Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania 17033, USA.
Surg Obes Relat Dis. 2010 Nov-Dec;6(6):635-42. doi: 10.1016/j.soard.2010.04.005. Epub 2010 May 4.
Revisional bariatric surgery (RBS) outcomes have been poorly characterized. We compared the RBS and primary bariatric surgery (PBS) outcomes at the Penn State Milton S. Hershey Medical Center in the United States.
A total of 72 RBS cases from 2000 to 2007 were reviewed and grouped by indication: failure of weight loss, gastrojejunal complications, or other. The RBS patients were compared with the 856 PBS patients who underwent Roux-en-Y gastric bypass. The mean follow-up time was 12.6 ± 1.2 months for the RBS group and 16 ± 0.5 months for the PBS group. Weight loss was analyzed as the kilograms lost and patients with ≥ 50% excess body weight loss (EBWL). Outcomes included mortality, leaks, surgical site infections, and length of stay.
The weight loss was 23 ± 2.8 kg after RBS and 41.3 ± 0.7 kg after PBS (P <.05 versus PBS). The post-RBS weight loss varied by surgical indication: failure of weight loss, 27.1 ± 2 kg; gastrojejunal complications, 8.7 ± 3.4 kg; and other 23.5 ± 10.6 kg. Also, 29% of the RBS patients had ≥ 50% excess body weight loss (versus the prerevision weight) and 61% (versus the initial weight) compared with 52.7% after PBS. Only age ≤ 50 years was associated with ≥ 50% excess body weight loss after RBS for the failure of weight loss group. No RBS patients died. However, leaks, surgical site infections, and length of stay were increased after RBS.
The results of our study have shown that weight loss after RBS varies with the surgical indication and is affected by age >50 years. Although the RBS patients had decreased weight loss and increased complications compared with the PBS patients, ≥ 50% EBWL was achieved by a significant number of RBS patients.
减重手术的翻修术（RBS）结果描述较差。我们在美国宾夕法尼亚州立大学米尔敦·赫尔希医疗中心比较了 RBS 和原发性减重手术（PBS）的结果。
回顾了 2000 年至 2007 年的 72 例 RBS 病例，并根据指征进行分组：体重减轻失败、胃空肠并发症或其他。将 RBS 患者与接受 Roux-en-Y 胃旁路术的 856 例 PBS 患者进行比较。RBS 组的平均随访时间为 12.6 ± 1.2 个月，PBS 组为 16 ± 0.5 个月。体重减轻分析为减轻的公斤数和体重减轻≥50%的患者（EBWL）。结果包括死亡率、漏诊、手术部位感染和住院时间。
RBS 后体重减轻 23 ± 2.8 公斤，PBS 后体重减轻 41.3 ± 0.7 公斤（P <.05 与 PBS 相比）。RBS 后体重减轻因手术指征而异：体重减轻失败，27.1 ± 2 公斤；胃空肠并发症，8.7 ± 3.4 公斤；其他 23.5 ± 10.6 公斤。此外，29%的 RBS 患者（与术前体重相比）和 61%的 RBS 患者（与初始体重相比）有≥50%的 EBWL，而 PBS 后有 52.7%的患者有≥50%的 EBWL。仅年龄≤50 岁与 RBS 后体重减轻失败组的≥50% EBWL 相关。没有 RBS 患者死亡。然而，RBS 后漏诊、手术部位感染和住院时间增加。
我们的研究结果表明，RBS 后的体重减轻因手术指征而异，并受年龄>50 岁的影响。尽管与 PBS 患者相比，RBS 患者的体重减轻减少且并发症增加，但仍有大量 RBS 患者达到了≥50%的 EBWL。
