Major Piotr, Zarzycki Piotr, Rymarowicz Justyna, Wysocki Michał, Łabul Michał, Hady Hady Razak, Głuszyńska Paulina, Myśliwiec Piotr, Kowalski Grzegorz, Orłowski Michał, Szeliga Jacek, Kupczyk Wojciech, Tarnowski Wiesław, Lech Paweł, Dowgiałło-Gornowicz Natalia, Proczko-Stepaniak Monika, Walędziak Maciej, Szymański Paweł, Stefura Tomasz, Pędziwiatr Michał
2 Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Krakow, Poland.
Wideochir Inne Tech Maloinwazyjne. 2022 Jun;17(2):372-379. doi: 10.5114/wiitm.2022.114525. Epub 2022 Mar 16.
Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid.
The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients.
This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS.
The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) - 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) - 289 (36.17%) patients and sleeve gastrectomy (SG) - 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common - 117 (14.64%) patients.
RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.
翻修手术在技术上更具挑战性，且与发病率和死亡率的增加相关。尽管如此，减重翻修手术（RBS）的频率仍在上升。因此，对这组患者进行研究目前看来是有意义的。
这项多中心研究的目的是收集、系统化并呈现波兰患者病态肥胖手术治疗后RBS的现有数据。
这项多中心研究包括对一个前瞻性维护数据库的回顾性分析。结果包括对RBS的指征、最常被选为RBS的手术类型以及接受RBS患者围手术期治疗过程的分析。
该组包括799名患者（624名（78.1%）女性，175名（21.9%）男性）。平均年龄为38.96±9.72岁。肥胖复发是RBS最常见的指征。最常进行的RBS手术是单吻合口胃旁路术（OAGB）——294名（36.8%）患者， Roux-en-Y胃旁路术（RYGB）——289名（36.17%）患者，以及袖状胃切除术（SG）——172名（21.52%）患者。初次手术后，63.58%的患者实现了足够的体重减轻，但RBS后只有38.87%。RBS后222例（27.78%）出现并发症，其中胃食管反流病（GERD）最为常见——117名（14.64%）患者。
RBS最常涉及接受SG手术后的患者。RBS的主要指征是体重反弹。OAGB和RYGB是最常被选择的两种RBS类型。二次手术导致进一步体重减轻。然而，RBS与显著的并发症风险相关。
