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Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding
Background Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RY...
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Published in: | Obesity surgery 2019-10, Vol.29 (10), p.3252-3263 |
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description | Background
Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common revision surgeries for failed LAGB, but the conclusions about their efficacy and safety have been inconsistent. This meta-analysis aimed to review the clinical outcomes of SG and RYGB after failed LAGB.
Methods
In accordance with the PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for articles that had studied the efficacy and safety of SG and RYGB. The most appropriate effects model was chosen based on the heterogeneity of the articles included in this meta-analysis. Statistical analysis was conducted using Stata 14.0.
Results
Of 586 articles that were retrieved, 16 articles which examined 2141 SG and 2990 RYGB patients met the inclusion criteria. The patients in RYGB groups showed increased percent excess weight loss (%EWL) at 12 and 24 months after revision surgery but no statistically significant change was found about %EWL after 3, 6, or 36 months. In addition, RYGB was associated with a higher rate of complications, interventions, and readmission in addition to being of more operative time.
Conclusions
This review suggested that RYGB was more effective at demonstrating weight loss after 12 and 24 months, but comparisons of the long-term efficacy of RYGB with that of SG remain inconclusive. In addition, RYGB was accompanied by a greater number of post-operative complications, interventions, and readmissions. Thus, surgeons should consider the overall status of the patients and their comorbidities as crucial factors when selecting a form of revision surgery. Additional high-quality randomized controlled studies are required to further compare the efficacy and safety of these treatments with longer follow-up times. |
doi_str_mv | 10.1007/s11695-019-03988-0 |
format | article |
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Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common revision surgeries for failed LAGB, but the conclusions about their efficacy and safety have been inconsistent. This meta-analysis aimed to review the clinical outcomes of SG and RYGB after failed LAGB.
Methods
In accordance with the PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for articles that had studied the efficacy and safety of SG and RYGB. The most appropriate effects model was chosen based on the heterogeneity of the articles included in this meta-analysis. Statistical analysis was conducted using Stata 14.0.
Results
Of 586 articles that were retrieved, 16 articles which examined 2141 SG and 2990 RYGB patients met the inclusion criteria. The patients in RYGB groups showed increased percent excess weight loss (%EWL) at 12 and 24 months after revision surgery but no statistically significant change was found about %EWL after 3, 6, or 36 months. In addition, RYGB was associated with a higher rate of complications, interventions, and readmission in addition to being of more operative time.
Conclusions
This review suggested that RYGB was more effective at demonstrating weight loss after 12 and 24 months, but comparisons of the long-term efficacy of RYGB with that of SG remain inconclusive. In addition, RYGB was accompanied by a greater number of post-operative complications, interventions, and readmissions. Thus, surgeons should consider the overall status of the patients and their comorbidities as crucial factors when selecting a form of revision surgery. Additional high-quality randomized controlled studies are required to further compare the efficacy and safety of these treatments with longer follow-up times.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-019-03988-0</identifier><identifier>PMID: 31292884</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Clinical outcomes ; Female ; Gastrectomy - adverse effects ; Gastrectomy - methods ; Gastrectomy - statistics & numerical data ; Gastric Bypass - adverse effects ; Gastric Bypass - methods ; Gastric Bypass - statistics & numerical data ; Gastrointestinal surgery ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Obesity, Morbid - surgery ; Original Contributions ; Postoperative Complications ; Reoperation - adverse effects ; Reoperation - methods ; Reoperation - statistics & numerical data ; Surgery ; Treatment Failure ; Weight Loss</subject><ispartof>Obesity surgery, 2019-10, Vol.29 (10), p.3252-3263</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Obesity Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-d9820ddb8f64b40cec0faf7d3d009a5af419c4f2ca7692bda2d680df8b675fcc3</citedby><cites>FETCH-LOGICAL-c375t-d9820ddb8f64b40cec0faf7d3d009a5af419c4f2ca7692bda2d680df8b675fcc3</cites><orcidid>0000-0003-1282-2741</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31292884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Chang</creatorcontrib><creatorcontrib>Wang, Fu-gang</creatorcontrib><creatorcontrib>Yan, Wen-Mao</creatorcontrib><creatorcontrib>Yan, Ming</creatorcontrib><creatorcontrib>Song, Mao-min</creatorcontrib><title>Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common revision surgeries for failed LAGB, but the conclusions about their efficacy and safety have been inconsistent. This meta-analysis aimed to review the clinical outcomes of SG and RYGB after failed LAGB.
Methods
In accordance with the PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for articles that had studied the efficacy and safety of SG and RYGB. The most appropriate effects model was chosen based on the heterogeneity of the articles included in this meta-analysis. Statistical analysis was conducted using Stata 14.0.
Results
Of 586 articles that were retrieved, 16 articles which examined 2141 SG and 2990 RYGB patients met the inclusion criteria. The patients in RYGB groups showed increased percent excess weight loss (%EWL) at 12 and 24 months after revision surgery but no statistically significant change was found about %EWL after 3, 6, or 36 months. In addition, RYGB was associated with a higher rate of complications, interventions, and readmission in addition to being of more operative time.
