Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass to Enhance Weight Loss: Single Enterprise Mid-Term Outcomes and Literature Review.

IF 0.4 4区医学 Q4 NURSING Bariatric Surgical Practice and Patient Care Pub Date : 2022-12-01 DOI:10.1089/bari.2021.0096

Gabriel Diaz Del Gobbo, Nada Mahmoud, Juan S Barajas-Gamboa, Michael Klingler, Paola Barrios, Carlos Abril, Javed Raza, Ali Aminian, Raul J Rosenthal, Ricard Corcelles, Matthew D Kroh

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引用次数: 2

Abstract

Background: Suboptimal weight loss (SWL) occurs up to 30% after sleeve gastrectomy (SG). Conversion to Roux-en-Y gastric bypass (cRYGB) has shown heterogeneous results in terms of additional weight loss and resolution of weight-related comorbidities. We aim to evaluate mid-term outcomes of cRYGB specifically for SWL after SG.

Methods: All patients who underwent cRYGB for SWL from April 2010 to June 2019 from prospective registries at three affiliated tertiary care centers were retrospectively reviewed. Patients who underwent revision or conversion for complications were excluded. Mixed-effects and polynomial regression models were used to evaluate weight loss results after conversion.

Results: Thirty-two patients underwent cRYGB from SG. About 68.7% were women with mean age of 46.6 years. Mean body mass index (BMI) before SG was 55.3 kg/m². Before conversion, mean BMI was 44.5 kg/m² with 17.3% total weight loss (TWL). All procedures were completed laparoscopically in a median surgical time of 183 min. Three major complications occurred (9.3%), one gastrojejunal (GJ) leak and two reoperations. Four cases (12.5%) of GJ stenosis were diagnosed. No mortality was registered. Mean follow-up time was 24 months and patients had 36 kg/m² mean BMI, 17.4% TWL, 27.2% had BMI >35 kg/m².

Conclusions: cRYGB after SG for SWL showed good mid-term results, better than those reported in literature.

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套筒胃切除术转化为Roux-en-Y胃旁路术以增强体重减轻:单一企业中期结果和文献综述。

背景:袖式胃切除术(SG)后体重下降不理想(SWL)的发生率高达30%。转到Roux-en-Y胃旁路(cRYGB)在额外体重减轻和体重相关合并症的解决方面显示出不同的结果。我们的目标是评估cRYGB对SG后SWL的中期疗效。方法:回顾性分析2010年4月至2019年6月来自三个附属三级医疗中心的前瞻性登记的所有因SWL接受cRYGB的患者。因并发症而进行翻修或转换的患者被排除在外。采用混合效应和多项式回归模型评价转换后的减肥效果。结果:32例患者接受了来自SG的cRYGB。约68.7%为女性，平均年龄46.6岁。SG前平均身体质量指数(BMI)为55.3 kg/m2。转换前，平均BMI为44.5 kg/m2，总体重减轻17.3% (TWL)。所有手术均在腹腔镜下完成，平均手术时间为183分钟。发生3例主要并发症(9.3%)，1例胃空肠(GJ)漏，2例再手术。诊断为GJ狭窄4例(12.5%)。没有死亡记录。平均随访时间24个月，平均BMI为36 kg/m2, 17.4%的患者体重正常，27.2%的患者BMI >35 kg/m2。结论:SWL SG术后cRYGB中期疗效较好，优于文献报道。

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Bariatric Surgical Practice and Patient Care NURSING-

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期刊介绍： Bariatric Surgical Practice and Patient Care is the essential peer-reviewed journal delivering clinical best practices and quality updates for achieving optimal bariatric surgical outcomes. Bariatric Surgical Practice and Patient Care coverage includes: Quality outcomes measurement and reporting Process innovations and care delivery Short- and long-term surgical complications Pre-surgical diagnosis and consultation Pre-op, peri-op, and post-op standards of practice Patient access Patient safety issues Nutritional and dietary support Bariatric surgical emergencies Best practices and current standards for bariatric surgery Culture and ethics Body contouring and reconstructive surgery Bariatric teamwork and communication.