Clinically Severe Obesity, Obesity Recidivism, Weight Recidivism, Weight Regain
Conditions
Keywords
Obesity recidivism, Weight Regain, Weight recidivism, Morbidity, Complication, Late complications, Revisional gastric bypass, Re-operative gastric bypass, Revisional bariatric surgery, Re-operative bariatric surgery
Brief summary
The main aim of this study is to analyze and report traditional, patient-centered, and composite intermediate-term outcomes after laparoscopic revision Roux-en-Y gastric bypass surgery for weight recidivism.
Detailed description
There is lack of standardization of primary and revisional bariatric surgery compounded by a scant long-term outcome data. The treatment of inadequate weight loss, weight recidivism, and most severe technical complications after primary bariatric surgery remains refractory to non-operative treatment. Failure rates have been reported up to 20% and 35% for the morbidly obese (MO) and super obese (SO), respectively at 2 to 3 years after surgery. The indication for further surgical intervention remains controversial, as does what type of revisional procedure, both operative and endoscopic, to recommend. Furthermore, there is no standardization of the limb lengths, pouch size or the use of prosthetic reinforcement. Therefore the approach to these patients must be as individualized as their original operations. We formally analyze our experience with all laparoscopic revisional strategies for weigh regain after failed gastric bypass.
Interventions
None listed
Sponsors
University of California, San Francisco
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients that underwent laparoscopic revisional RYGB for failed RYGB with weight recidivism or weight regain WR pattern
Exclusion criteria
* failed RYGB with an Inadequate Initial Weight Loss IIWL pattern * patients with prior major bariatric conversion or esophago-gastric surgeries * RYGB patients revised by an open surgical approach * RYGB patients who underwent laparoscopic revisional RYGB surgery somewhere else and continue their follow-up care with our program * missing records and/or unreachable patients with scant information for analysis
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Comorbidity status | throughout follow-up |
| Health-Related Quality of Life (HR-QoL). | at the last follow-up |
| Morbidity and mortality | throughout follow-up |
| Weight loss expressed as Body Mass Index and Percentage Excess Weight Loss | At the lowest weight loss point and at last follow-up |
| Subjective Satisfaction | at last follow-up |
Secondary
| Measure | Time frame |
|---|---|
| To evaluate the patients´ metabolic and nutritional status | throughout follow-up |
| To assess failures | at yearly intervals throughout follow-up |
Countries
United States
Outcome results
None listed