Evidence map›Paper›PMID 29679337›Full record

ArticleObesity surgery2018

Revisional Bariatric Surgery for Weight Regain and Refractory Complications in a Single MBSAQIP Accredited Center: What Are We Dealing with?

Jeffrey Qiu, Peter W Lundberg, T Javier Birriel, Leonardo Claros, Jill Stoltzfus, Maher El Chaar

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Article in Obesity surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 4 pooled it
8.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jeffrey QiuTemple University, Lewis Katz School of Medicine, Philadelphia, PA, USA.
Peter W LundbergSt Luke's University Health Network, Bethlehem, PA, USA. peter.lundberg@sluhn.org.
T Javier BirrielSt Luke's University Health Network, Bethlehem, PA, USA.
Leonardo ClarosSt Luke's University Health Network, Bethlehem, PA, USA.
Jill StoltzfusSt Luke's University Health Network, Bethlehem, PA, USA.
Maher El ChaarTemple University, Lewis Katz School of Medicine, Philadelphia, PA, USA.
St. Luke's University Health Network · USTemple University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRevisional surgery is the fastest growing area in bariatric surgery, constituting 13.6% of all procedures performed as of 2015. This reflects a rising need to treat adverse sequelae of primary bariatric procedures. Despite the increase in revisions, their safety and efficacy remain controversial. The objective of this study is to review the experience of revisional bariatric surgery in our center and the relevant literature to date.

methodsWe performed an IRB-approved review of prospectively collected data from all patients undergoing revisional bariatric surgery between 2012 and 2015. Due to patient heterogeneity, we divided subjects into two groups: patients who underwent surgery for weight regain (WR) and those who underwent surgery to address refractory complications (RC) related to their primary bariatric procedure. Demographics, indications, and outcomes of each group were compared using Fisher's exact test, Mann-Whitney rank sums, and chi-square tests. We also divided WR patients based on their primary index procedure and analyzed them separately.

resultsWe performed a total of 84 procedures over 4 years. Forty-three patients (53.6%) underwent surgery for WR and 41 (46.4%) for RC. The variety and distribution of primary bariatric procedures were gastric band (40%), gastric bypass (35.4%), sleeve gastrectomy (22%), and vertical banded gastroplasty (3.7%). The indications for revisional surgery due to RC included gastroesophageal reflux disease, internal hernia, gastro-gastric fistula, marginal ulcer, excess weight loss, and pain. Overall complication rate was 14.3% (three early, nine late); there was one leak. Five patients required a reoperation (5.9%; two early, three late). Excess weight loss varied from 31.5-79.1% 12 months after revision.

conclusionPatients presenting to our center for revisional surgery do so for either WR or RC, most commonly following gastric banding. Revisional bariatric surgery can be performed with low complication rates and with acceptable 12-month weight loss, though not with the same safety as primary procedures.

Indexed as

Bariatric SurgeryObesity, MorbidPostoperative ComplicationsWeight GainHumansRetrospective StudiesTreatment OutcomeWeight LossConversionGastric bandGastric bypassRefractory complicationsRevision bariatric surgerySleeve gastrectomyWeight regain

Identifiers

PMID29679337
OpenAlexW2803025366

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.