Conclusions
This review suggested that RYGB was more effective at demonstrating weight loss after 12 and 24 months, but comparisons of the long-term efficacy of RYGB with that of SG remain inconclusive. In addition, RYGB was accompanied by a greater number of post-operative complications, interventions, and readmissions. Thus, surgeons should consider the overall status of the patients and their comorbidities as crucial factors when selecting a form of revision surgery. Additional high-quality randomized controlled studies are required to further compare the efficacy and safety of these treatments with longer follow-up times.</description><subject>Adult</subject><subject>Clinical outcomes</subject><subject>Female</subject><subject>Gastrectomy - adverse effects</subject><subject>Gastrectomy - methods</subject><subject>Gastrectomy - statistics & numerical data</subject><subject>Gastric Bypass - adverse effects</subject><subject>Gastric Bypass - methods</subject><subject>Gastric Bypass - statistics & numerical data</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Postoperative Complications</subject><subject>Reoperation - adverse effects</subject><subject>Reoperation - methods</subject><subject>Reoperation - statistics & numerical data</subject><subject>Surgery</subject><subject>Treatment Failure</subject><subject>Weight Loss</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kU1r3DAQhkVoSbbb_IEcgqCXXtSOZEuWjtslSQuBQD8CORlZGgUvtrWV7ND993XqpIEeepkZmGfeGeYl5IzDBw5QfcycKyMZcMOgMFozOCIrXsFclEK_IiswCpg2ojghb3LeAQiuhDgmJwUXRmhdrkjcdu3QOtvRm2l0scdMY6DfOsQHpFc2jwndGPsDvcWUp0y_xukXuxjY3dJsHf102Nuc6SaMmOilbTv0dON3Ux5t0-ELZgffDvdvyetgu4ynT3lNflxefN9-Ztc3V1-2m2vmikqOzBstwPtGB1U2JTh0EGyofOEBjJU2lNy4MghnK2VE463wSoMPulGVDM4Va_J-0d2n-HPCPNZ9mx12nR0wTrkWQioOUpVyRt_9g-7ilIb5ukdKCil0oWZKLJRLMeeEod6ntrfpUHOoH-2oFzvq2Y76jx1zXJPzJ-mp6dH_HXn-_wwUC5Dn1nCP6WX3f2R_A7YsljQ</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Wu, Chang</creator><creator>Wang, Fu-gang</creator><creator>Yan, Wen-Mao</creator><creator>Yan, Ming</creator><creator>Song, Mao-min</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1282-2741</orcidid></search><sort><creationdate>20191001</creationdate><title>Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding</title><author>Wu, Chang ; Wang, Fu-gang ; Yan, Wen-Mao ; Yan, Ming ; Song, Mao-min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-d9820ddb8f64b40cec0faf7d3d009a5af419c4f2ca7692bda2d680df8b675fcc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Clinical outcomes</topic><topic>Female</topic><topic>Gastrectomy - adverse effects</topic><topic>Gastrectomy - methods</topic><topic>Gastrectomy - statistics & numerical data</topic><topic>Gastric Bypass - adverse effects</topic><topic>Gastric Bypass - methods</topic><topic>Gastric Bypass - statistics & numerical data</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Postoperative Complications</topic><topic>Reoperation - adverse effects</topic><topic>Reoperation - methods</topic><topic>Reoperation - statistics & numerical data</topic><topic>Surgery</topic><topic>Treatment Failure</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Chang</creatorcontrib><creatorcontrib>Wang, Fu-gang</creatorcontrib><creatorcontrib>Yan, Wen-Mao</creatorcontrib><creatorcontrib>Yan, Ming</creatorcontrib><creatorcontrib>Song, Mao-min</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Chang</au><au>Wang, Fu-gang</au><au>Yan, Wen-Mao</au><au>Yan, Ming</au><au>Song, Mao-min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>29</volume><issue>10</issue><spage>3252</spage><epage>3263</epage><pages>3252-3263</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common revision surgeries for failed LAGB, but the conclusions about their efficacy and safety have been inconsistent. This meta-analysis aimed to review the clinical outcomes of SG and RYGB after failed LAGB.
Methods
In accordance with the PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for articles that had studied the efficacy and safety of SG and RYGB. The most appropriate effects model was chosen based on the heterogeneity of the articles included in this meta-analysis. Statistical analysis was conducted using Stata 14.0.
Results
Of 586 articles that were retrieved, 16 articles which examined 2141 SG and 2990 RYGB patients met the inclusion criteria. The patients in RYGB groups showed increased percent excess weight loss (%EWL) at 12 and 24 months after revision surgery but no statistically significant change was found about %EWL after 3, 6, or 36 months. In addition, RYGB was associated with a higher rate of complications, interventions, and readmission in addition to being of more operative time.
Conclusions
This review suggested that RYGB was more effective at demonstrating weight loss after 12 and 24 months, but comparisons of the long-term efficacy of RYGB with that of SG remain inconclusive. In addition, RYGB was accompanied by a greater number of post-operative complications, interventions, and readmissions. Thus, surgeons should consider the overall status of the patients and their comorbidities as crucial factors when selecting a form of revision surgery. Additional high-quality randomized controlled studies are required to further compare the efficacy and safety of these treatments with longer follow-up times.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31292884</pmid><doi>10.1007/s11695-019-03988-0</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-1282-2741</orcidid></addata></record> |
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subjects | Adult Clinical outcomes Female Gastrectomy - adverse effects Gastrectomy - methods Gastrectomy - statistics & numerical data Gastric Bypass - adverse effects Gastric Bypass - methods Gastric Bypass - statistics & numerical data Gastrointestinal surgery Humans Male Medicine Medicine & Public Health Middle Aged Obesity Obesity, Morbid - surgery Original Contributions Postoperative Complications Reoperation - adverse effects Reoperation - methods Reoperation - statistics & numerical data Surgery Treatment Failure Weight Loss |
title | Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding |
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