Re-sleeve gastrectomy is a safe and sensible intervention in selected patients - retrospective cohort study

Abstract

Introduction: Sleeve gastrectomy (SG) is a good treatment intervention to control metabolic syndrome in patients with obesity worldwide. However, weight regain is of great concern and would usually necessitate a re-intervention. In recent years, re-sleeve gastrectomy (ReSG) has been proposed to treat weight regain in the context of a large residual stomach. Our objective was to analyze the long-term results and safety profile of this intervention in a large case series. Methods: From September 2010 to March 2021, a retrospective cohort study in a tertiary non-university hospital was performed. Seventy-nine patients received a ReSG by laparoscopy. Pre-operative radiologic imaging showed a dilation of the gastric pouch exceeding 250 cc in all cases. Results: A total of seventy-nine patients (87% females) with a mean age of 44.8 years old and a mean Body Mass Index (BMI) of 40.0 kg/m2 were enrolled in the study. The mean follow-up was 44.8 months. The ReSG indication was insufficient weight loss in 37 patients (46.8%) and weight regain in 39 patients (53.2%). We noticed a 10.1% complications rate: gastric stenosis (5.1%), bleeding (2.5%), and incisional site hernia in 2.5%, with no death. There was no gastric fistula detected. The mean BMI decreased to 33.1 kg/m2 after ReSG (a decrease of 6.9 kg/m2). Conclusion: After insufficient weight loss or weight regain following sleeve gastrectomy and in presence of localized or global gastric tube dilation, ReSG seems to be a good treatment choice and a safe procedure.