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Master Thesis

Résultats à très long terme du Roux-en-Y gastric bypass primaire comparé au Roux-en-Y gastric bypass secondaire après anneau gastrique et intervention de Mason-McLean

Abstract : Purpose: The aim of the study is to compare the outcomes of patients treated with secondary Roux-en-Y gastric bypass (RYGB) after adjustable gastric banding (AGB) or vertical banded gastroplasty (VBG) with those of patients having primary RYGB.
Materials and Methods: Patients undergoing secondary RYGB after AGB or VBG between 1997 and 2004 with a minimal follow-up of 15 years were matched using a propensity score (according to gender, age, BMI, duration of follow-up) with comparable patients who underwent primary RYGB.
Results: The mean follow-up was 16.50 years in the secondary RYGB group (N = 32) versus 16.33 years in the primary RYGB group (N = 32). Early postoperative complications rate was 6.25% in the secondary RYGBs versus 9.38% in the primary RYGBs (P = 1). Late postoperative complications and additional surgical procedures were 56.25% and 37.5% in the secondary and primary RYGB group, respectively (P = 0.21). Long-term (at 16–20 years) %TWL and %EWL were significantly lower (P < 0.01 and P = 0.013, respectively) after secondary RYGB (%TWL = 7.56%; %EWL = 17.15%) than after primary RYGB (%TWL = 24.51%; %EWL = 55.61%). Remission of obesity-related comorbidities was comparable (P > 0.05). Gastroesophageal reflux was more frequent after secondary RGYB—43.75% versus 25%, P < 0.05. Quality of life— Morehead-Ardelt II score (0.02 in secondary RYGB versus 0.69 in primary RYGB, P = 0.13), general self-assessment of health status and weight satisfaction were comparable.
Conclusion: Secondary RYGB after AGB or VBG is less efficient at weight loss, GERD remission and energy expenditure at 15 years after conversion. However, it is as effective for improvement/resolution of obesity-related comorbidities and is associated with similar QoL scores.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03111892
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Submitted on : Friday, January 15, 2021 - 5:15:25 PM
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Jean-Hubert Etienne. Résultats à très long terme du Roux-en-Y gastric bypass primaire comparé au Roux-en-Y gastric bypass secondaire après anneau gastrique et intervention de Mason-McLean. Médecine humaine et pathologie. 2020. ⟨dumas-03111892⟩

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