TY - JOUR
T1 - Laparoscopic Sleeve Gastrectomy Following Failed Laparoscopic Adjustable Gastric Banding—a Comparison Between One- and two-Stage Procedures, an Israeli National Database Study
AU - Perry, Zvi
AU - Romano-Zelekha, Orly
AU - Sakran, Nasser
AU - Avital, Itzhak
AU - Atias, Shahar
AU - Netz, Uri
AU - Kirshtein, Boris
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Purpose: The optimal revisional bariatric surgery procedure following a previous failed gastric band surgery is yet to be determined. The aim of our study was to compare single- and two-stage laparoscopic sleeve gastrectomy (LSG) following laparoscopic adjustable gastric banding (LAGB) in terms of short- and mid-term outcomes. Materials and Methods: Patients who underwent LSG after a failed LAGB in Israel during 2014–2017 were included. Data were obtained from the Israeli National Bariatric Surgery Registry. Data analyzed included comorbidities, postoperative complications, and anthropometric outcomes. Results: Of 595 patients included in the data analysis, 381 (64%) underwent one-stage and 214 (36%) had two-stage LSG. No differences were observed between the groups in complication rates (5.0 vs. 5.1%, p=0.93). Percent of total weight loss was lower following one-stage than two-stage procedure at both 6 months (19.3±9.3 vs. 21.5±8.1%; p=0.02) and 1 year postoperative (24.9±10.4 vs. 27.8±9.9%; p=0.02). No difference was observed in the percent excess weight loss (51 vs. 56%; p=0.34 and 66 vs. 72%; p=0.38, at 6 months and 12 months postoperative, respectively). In a regression analysis, percent excess weight loss was greater in the two-stage procedure (p=0.02), with no difference in the complication rates (p=0.98). Conclusion: Single-step LSG had a similar safety profile as two-stage LSG following a failed LAGB. Better weight loss was seen following two-stage LSG. Further prospective studies should investigate long-term follow-up after one- and two-stage procedure.
AB - Purpose: The optimal revisional bariatric surgery procedure following a previous failed gastric band surgery is yet to be determined. The aim of our study was to compare single- and two-stage laparoscopic sleeve gastrectomy (LSG) following laparoscopic adjustable gastric banding (LAGB) in terms of short- and mid-term outcomes. Materials and Methods: Patients who underwent LSG after a failed LAGB in Israel during 2014–2017 were included. Data were obtained from the Israeli National Bariatric Surgery Registry. Data analyzed included comorbidities, postoperative complications, and anthropometric outcomes. Results: Of 595 patients included in the data analysis, 381 (64%) underwent one-stage and 214 (36%) had two-stage LSG. No differences were observed between the groups in complication rates (5.0 vs. 5.1%, p=0.93). Percent of total weight loss was lower following one-stage than two-stage procedure at both 6 months (19.3±9.3 vs. 21.5±8.1%; p=0.02) and 1 year postoperative (24.9±10.4 vs. 27.8±9.9%; p=0.02). No difference was observed in the percent excess weight loss (51 vs. 56%; p=0.34 and 66 vs. 72%; p=0.38, at 6 months and 12 months postoperative, respectively). In a regression analysis, percent excess weight loss was greater in the two-stage procedure (p=0.02), with no difference in the complication rates (p=0.98). Conclusion: Single-step LSG had a similar safety profile as two-stage LSG following a failed LAGB. Better weight loss was seen following two-stage LSG. Further prospective studies should investigate long-term follow-up after one- and two-stage procedure.
KW - Laparoscopic sleeve gastrectomy (LSG)
KW - Outcomes
KW - Postoperative complications
KW - Revisional bariatric surgery
KW - Single-stage
KW - Two-stage
UR - http://www.scopus.com/inward/record.url?scp=85106133089&partnerID=8YFLogxK
U2 - 10.1007/s11695-021-05312-1
DO - 10.1007/s11695-021-05312-1
M3 - Article
C2 - 33660151
AN - SCOPUS:85106133089
SN - 0960-8923
VL - 31
SP - 2364
EP - 2372
JO - Obesity Surgery
JF - Obesity Surgery
IS - 6
ER -