Copyright
©The Author(s) 2016.
World J Gastrointest Surg. Mar 27, 2016; 8(3): 238-245
Published online Mar 27, 2016. doi: 10.4240/wjgs.v8.i3.238
Published online Mar 27, 2016. doi: 10.4240/wjgs.v8.i3.238
Table 1 Baseline characteristics (n = 152)
Re-VBG n = 21 (13.8%) Mean ± SD | cSG n = 16 (10.5%) Mean ± SD | cRYGB n = 115 (75.7%) Mean ± SD | P value | |
Age (yr) | 42.3 ± 8.6 | 41.6 ± 11.4 | 43.0 ± 8.9 | 0.828 |
Male:female | 5:16 | 3:13 | 19:96 | 0.674 |
Body mass index before VBG (kg/m2) | 42.6 ± 5.4 | 43.6 ± 5.0 | 44.1 ± 4.9 | 0.445 |
Preoperative comorbidities | ||||
Type 2 diabetes mellitus (n) | 4 | 2 | 13 | 0.538 |
Hypertension (n) | 4 | 2 | 25 | 0.79 |
Dyslipidemia (n) | 0 | 3 | 11 | 0.111 |
Sleep apnea (n) | 1 | 1 | 2 | 0.249 |
Osteo-articular disease (n) | 5 | 0 | 9 | 0.038 |
Patients with 1 or more comorbidity | 10 | 5 | 41 | 0.512 |
Operative time (min) | 77.0 ± 39.2 | 100.6 ± 19.6 | 130.7 ± 47.3 | < 0.001 |
Length of hospital stay (d) | 3.1 ± 2.9 | 3.8 ± 2.2 | 4.1 ± 5.8 | 0.761 |
Interval between VBG and revision (mo) | 12.3 ± 10.7 | 30.7 ± 26.5 | 47.8 ± 34.8 | < 0.001 |
Average %EWL after VBG (%) | 61.7 ± 27.0 | 38.7 ± 22.9 | 43.5 ± 25.0 | 0.007 |
Table 2 Complaints before revision (n = 152)
Re-VBG n = 21 (n) | cSG n = 16 (n) | cRYGB n = 115 (n) | Total (%) | P value | |
Vomiting/ dysphagia/food intolerance | 17 | 8 | 36 | 40.2 | < 0.001 |
Weight regain | 1 | 4 | 42 | 30.8 | 0.007 |
Insufficient weight loss | 3 | 4 | 25 | 21.1 | 0.665 |
Unknown | 0 | 0 | 6 | 3.9 | 0.792 |
Severe GERD | 0 | 0 | 4 | 2.6 | 1.000 |
Decline comorbidities | 0 | 0 | 1 | 0.7 | 1.000 |
Excessive weight loss | 0 | 0 | 1 | 0.7 | 1.000 |
Table 3 Results after primary revision at last follow-up (n = 152)
Re-VBG n = 21 Mean ± SD | cSG n = 16 Mean ± SD | cRYGB n = 115 Mean ± SD | Corrected P value | |||
Re-VBGvscSG | cRYGB vs Re-VBG | cRYGBvscSG | ||||
Follow-up (mo) | 39.1 ± 48.7 | 49.3 ± 17.6 | 50.0 ± 33.3 | |||
Average %EWL after VBG (%) | 61.7 ± 27.0 | 38.7 ± 22.9 | 43.5 ± 25.0 | |||
Additional %EWL | -14.6 ± 19.9 | 17.9 ± 32.7 | ||||
Total %EWL (%) | 45.4 ± 25.5 | 56.6 ± 24.4 | 71.7 ± 23.8 | 0.614 | 0.006 | 0.025 |
Total body weight loss (%) | 18.4 ± 11.1 | 24.1 ± 11.6 | 30.4 ± 10.1 | 0.049 | < 0.001 | 0.016 |
Change body mass index (kg/m2) | 8.1 ± 5.8 | 10.8 ± 5.8 | 13.5 ± 5.1 | 0.119 | < 0.001 | 0.042 |
