Roux-en-Y Gastric Bypass Versus One Anastomosis Gastric Bypass as a Preferred Revisional Bariatric Surgery After a Faile
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ORIGINAL CONTRIBUTIONS
Roux-en-Y Gastric Bypass Versus One Anastomosis Gastric Bypass as a Preferred Revisional Bariatric Surgery After a Failed Silastic Ring Vertical Gastroplasty Nadav Nevo 1 & Yonatan Lessing 1 & Subhi Abu-Abeid 1,2 & Adam Lee Goldstein 1 & David Hazzan 3 & Ido Nachmany 1 & Shai Meron Eldar 1,2 Received: 17 June 2020 / Revised: 7 September 2020 / Accepted: 10 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Over the years, the silastic ring vertical gastroplasty (SRVG) has shown poor long-term outcomes with both weight regain and complications. Therefore, most bariatric surgeons have been presented with the need to perform a successful and safe conversion procedure. Yet the preferred and recommended conversion surgery regarding weight loss, comorbidity improvement, and postoperative complications remains under debate. Objective The aim of this study is to compare the outcomes of conversion from SRVG with either Roux-en-Y gastric bypass (RYGBP) or one anastomosis gastric bypass (OAGB). Materials and Methods A retrospective study was conducted from our bariatric surgery units’ database. We reviewed the files of patients who underwent either a RYGBP or OAGB after a previous SRVG. Demographics, obesity-related comorbidities, BMI before and after the procedure, postoperative complications, and length of hospital stay were analyzed. Results Between May 2008 and August 2018, fifty-four patients underwent conversion from a failed SRVG. Twenty-one patients underwent conversion to OAGB (39%), and thirty-three patients underwent conversion to RYGBP (61%). Major complications were reported in 9.5% of the OAGB group and 15.1% of the RYGBP group. At a mean follow-up of 28 months, the OAGB group achieved a 78.5% excess BMI loss compared with 57.6% in the RYGBP group (p = 0.137). One patient (4.7%) of the OGBP group and 5 (15.1%) of the RYGBP group needed reoperations due to complications (p = 0.224). Conclusion The OGBP is gaining popularity and evidence as an effective and safe procedure. Here we show the successful utilization of the OGBP, when compared with RYGBP, as a revisional procedure after SRVG. Keywords Bariatric surgery . Sleeve gastrectomy . Elderly
Dr. Yonatan Lessing have contributed equally to this work * Nadav Nevo [email protected] Yonatan Lessing [email protected]
Shai Meron Eldar [email protected]
1
Department of General Surgery, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
2
Bariatric Surgery Unit, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3
General Surgery Department C, Sheba Medical Center, Ramat Gan, Israel
Subhi Abu-Abeid [email protected] Adam Lee Goldstein [email protected] David Hazzan [email protected] Ido Nachmany [email protected]
OBES SURG
Introduction Numerous popular bariatric procedures in the past have failed the test of time. Currently,
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