Evidence map›Paper›PMID 36261645›Full record

ArticleSurgical endoscopy2023

Distal gastric bypass revision for weight recurrence or nonresponse to primary procedure: initial experience and outcomes in an academic practice.

Bhavani Pokala, Spyridon Giannopoulos, Dimitrios I Athanasiadis, Seyed Mohammad Kalantar Motamedi, Dimitrios Stefanidis

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Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.0field-weighted citation impact, top 14% 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

5 citing papers in PubMed, 10 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

5 authors at 2 institutions in 1 country.

Bhavani PokalaDepartment of Surgery, Indiana University School of Medicine, 545 Emerson Hall, EH 130, Indianapolis, IN, 46202, USA.
Spyridon GiannopoulosDepartment of Surgery, Indiana University School of Medicine, 545 Emerson Hall, EH 130, Indianapolis, IN, 46202, USA.
Dimitrios I AthanasiadisDepartment of Surgery, Indiana University School of Medicine, 545 Emerson Hall, EH 130, Indianapolis, IN, 46202, USA.
Seyed Mohammad Kalantar MotamediDepartment of Surgery, Indiana University School of Medicine, 545 Emerson Hall, EH 130, Indianapolis, IN, 46202, USA.
Dimitrios StefanidisDepartment of Surgery, Indiana University School of Medicine, 545 Emerson Hall, EH 130, Indianapolis, IN, 46202, USA. dimstefa@iu.edu.ORCID 0000-0002-2177-0763
Indiana University School of MedicineIndiana University Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConsiderable weight recurrence (WR) after Roux-en-Y gastric bypass (RYGB) may occur in nearly 20% of patients. While several nonoperative, endoscopic, and surgical interventions exist for this population, the optimal approach is unknown. This study reports our initial experience with distal bypass revision (DGB) and provides a comparison with patients after primary RYGB.

methodsSingle-institution, retrospective review was conducted for patients who underwent DGB from 2018 to 2020. A Roux and common channel of 150 cm each were constructed (total alimentary limb 300 cm). A group of primary RYGB patients with similar demographics were selected as controls. Demographics, comorbidity resolution, surgical technique, complications, excess weight loss (EWL), total weight loss (TWL), BMI, and weight change data were compared. Patient postoperative weight loss (WL) was also compared after their primary and DGB operations.

resultsSixteen DGB patients, all female, were compared with 29 controls. DGB was performed on average 12.3 years after primary RYGB. In the DGB group, mean BMI was 53.7 before primary RYGB, 31.9 at nadir, and 44.1 prior to DGB. Post-DGB, mean BMI was 40.5, 37.4, 34.8, and 34.4, at 3-, 6-, 12-, and 24-months, respectively. Five patients (31.3%) experienced complications and were readmitted within 30 days, with two of them (12.5%) requiring reintervention and one (6.3%) undergoing reoperation. Mean EWL and TWL up to 2 years after DGB were lower than that after the patient's original RYGB (52.3 ± 18.6 vs. 67.2 ± 33.2; p = 0.126 and 19.6 ± 13.3 vs. 29.6 ± 11.8; p = 0.027, respectively).

conclusionsDGB resulted in excellent WL up to 2 years after surgery but was associated with considerable postoperative complication rates. The magnitude of TWL was lower compared with the primary operation. Only a few patients experienced nutritional complications. Results of this study can help counsel patients pursuing DGB for WR or nonresponse to primary RYGB. The comparative effectiveness of this approach to other available options remains to be determined.

Indexed as

Gastric BypassLaparoscopyObesity, MorbidBody Mass IndexComorbidityFemaleHumansReoperationRetrospective StudiesTreatment OutcomeWeight LossBariatricsDistal bypassMinimally invasive surgeryRevisional surgeryRoux-en-Y gastric bypassWeight recurrence

Identifiers

PMID36261645
OpenAlexW4306822629

What OpenQuestion holds

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Registered trials

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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.