Bariatric surgery is the most effective available treatment for obesity, inducing a significant and durable weight loss, and improving several obesity-associated diseases. However, as the number of bariatric surgeries performed increases, so does the prevalence of patients who experience either insufficient weight loss or weight regain, accompanied by relapse or the emergence of new obesity-related diseases. Endoscopic and surgical bariatric revisional procedures are used to promote weight loss and improve metabolic function to address these problems. After a psychological, nutritional, medical, and anatomical evaluation of the gastrointestinal anatomy has been completed, patient candidacy to a revisional procedure must be defined. In those patients with insufficient weight loss or weight regain associated with relapse, the emergence of new obesity-related diseases, or quality-of-life deterioration, a revisional procedure must be selected. Although current evidence comes mainly from observational and retrospective studies, with a limited number of patients and short follow-up times, the available data indicate that revisional procedures are useful to induce a significant weight loss and/or promote remission of obesity-associated diseases, albeit an increased risk of surgical and/or nutritional complications. Thus, careful selection of patients is needed to minimize risk and maximize the benefit of these procedures.

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Mid-long-term Revisional Surgery After Sleeve Gastrectomy: a Systematic Review and Meta-analysis

Cited by 67 publications

References 53 publications

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Interventions for Weight Regain after Bariatric Surgery

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