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- Title
One-Stage vs Two-Stage Laparoscopic Roux-en-Y Gastric Bypass in Obese Patients with Body Mass Index >55 Kg/m; 5-YEAR FOLLOW UP.
- Authors
Díaz-Tobarra, María; Cassinello Fernández, Norberto; Jordá Gómez, Pablo; Nofal, Mohammad; Alfonso Ballester, Raquel; Ortega Serrano, Joaquín
- Abstract
Background: Surgical strategies in patients with BMI > 55 kg/m are not well established. Objectives: The objective of this study is to compare the long term results and complications of 1- vs. 2-stage laparoscopic 'Roux-en-Y″ gastric bypass (LRYGB) for patients with BMI > 55 kg/m. Methods: Retrospective review of the complications and outcomes, between January 2007 and January 2010, for patients with a BMI > 55 kg/m who underwent directly a LRYGB (1-stage) or a LRYGB as a 2nd stage of a laparoscopic sleeve gastrectomy (LSG). Results: Twenty-four patients were enrolled (no patient was lost during the 5-year follow-up). In the 1-stage LRYGB group, two patients had grade II complications according to Clavien-Dindo classification. In the 2-stage LRYGB group, complications of the first and the second surgery were summed. There were no differences between the two groups despite being heterogenous (more men with a higher BMI in the 2-stage group). There was a statistically significant difference in the final BMI in 1-stage LRYGB group compared to the 2-stage LRYGB group (34.46 ± 6.29 vs. 40.40 ± 3.47; p = 0.01, respectively) and in percentage of excess of BMI loss (%EBMIL; 69.80 ± 19.96 vs. 54.54 ± 13.93; p = 0.04, respectively). Conclusions: In patients with a BMI > 55 kg/m, both 1- and 2-stage LRYGB give good long-term results. If feasible, a 1-stage LRYGB obtains a better percentage of excess of BMI loss but if not possible, the strategy of initially performing a laparoscopic sleeve gastrectomy followed by a LRYGB is safe and there were no differences in complications.
- Subjects
GASTRIC bypass; SURGICAL complications; BODY mass index; OVERWEIGHT persons; GASTROENTEROSTOMY
- Publication
Obesity Surgery, 2017, Vol 27, Issue 4, p955
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-016-2411-x