Department of General and Visceral Surgery, University of Freiburg, Surgical Metabolic and Anastomotic Research Team, Hugstetter Strasse 55, 79106 Freiburg, Germany.
Surg Endosc. 2012 Jun;26(6):1718-23. doi: 10.1007/s00464-011-2098-y. Epub 2011 Dec 22.
A growing number of revisionary and secondary bariatric operations have been performed in recent years, with the number of operations doubling each year at the authors' center. Diagnostics, indications, and most revisionary operations should be performed by an experienced bariatric surgeon. This study was undertaken to evaluate indications and outcomes of revisionary bariatric operations at a specialized center.
At the Centre of Obesity and Metabolic Surgery (University of Freiburg, Germany), 100 consecutive revisionary bariatric operations performed between March 2007 and September 2009 were analyzed concerning indications and outcomes.
Only 9 of the 100 revisions were due to early complications (<30 days after the primary operation). The indication for most revisions was poor weight loss (n = 55). A mean body mass index reduction of 10 points could be achieved in 1 year, which equals a 56% excess weight loss (EWL). No significant difference in weight reduction between restrictive and malabsorptive revisions was observed. Revisions due to implant-related problems also were frequent (n = 25). Laparoscopic revision was possible in 95% of the cases.
Insufficient weight loss is the most frequent indication for revisionary bariatric surgery. The surgery can be performed laparoscopically in most cases, and a significant EWL (> 50%) can be achieved in 1 year if the right revisionary procedure is chosen.
近年来，越来越多的减重手术修复和二次手术已经实施，在作者所在的中心，手术数量每年翻一番。诊断、适应证和大多数修复手术应由经验丰富的减重外科医生进行。本研究旨在评估一个专业中心进行减重手术修复的适应证和结果。
在肥胖与代谢外科中心（德国弗莱堡大学），对 2007 年 3 月至 2009 年 9 月期间进行的 100 例连续减重手术修复病例进行了分析，涉及适应证和结果。
100 例修复手术中仅有 9 例是由于早期并发症（原发性手术后 30 天内）。大多数修复的适应证是减重效果不佳（n=55）。1 年内平均体重指数降低 10 点，相当于 56%的多余体重减轻（EWL）。限制型和吸收不良型修复术在减重效果方面没有显著差异。因植入物相关问题而进行的修复也很常见（n=25）。95%的病例可以通过腹腔镜进行修复。
减重不足是减重手术修复最常见的适应证。如果选择正确的修复手术，大多数情况下可以通过腹腔镜进行手术，并且在 1 年内可以实现显著的 EWL（>50%）。
