[Revisional Surgery and Reoperations in Obesity and Metabolic Surgery : Data Analysis of the German Bariatric Surgery Registry 2005-2012]

Overview

Journal Chirurg

Specialty General Surgery

Date 2014 May 15

PMID 24824002

Citations 6

Authors

C Stroh

R Weiner

S Wolff

C Knoll

T Manger

Affiliations

Soon will be listed here.

Abstract

Background: Increasing numbers of interventions for obesity and metabolic surgery have led to an increase of primary bariatric operations as well as redo operations and revisional surgery after various primary bariatric procedures. Evidence-based guidelines for indications and choice of procedure for revisional surgery do not currently exist.

Aim: The spectrum of various revisional and redo operations following standard operative procedures for obesity and metabolic surgery is presented based on current data from the German bariatric surgery registry (GBSR, German nationwide survey on quality assurance in bariatric surgery) and a literature search.

Material And Methods: Since 1 January 2005, the current situation of bariatric surgery has been examined using the GBSR. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. Since 2005 a total of 24,070 primary bariatric procedures, 2070 revisional procedures and 1124 redo operations were analyzed. The study evaluated 1021 revisional and 491 redo operations after gastric banding (GB), 443 redo operations after sleeve gastrectomy (SG) and 306 revisional procedures and 10 redo operations after a Roux-en-Y gastric bypass (RYGBP).

Results: Reoperations of GB to SG were performed in 240 cases. The complication rate for GB removal and SG showed a significantly higher leakage rate for one step operations than for two step procedures of 3.3% vs. 0.0%. Conversion of GB to RYGBP was performed in 402 operations without any significant differences between one and two step approaches (1.9% vs. 2.2%). The specific complication rate in the 443 interventions in patients for conversion from SG to RYGBP was 10.8% which is higher than for primary SG (4.9%) and RYGBP (5.3%).

Conclusion: Compared with the primary surgical procedures redo operations and revisional procedures have significantly higher complication rates. The data evaluated show that strong and differentiated indications are necessary for revisional and redo operations particularly in cases of therapy or metabolic failure.

Citing Articles

Resectional One Anastomosis Gastric Bypass/Mini Gastric Bypass as a Novel Option for Revision of Restrictive Procedures: Preliminary Results.

Noun R, Slim R, Chakhtoura G, Gharios J, Chouillard E, Tohme-Noun C J Obes. 2018; 2018:4049136.

PMID: 30319821 PMC: 6167600. DOI: 10.1155/2018/4049136.

[Metabolic surgery or conservative measures as therapy of obese type 2 diabetics?].

Jahn U, Schubert T, Schlepp S, Deuber H Wien Med Wochenschr. 2016; 167(9-10):234-244.

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FROM COMPLEX EVOLVING TO SIMPLE: CURRENT REVISIONAL AND ENDOSCOPIC PROCEDURES FOLLOWING BARIATRIC SURGERY.

Zorron R, Galvao-Neto M, Campos J, Branco A, Sampaio J, Junghans T Arq Bras Cir Dig. 2016; 29Suppl 1(Suppl 1):128-133.

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[Conversional and endoscopic procedures following bariatric surgery].

Zorron R, Bothe C, Junghans T, Pratschke J, Benzing C, Krenzien F Chirurg. 2016; 87(10):857-64.

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[Anastomosis and suture insufficiency after interventions for bariatric and metabolic surgery].

Weiner S, Heidsieck T, Chiappetta S, Stier C, Weiner R Chirurg. 2015; 86(9):824-32.

PMID: 26296509 DOI: 10.1007/s00104-015-0071-3.

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