Gastric Pouch Resizing for Recurrent Weight Gain After Roux-en-Y Gastric Bypass-Does It Have Its Rational?

Autor: Hehl SJ; Department of Visceral and Transplant Surgery, Swiss HPB Center, University Hospital Zurich, 8091, Zurich, Switzerland. stefanie-hehl@gmx.ch.; Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. stefanie-hehl@gmx.ch., Birrer DL; Department of Visceral and Transplant Surgery, Swiss HPB Center, University Hospital Zurich, 8091, Zurich, Switzerland., Hauser R; Faculty of Medicine, University of Zurich, 8091, Zurich, Switzerland., Gero D; Department of Visceral and Transplant Surgery, Swiss HPB Center, University Hospital Zurich, 8091, Zurich, Switzerland., Thalheimer A; Department of Visceral and Transplant Surgery, Swiss HPB Center, University Hospital Zurich, 8091, Zurich, Switzerland.; Department of Surgery, Männedorf Hospital, 8708, Männedorf, Switzerland., Bueter M; Department of Visceral and Transplant Surgery, Swiss HPB Center, University Hospital Zurich, 8091, Zurich, Switzerland.; Department of Surgery, Männedorf Hospital, 8708, Männedorf, Switzerland., Widmer J; Department of Visceral and Transplant Surgery, Swiss HPB Center, University Hospital Zurich, 8091, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2024 Nov 12. Date of Electronic Publication: 2024 Nov 12.
DOI: 10.1007/s11695-024-07581-y
Abstrakt: Introduction: The most effective treatment for obesity and associated comorbidities is metabolic-bariatric surgery (MBS). Nevertheless, recurrent weight gain is reported in up to 40% of patients after Roux-en-Y gastric bypass (RYGB), eventually with a recurrence of obesity-associated comorbidities. Gastric pouch resizing (GPR) is performed as a low-risk secondary surgery to cease weight regain. We herewith analyzed the effect of GPR after primary RYGB on long-term weight loss, course of comorbidities, safety, and patient satisfaction.
Methods: Forty-eight patients undergoing GPR between 2016 and 2020 at the University Hospital of Zurich were included. Data were collected from a prospective database. GPR was performed laparoscopically and included a resection of the enlarged gastric pouch and a redo of the gastrojejunostomy. Additionally, 37 patients participated in a survey to evaluate PROMs (patient-reported outcome measures).
Results: GPR followed RYGB after a mean time of 106.2 ± 45.5 months at a mean BMI of 39 ± 5.4 kg/m 2 . Mean follow-up was 55.9 ± 18.5 months with a mean BMI 1- and 5-years postoperative of 37 ± 5.5 kg/m 2 and 35 ± 7.5 kg/m 2 , respectively. Obesity-associated comorbidities were resolved in 53% of patients at follow-up (p < 0.05). Minor postoperative complications occurred in 12.5% while major complications occurred in 10.4% of patients. The PROMs showed high levels of satisfaction after GPR.
Conclusion: GPR for recurrent weight gain after primary RYGB is a safe procedure resulting in weight stabilization and resolution of obesity-associated comorbidities. It is thus a valuable surgical option in well-selected patients.
Competing Interests: Declarations Ethical Approval The institutional review board (IRB) of the Canton Zurich, Switzerland, approved the study (BASEC-Nr.2020–02584). Informed consent was obtained from all individual participants included in the study. Patient data were anonymized and de-identified prior to analysis. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed Consent Informed consent was obtained from all individual participants included in the study. Competing Interest The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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