Primary Versus Revisional Bariatric and Metabolic Surgery in Patients with a Body Mass Index ≥ 50 kg/m 2 -90-Day Outcomes and Risk of Perioperative Mortality.
Autor: | Abu-Abeid A; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel. adamabuabeid@gmail.com.; Division of General Surgery, Bariatric Unit, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel. adamabuabeid@gmail.com.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel. adamabuabeid@gmail.com., Dvir N; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel., Lessing Y; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Division of General Surgery, Bariatric Unit, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel., Eldar SM; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Division of General Surgery, Bariatric Unit, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel., Lahat G; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Division of General Surgery, Bariatric Unit, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel., Keidar A; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Division of General Surgery, Bariatric Unit, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel., Yuval JB; Division of General Surgery, Tel Aviv Sourasky Medical Center, 6, Weizman St., 6423906, Tel- Aviv, Israel.; Tel Aviv University, The Faculty of Medical & Health Sciences, Tel- Aviv, Israel. |
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Jazyk: | angličtina |
Zdroj: | Obesity surgery [Obes Surg] 2024 Aug; Vol. 34 (8), pp. 2872-2879. Date of Electronic Publication: 2024 Jun 15. |
DOI: | 10.1007/s11695-024-07310-5 |
Abstrakt: | Background: Bariatric and metabolic surgery (BMS) is an effective treatment for patients with severe obesity. Patients with higher body mass index (BMI) and patients undergoing revisional surgery have a higher rate of major complications. This study purpose is to evaluate perioperative outcomes of patients with BMI ≥ 50 kg/m 2 . Materials and Methods: A retrospective analysis of patients with a BMI ≥ 50 kg/m 2 undergoing BMS between 2015 and 2023 was conducted. A comparative analysis was performed between patients undergoing primary versus revisional surgery. Results: A total of 263 patients were included in the study. Primary procedures were performed in 220 patients (83.7%) and revisional procedures in 43 patients (16.3%). BMS included one anastomosis gastric bypass (n = 183), sleeve gastrectomy (n = 63), and other procedures (n = 17). Mean BMI was 54.6 with no difference between groups. There was no difference in baseline characteristics except the revisional group was older (44.8 ± 9.6 versus 39 ± 13 years; p = 0.006), had higher rates of gastroesophageal reflux disease (21% vs 7.3%; p = 0.005), and fatty liver disease (74% vs 55%; p = 0.02). There was perioperative mortality in three cases (1.1%) with no significant difference between groups. Leak rates were higher, and length of stay (LOS) was longer in the revisional group (4.6% vs 0.45%; p = 0.018 and 2.9 vs 3.7; p = 0.006, respectively). Conclusion: Revisional BMS in patients with a BMI ≥ 50 kg/m 2 is associated with increased leak rates and LOS. Mortality rate is 1.1% and is insignificantly different between groups. Further prospective and large-scale studies are needed to clarify the optimal surgical approach to patients with extreme BMI including revisional surgery. (© 2024. The Author(s).) |
Databáze: | MEDLINE |
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