Revisional vs. Primary Roux-en-Y Gastric Bypass-a Case-matched analysis: Less weight loss in revisions

With the increase in bariatric procedures performed, revisional surgery is now required more frequently. Roux-en-Y gastric bypass (RYGB) is considered to be the gold standard revision procedure. However, data comparing revisional vs. primary RYGB is scarce, and no study has compared nonresectional primary and revisional RYGB in a matched control setting. Analysis of 61 revisional RYGB that were matched one to one with 61 primary RYGB was done.Matching criteria were preoperative bodymass index, age, gender, comorbidities and choice of technique (laparoscopic vs. open). After matching, the groups did not differ significantly. Previous bariatric procedures were 13 gastric bands, 36 vertical banded gastroplasties, 10 RYGB and two sleeve gastrectomies. The indication for revisional surgery was insufficient weight loss in 55 and reflux in 6. Intraoperative and surgical morbidity was not different, butmedicalmorbidity was significantly higher in revisional procedures (9.8% vs. 0%, p=0.031). Patients undergoing revisional RYGB lost less weight in the first two postoperative years compared with patients with primary RYGB (1 month, 14.9% vs. 29.7%, p=0.004; 3 months, 27.4% vs. 51.9%, p=0.002; 6 months, 39.4 vs. 70.4%, p< 0.001; 12 months, 58.5% vs. 85.9%, p