Background
It is well known that bariatric surgery is effective in the long-term management of weight loss and comorbidity improvement. The frequency of revision procedures is increasing, although they are known to be less effective and are associated with complications.
Patients and methods
This study was conducted at the Gastrointestinal Surgery Center of Mansoura University, Egypt, aiming to evaluate the indications, efficacy, and safety of reoperative bariatric surgery. We retrospectively reviewed the data of all patients who underwent reoperation for a bariatric-related cause during the duration between December 2012 and October 2021. A total of 90 reoperative bariatric surgeries were done during the study period. Patients had undergone revisional surgery for either insufficient weight loss or refractory complications such as gastroesophageal reflux.
Results
When comparing insufficient weight loss group and refractory complication group r, our results showed the following finding: a significant difference was noted between the two groups regarding age, the interval between both operations, weight and BMI at both primary and redo operations, ΔBMI and % excess weight loss at reoperation, the laparoscopic approach of both primary and reoperation, postoperative hospital stay, and physical and mental quality of life. The most commonly failed primary operation was sleeve gastrectomy (SG). The most frequent primary operation in the leakage group was SG. The second most common failed primary operation was vertical band gastroplasty. Mini-gastric bypass was the most common primary operation in the malnutrition group (80%), vertical band gastroplasty was the most common primary operation in the stricture group (57%), and SG was the only primary operation in the gastroesophageal reflux group (100%).
Conclusion
Reoperative procedure should be based on the primary operation, the patient’s anatomy, the patient’s weight and comorbidities, and the experience of the surgeon.