Jawhar Noura, Sample Jack W, Salame Marita, Marrero Katie, Tomey Daniel, Puvvadi Suraj, Ghanem Omar M
Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Carle Foundation Hospital General Surgery Residency, Champaign, IL 61801, USA.
J Clin Med. 2024 Mar 25;13(7):1878. doi: 10.3390/jcm13071878.
Metabolic and bariatric surgery (MBS) is the most effective therapeutic intervention for patients with obesity, with sleeve gastrectomy (SG) being the most commonly performed primary MBS procedure. Long-term studies have demonstrated that 15-20% of patients require revisional bariatric surgery (RBS) due to weight-related issues or surgical complications. Despite the gold standard being laparoscopic revision, there are other available approaches such as open or robotic-assisted. An extensive literature review was performed for articles from their inception to February 2024. A descriptive review of MBS procedures (SG, Roux-en-Y gastric bypass (RYGB), single anastomosis duodeno-ileostomy (SADI) and biliopancreatic diversion-duodenal switch (BPD-DS)) was carried out to report and compare outcomes between primary and revisional bariatric surgery. A similar review was conducted to compare outcomes of revisional approaches (open, laparoscopic, robotic). RYGB remains the dominant RBS with a similar safety profile compared to revisional SADI and BPD-DS. In terms of the RBS surgical approach, all three options showed comparable short and long-term outcomes, with robotic RBS being associated with longer operative time and variable length of stay. Additional long-term studies are required to further validate our conclusions.
代谢与减重手术（MBS）是肥胖患者最有效的治疗干预手段，其中袖状胃切除术（SG）是最常实施的主要MBS术式。长期研究表明，15%至20%的患者因体重相关问题或手术并发症需要进行减重手术翻修术（RBS）。尽管腹腔镜翻修术是金标准，但还有其他可用方法，如开放手术或机器人辅助手术。对从文章发表之初到2024年2月的文献进行了广泛综述。对MBS术式（SG、Roux-en-Y胃旁路术（RYGB）、单吻合十二指肠回肠旁路术（SADI）和胆胰分流十二指肠转位术（BPD-DS））进行了描述性综述，以报告和比较初次与翻修减重手术的结果。进行了类似的综述以比较翻修方法（开放、腹腔镜、机器人辅助）的结果。与翻修SADI和BPD-DS相比，RYGB仍然是主要的RBS术式，且安全性相当。就RBS手术方式而言，所有三种选择的短期和长期结果相当，机器人辅助RBS手术时间更长，住院时间不一。需要更多长期研究来进一步验证我们的结论。
