Analysis of the risk factors for perioperative morbidity after laparoscopic revisional bariatric procedures: results from the multicenter Polish Revision Obesity Surgery Study.

Autor:	Wysocki M; Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Cracow, Poland., Łabul M; Department of General Surgery, Specialist Hospital, Legnica, Poland., Małczak P; Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland. Electronic address: pmmalczak@gmail.com., Proczko-Stepaniak M; Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland., Szymański M; Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland., Hady HR; First Department of General and Endocrinological Surgery, Medical University of Bialystok, Bialystok, Poland., Głuszyńska P; First Department of General and Endocrinological Surgery, Medical University of Bialystok, Bialystok, Poland., Myśliwiec P; First Department of General and Endocrinological Surgery, Medical University of Bialystok, Bialystok, Poland., Walędziak M; Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland., Zarzycki P; Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland., Rymarowicz J; Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland., Pędziwiatr M; Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland., Pisarska-Adamczyk M; Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland., Major P; Second Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2023 Jan; Vol. 19 (1), pp. 68-75. Date of Electronic Publication: 2022 Aug 25.
DOI:	10.1016/j.soard.2022.08.011
Abstrakt:	Background: The growing number of primary bariatric operations has led to an increase in demand for revision surgeries. Higher numbers of revisional operations are also observed in Poland, yet their safety and efficacy remain controversial because of a lack of current recommendations and guidelines. Objective: To review risk factors influencing perioperative morbidity. Methods: A retrospective study was conducted to analyze the results of surgical treatment among 12 Polish bariatric centers. Inclusion criteria were laparoscopic revisional bariatric surgeries and patients ≥18 years of age. The study included 795 patients, of whom 621 were female; the mean age was 47 years (range: 40-55 years). Results: Perioperative morbidity occurred in 92 patients (11.6%) enrolled in the study, including 76 women (82.6%). The median age was 45 years (range: 39-54 years). Statistically significant risk factors in univariate logistic regression models for perioperative complications were the duration of obesity, revisional surgery after Roux-en-Y gastric bypass (RYGB) or adjustable gastric band (AGB), difference in body mass index before revisional surgery and the lowest achieved after primary surgery, and postoperative morbidity of the primary surgery as the cause for revisional bariatric surgery. These factors were included in the multivariate regression model. Revisional surgery after AGB (odds ratio [OR] = 2.18; 95% confidence interval [CI]: 1.28-3.69; P = .004), revisional surgery performed after RYGB (OR = 6.52; 95% CI: 1.98-21.49; P = .002), and revisions due to complication of the primary surgery (OR = 1.89; 95% CI: 1.06-3.34; P = .030) remained independent risk factors for perioperative morbidity. Conclusion: Revisional operations after RYGB or AGB and those performed because of postoperative morbidity after primary surgery as the main cause for revisional surgery were associated with a significantly increased risk of postoperative morbidity. (Copyright © 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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