Malinka T, et al. – Authors here evaluated weight and comorbidity outcomes comparing revisional laparoscopic Roux–en–Y gastric bypass (rLRYGB) with primary LRYGB (pLRYGB). Observations suggested rLRYGB as a feasible and practical surgical approach that allowed effective weight loss at 3 years of follow–up and alleviated refractory reflux symptoms. Although lower weight loss was observed compared to pLRYGB, resolution or improvement of coexisting comorbidities appeared similar. Therefore, for addressing failure after laparoscopic sleeve gastrectomy (LSG), rLRYGB seemed a reliable procedure.

Methods

• Authors conducted a retrospective single–centre case–matched analysis at a bariatric tertiary referral centre.
• 239 patients were entered into a prospective database from January 2009 to July 2013; 32 patients undergoing rLRYGB (cases) were matched with 32 patients undergoing pLRYGB (controls) for sex, age and BMI.
• Data obtained at 3 years of follow–up was observed as the end point.
• During the study period, thirty–one patients (12.9%) were lost to follow–up.

Results

• Observations revealed no marked differences in patient demographics or median BMI (kg/m²) for pLRYGB or rLRYGB (42.8 ± 12.1 vs. 42.3 ± 11.5, respectively; p = 0.748).
• Both the groups were similar regarding coexisting comorbidities rates.
• At 3 years, higher percentage of excess weight loss (74.4 ± 23.3 vs 52.0 ± 26, respectively; p = 0.007) was observed for pLRYGB than rLRYGB, while there appeared similar improvements in coexisting comorbidities.