Reinhold (%EWL > 50%) (%) | 47.6 | 56.3 | 82.6 | 0.7911 (0.211; 2.972) | 0.3421 (0.125; 0.934) | 0.2711 (0.090; 0.812) |
Long-term complications (%) | 61.9 | 62.5 | 15.7 | 0.8331 (0.214; 3.244) | 10.1051 (3.600; 28.367) | 8.4211 (2.733; 25.950) |
2nd revisional procedure (n, %) | 10 (47.6%) | 5 (31.3%) | 1 (0.9%) | NA | NA | NA |
Improvement/ resolution in patients with 1 or more comorbidities (%) | 80 (8/10) | 60 (3/5) | 92.7 (38/41) | 0.3751 (0.081; 1.738) | 1.2471 (0.476; 3.265) | 0.4681 (0.126; 1.740) |
Table 4 Long-term complaints after revision (n = 152)
Re-VBG n = 21 (n) | cSG n = 16 (n) | cRYGB n = 115 (n) | Total (%) | |
Vomiting/dysphagia/ food intolerance | 4 | 4 | 6 | 9.2 |
Weight regain | 6 | 4 | 4 | 9.2 |
Insufficient weight loss | 2 | 1 | 0 | 2.0 |
Petersen’s hernia | NA | NA | 4 | 2.6 |
Incisional hernia | 0 | 0 | 3 | 2.0 |
Recurrent abdominal pain | 1 | 1 | 1 | 2.0 |
None | 8 | 6 | 97 | 73.0 |
Table 5 Subgroup analysis (n = 152) (weight regain/insufficient weight loss vs other complaints)
WR/IWL n = 79 Mean ± SD | Other n = 73 Mean ± SD | P value | |
Age (yr) | 41.6 ± 7.4 | 43.9 ± 10.7 | 0.121 |
Male:female (n) | 13:66 | 14:59 | 0.661 |
Body mass index before VBG (kg/m2) | 44.7 ± 5.0 | 42.8 ± 4.8 | 0.016 |
Operative time (min) | 128.2 ± 46.3 | 109.7 ± 48.6 | 0.02 |
Length of hospital stay (d) | 4.3 ± 6.8 | 3.4 ± 2.0 | 0.858 |
Type of revision | |||
Re-VBG | 4 | 17 | 0.004 |
cSG | 8 | 8 | |
cRYGB | 67 | 48 | |
Average %EWL after VBG (%) | 31.3 ± 19.0 | 61.2 ± 23.1 | < 0.001 |
Postoperative complications < 30 d (n, %) | 12 (15.2%) | 6 (8.2%) | 0.184 |
Total %EWL (%) | 67.5 ± 23.7 | 65.2 ± 28.1 | 0.583 |
Reinhold (%EWL > 50%) (%) | 79.7 | 74 | 0.398 |
Long-term complications (%) | 22.8 | 28.8 | 0.399 |
2nd revisional procedure (n) | 5 | 11 | 0.079 |
Improvement/resolution rate (%, n) | |||
Type 2 diabetes mellitus | 90 (9/10) | 55.6 (5/9) | NA |
Hypertension | 76.9 (10/13) | 44.4 (8/18) | NA |
Dyslipidemia | 100 (9/9) | 100 (5/5) | NA |
Sleep apnea | 0 (0/1) | 66.7 (2/3) | NA |
Osteo-articular disease | 57.1 (4/7) | 57.1 (4/7) | NA |
- Citation: van Wezenbeek MR, Smulders FJF, de Zoete JPJGM, Luyer MD, van Montfort G, Nienhuijs SW. Long-term results after revisions of failed primary vertical banded gastroplasty. World J Gastrointest Surg 2016; 8(3): 238-245
- URL: https://www.wjgnet.com/1948-9366/full/v8/i3/238.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v8.i3.238