By-pass gastrique de révision : une opportunité chirurgicale sûre ? : résultats d'une étude cas-témoins

Abstract : Objectives: to evaluate the safety and efficacy of revisional RYGB after AGB or SG compared with primary RYGB, in regards to early and late morbidity, weight, and resolution of obesity related comorbidities. Methods: the group of patients undergoing revisional RYGB was matched in a 1:1 ratio with control patient who underwent a primary RYGB, based on age, gender, ASA score, preoperative body mass index (BMI), and diabetes mellitus. Demographics, anthropometrics, pre-operative work-up and perioperative data were retrieved. Results: 115 patients (16 males and 99 females) with a mean age of 45.5 +/- 1.5 years underwent revisional RYBG following either LAGB in 82 patients (71.3%) or LSG in 33 patients (28.7%). There was no conversion and no mortality in either group. Revisional RYBG was associated with similar early (16.5 v 15.6%, ns) and late (42.6% vs 32.2%, ns) morbidity rates with a mean follow-up of 25.3 +/- 16.6 months compared to primary LRYGB. Revisional RYGB group had significantly less weight loss (mean %EWL 67.4 +/- 20.7 vs 72.7 +/- 22.9, p=0.023; and mean %EBMI 68.1 +/- 22 vs 78.3 +/- 25.7; p = 0.01) at the time of at one year. Improvement of comorbidities including hypertension (62.5 vs 70.5%; p>0.05), diabetes (73.7 vs 79%; p>0.05), and OSAS (100 vs 97%; p>0.05) was similar. Conclusion: this large case-matched study suggests that conversion of SG or AGB to RYGB is feasible with early and late comparable morbidity in accredited center, even weight results might be inferior.
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VALLOIS Antoine Chirurgie Gé...
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Antoine Vallois. By-pass gastrique de révision : une opportunité chirurgicale sûre ? : résultats d'une étude cas-témoins. Médecine humaine et pathologie. 2018. ⟨dumas-02103075⟩

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