Format

Send to

Choose Destination
Surg Obes Relat Dis. 2018 Apr;14(4):500-507. doi: 10.1016/j.soard.2017.12.019. Epub 2017 Dec 29.

Rate of revisions or conversion after bariatric surgery over 10 years in the state of New York.

Author information

1
Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: maria.altieri@stonybrookmedicine.edu.
2
Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, New York.
3
Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, New York.
4
Department of Surgery, Banner-University Medical Center, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.
5
Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Abstract

BACKGROUND:

A primary measure of the success of a procedure is the whether or not additional surgery may be necessary. Multi-institutional studies regarding the need for reoperation after bariatric surgery are scarce.

OBJECTIVES:

The purpose of this study is to evaluate the rate of revisions/conversions (RC) after 3 common bariatric procedures over 10 years in the state of New York.

SETTING:

University Hospital, involving a large database in New York State.

METHODS:

The Statewide Planning and Research Cooperative System database was used to identify all patients undergoing laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) between 2004 and 2010. Patients were followed for RC to other bariatric procedures for at least 4 years (up to 2014). Multivariable cox proportional hazard regression analysis was performed to identify risk factors for additional surgery after each common bariatric procedure. Multivariable logistic regression was used to check the factors associated with having ≥2 follow-up procedures.

RESULTS:

There were 40,994 bariatric procedures with 16,444 LAGB, 22,769 RYGB, and 1781 SG. Rate of RC was 26.0% for LAGB, 9.8% for SG, and 4.9% for RYGB. Multiple RC ( = />2) were more common for LAGB (5.7% for LAGB, .5% for RYGB, and .2% for LSG). Band revision/replacements required further procedures compared with patients who underwent conversion to RYGB/SG (939 compared with 48 procedures). Majority of RC were not performed at initial institution (68.2% of LAGB patients, 75.9% for RYGB, 63.7% of SG). Risk factors for multiple procedures included surgery type, as LAGB was more likely to have multiple RC.

CONCLUSIONS:

Reoperation was common for LAGB, but less common for RYGB (4.9%) and SG (9.8%). RC rate are almost twice after SG than after RYGB. LAGB had the highest rate (5.7%) of multiple reoperations. Conversion was the procedure of choice after a failed LAGB.

KEYWORDS:

Bariatric revisions

PMID:
29496440
DOI:
10.1016/j.soard.2017.12.019
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center