• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Outcomes of Laparoscopic Roux-en-Y Gastric Bypass As a Primary Versus Revisional Bariatric Surgery.

BACKGROUND: The purpose of this study was to compare the outcomes of laparoscopic Roux-en-Y gastric bypass (LRYGB) as a primary (CG) versus revisional bariatric surgery (RBS).

METHODS: Data of 514 consecutive patients who underwent LRYGB by one surgeon between August 2004 and June 2009 as primary (n=481, 93.6%) or RBS (n=33, 6.4%) were compared. Collected data included age, body mass index (BMI), operative time (OT), length of hospital stay (LOS), conversion to open surgery, early (< 30 days), or late (> 30 days) major complications, % excess weight loss (%EWL), status of comorbidities including hypertension (HTN), diabetes (DM), gastro-esophageal reflux disease (GERD), obstructive sleep apnea (OSA) and dyslipidemia, as well as score change of SF-36 quality of life (QoL) questionnaire. Indications for RBS included inadequate weight loss (n=13), intractable GERD (n=12), weight regain (n=10), abdominal pain (n=6), intractable or perforated ulcer (n=3), and anastomotic stricture (n=1). RBS procedures included: 1) conversion to Roux-en-Y gastric bypass of jejuno-ileal bypass (n=2), adjustable gastric band (n=5), sleeve gastrectomy (n=1), vertical banded gastroplasty (n=8), Nissen fundoplication (n=4), 2) revision of gastrojejunostomy (n=8), 3) Roux limb lengthening (n=5), 4) resection of Roux limb blind loop end (n=2) and 5) revision of gastric pouch (n=1). Differences in continuous and categorical variables between groups were explored with analysis of covariance (ANCOVA) and multinomial logistic regression respectively, both models adjusting for BMI, age and gender. P < 0.05 was considered significant.

RESULTS: There was a significant difference between CG and RBS groups in relation to BMI (47.2 vs. 38.6 Kg/m2, p<.001), but not age (42.3 vs. 45.2 years, p=.137). Compared to the CG, RBS patients had significantly longer OT (337.6 vs. 224.0 min, p <0.001), LOS (3.9 vs. 2.0 days, p <0.001) and higher conversion rates (18.2% vs 0.4%, p < 0.001). Although early major morbidity was higher in RBS patients (26.9% vs 4.7%, p=.002), late major complications were similar (8% RBS vs. 5.2% CG, p=.321). At an average follow-up of 12.1 months, 95.2% of RBS patients reported improvement of symptoms related to original bariatric procedure. %EWL at 1 year was greater for the CG (57% vs. 44.3%, p <0.001). Both patient groups reported significant improvement in all co-morbidities at 1-year follow-up. Percentage improvement of HTN (91.7% vs. 88.2%), DM (88.9% vs. 95.3%), OSA (66.7% vs. 84.7%) and dyslipidemia (50% vs. 62.4%) was similar in RBS and CG respectively, whereas GERD improvement was reported more frequently in the CG (100% vs. 81%, p<.001). At 6-month follow-up RBS patients reported lower QoL scores for the physical component (44.9 vs. 52.1, p=.009), whereas QoL scores for the mental component were similar in both groups (51.2 vs 53.4, p=.077).

CONCLUSIONS: Although RBS is associated with higher conversion rates, laparoscopic approach is feasible in more than 80% of patients. RBS carries higher peri-operative risks, but long-term risks are similar to the CG. Weight loss after RBS is significantly lower compared to the CG, but long term improvement of pre-operative symptoms related to original bariatric surgery and associated co-morbidities is very likely.


Session: Podium Presentation

Program Number: S062

67

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2010 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons