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Outcomes of Reoperation After Laparoscopic Gastric Plication Failure.
Obes Surg. 2019 02; 29(2):376-386.OS

Abstract

BACKGROUND

Management of failed laparoscopic gastric plication (LGP), defined as weight regain or inadequate weight loss, is a challenging issue.

METHODS

This prospective investigation was conducted in individuals with morbid obesity who had undergone LGP from 2000 to 2016. Patients with weight loss failure, weight regain, and regain-prone cases were indicated for reoperation. Re-plication, laparoscopic one anastomosis gastric bypass (LOAGB), and modified jejunoileal bypass were done as revisional surgery.

RESULTS

Revisional surgery was performed in 102 of 124 patients who needed reoperation. Overall, 39 re-plication, 38 LOAGB, and 25 malabsorptive procedures were performed. Re-plication was the shortest surgery and had the shortest length of hospital stay. The percentage of TWL at 6, 12, and 24 months of follow-up was 20.5%, 25%, and 26.8% for re-plication; 20.2%, 27%, and 30.5% for LOAGB; and 22.9%, 28.9%, and 32.6% for the malabsorptive procedure, respectively. In addition, the percentage of EWL at 6, 12, and 24 months of follow-up was 62%, 74.6%, and 79.6% for re-plication; 51.6%, 68.2%, and 75.9% for LOAGB; and 55.4%, 70.1%, and 79.1% for malabsorptive procedure, respectively. In long-term follow-up, according to %TWL, LOAGB and malabsorptive procedure had better outcome compared to re-plication, whereas there was no statistically significant difference in %EWL among the three surgical approaches.

CONCLUSIONS

In terms of weight loss, reoperation on failed LGP was completely successful and no treatment failure was reported. All three revisional procedures, including re-plication, LOAGB, and malabsorptive procedure showed promising results and provided substantial weight loss. Since there is little information about the long-term efficacy and safety of revisional surgery on failed LGP, we highly recommend further investigations to confirm our results.

Authors+Show Affiliations

School of Medicicne, Tehran University of Medical Sciences, Tehran, Iran. Universal Scientific, Educational, and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran. Ward of Laparoscopy, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.School of Medicicne, Tehran University of Medical Sciences, Tehran, Iran. mtaleb7155@gmail.com. Ward of Laparoscopy, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. mtaleb7155@gmail.com.School of Medicicne, Tehran University of Medical Sciences, Tehran, Iran. Universal Scientific, Educational, and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran.School of Medicicne, Tehran University of Medical Sciences, Tehran, Iran. Universal Scientific, Educational, and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran. Ward of Laparoscopy, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.School of Medicicne, Tehran University of Medical Sciences, Tehran, Iran. Ward of Laparoscopy, Department of Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30251095

Citation

Heidari, Reza, et al. "Outcomes of Reoperation After Laparoscopic Gastric Plication Failure." Obesity Surgery, vol. 29, no. 2, 2019, pp. 376-386.
Heidari R, Talebpour M, Soleyman-Jahi S, et al. Outcomes of Reoperation After Laparoscopic Gastric Plication Failure. Obes Surg. 2019;29(2):376-386.
Heidari, R., Talebpour, M., Soleyman-Jahi, S., Zeinoddini, A., Sanjari Moghaddam, A., & Talebpour, A. (2019). Outcomes of Reoperation After Laparoscopic Gastric Plication Failure. Obesity Surgery, 29(2), 376-386. https://doi.org/10.1007/s11695-018-3522-3
Heidari R, et al. Outcomes of Reoperation After Laparoscopic Gastric Plication Failure. Obes Surg. 2019;29(2):376-386. PubMed PMID: 30251095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of Reoperation After Laparoscopic Gastric Plication Failure. AU - Heidari,Reza, AU - Talebpour,Mohammad, AU - Soleyman-Jahi,Saeed, AU - Zeinoddini,Atefeh, AU - Sanjari Moghaddam,Ali, AU - Talebpour,Atieh, PY - 2018/9/27/pubmed PY - 2019/12/31/medline PY - 2018/9/26/entrez KW - LOAGB KW - Laparoscopic gastric plication KW - Obesity KW - Re-plication KW - Revisional bariatric surgery KW - Total weight loss SP - 376 EP - 386 JF - Obesity surgery JO - Obes Surg VL - 29 IS - 2 N2 - BACKGROUND: Management of failed laparoscopic gastric plication (LGP), defined as weight regain or inadequate weight loss, is a challenging issue. METHODS: This prospective investigation was conducted in individuals with morbid obesity who had undergone LGP from 2000 to 2016. Patients with weight loss failure, weight regain, and regain-prone cases were indicated for reoperation. Re-plication, laparoscopic one anastomosis gastric bypass (LOAGB), and modified jejunoileal bypass were done as revisional surgery. RESULTS: Revisional surgery was performed in 102 of 124 patients who needed reoperation. Overall, 39 re-plication, 38 LOAGB, and 25 malabsorptive procedures were performed. Re-plication was the shortest surgery and had the shortest length of hospital stay. The percentage of TWL at 6, 12, and 24 months of follow-up was 20.5%, 25%, and 26.8% for re-plication; 20.2%, 27%, and 30.5% for LOAGB; and 22.9%, 28.9%, and 32.6% for the malabsorptive procedure, respectively. In addition, the percentage of EWL at 6, 12, and 24 months of follow-up was 62%, 74.6%, and 79.6% for re-plication; 51.6%, 68.2%, and 75.9% for LOAGB; and 55.4%, 70.1%, and 79.1% for malabsorptive procedure, respectively. In long-term follow-up, according to %TWL, LOAGB and malabsorptive procedure had better outcome compared to re-plication, whereas there was no statistically significant difference in %EWL among the three surgical approaches. CONCLUSIONS: In terms of weight loss, reoperation on failed LGP was completely successful and no treatment failure was reported. All three revisional procedures, including re-plication, LOAGB, and malabsorptive procedure showed promising results and provided substantial weight loss. Since there is little information about the long-term efficacy and safety of revisional surgery on failed LGP, we highly recommend further investigations to confirm our results. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/30251095/Outcomes_of_Reoperation_After_Laparoscopic_Gastric_Plication_Failure_ L2 - https://dx.doi.org/10.1007/s11695-018-3522-3 DB - PRIME DP - Unbound Medicine ER -