Revisional surgeries after failed restrictive bariatric operations: a meta-analysis

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Abstract

Introduction
Recently laparoscopic sleeve gastrectomy has gained increased popularity both as a primary operation for weight reduction and as a revisional procedure after failed restrictive bariatric surgery. On the contrary, the conversion to laparoscopic Roux-en-Y gastric bypass is a solution with some drawbacks such as long operative time and higher complication rates.
Aim
To find an evidence of BMI reduction and/or less surgical complications following revisional surgeries (laparoscopic Roux-en-Y gastric bypass, mini gastric bypass-one-anastomosis gastric bypass, and laparoscopic sleeve gastrectomy) after failed restrictive bariatric surgeries (vertical banded gastroplasty or laparoscopic adjustable gastric banding).
Patients and methods
A retrospective observational secondary study was performed on published research and meta-analysis for each eligible study according to inclusion and exclusion criteria.
Results
The 24-, 36-, and 48-month postoperative extra weight loss percentage was lower in sleeve gastrectomy than gastric bypasses, with overall significantly better decrease. Conversely, when comparing RYGB with mini gastric bypass at 12 months after conversion, there was more extra weight loss percentage for RYGB, with significant overall difference.
Conclusion
Our meta-analysis showed that both sleeve gastrectomy and gastric bypasses as revisional operations had no significant difference regarding postoperative leakage and major bleeding.

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