Review Article: Systematic Review on Reoperative Bariatric Surgery
American Society for Metabolic and Bariatric Surgery Revision Task Force
Stacy A. Brethauer, MD*, Shanu Kothari, MD, Ranjan Sudan, MD, Brandon Williams, MD, Wayne J. English, MD, Matthew Brengman, MD, Marina Kurian, MD, Matthew Hutter, MD, Lloyd Stegemann, MD, Kara Kallies, MS, Ninh T. Nguyen, MD, Jaime Ponce, MD, John M. Morton, MD
Surgery for Obesity and Related Diseases 10 (2014) 952–972
Received January 30, 2014; accepted February 10, 2014
Background: Reoperative bariatric surgery has become a common practice in many bariatric surgery programs. There is currently little evidence-based guidance regarding specific indications and outcomes for reoperative bariatric surgery. A task force was convened to review the current evidence regarding reoperative bariatric surgery. The aim of the review was to identify procedure-specific indications and outcomes for reoperative procedures.
Methods: Literature search was conducted to identify studies reporting indications for and outcomes after reoperative bariatric surgery. Specifically, operations to treat complications, failed weight loss, and weight regain were evaluated. Abstract and manuscript reviews were completed by the task force members to identify, grade, and categorize relevant studies.
Results: A total of 819 articles were identified in the initial search. After review for inclusion criteria and data quality, 175 articles were included in the systematic review and analysis. The majority of published studies are single center retrospective reviews. The evidence supporting reoperative surgery for acute and chronic complications is described. The evidence regarding reoperative surgery for failed weight loss and weight regain generally demonstrates improved weight loss and co-morbidity reduction after reintervention. Procedure-specific outcomes are described. Complication rates are generally reported to be higher after reoperative surgery compared to primary surgery.
Conclusion: The indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, co-morbid disease, and complications.
(R) 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.
Keywords: Reoperative; Revisional; Bariatric; Weight regain; Complications