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Comparison of 30-day outcomes after non-LapBand primary and revisional bariatric surgical procedures from the Longitudinal Assessment of Bariatric Surgery study
Open accessAbstract
Background The goals were to compare the morbidity and mortality between primary and revisional bariatric surgery and to identify the clinical predictors of adverse outcomes among patients undergoing revisional surgery in the Longitudinal Assessment of Bariatric Surgery consortium. The study was multi-institutional at university hospitals in the United States.Methods Data from the LABS-1 (safety) cohort were analyzed, excluding primary gastric banding patients. A total of 3802 LABS-1 patients were included: 3577 who underwent primary surgery and 225 who underwent revisional surgery. The demographic, clinical, operative, and 30-day outcome data were compared between the 2 groups. A nonlinear mixed effects logit model was used to identify independent risk factors for adverse outcomes (death, deep vein thrombosis, pulmonary embolism, reintubation, reoperation, or discharge after 30 days).Results Compared with those undergoing revisional surgery, the primary surgery patients were younger (median age 44 versus 49 years, P <.0001) and more likely to be male (20.5% versus 12.7%, P = .006) and heavier (median body mass index 47.3 versus 41.2 kg/m(2), P <.0001) and to have more co-morbidities (P <.0001), including hypertension (56.0% versus 46.0%, P = .0044), diabetes (35.7% versus 20.0%, P <.0001), and sleep apnea (50.3% versus 27.2%, P <.0001). The operative time for the revisional procedures was longer (median 181 versus 135 min, P <.0001) and associated with greater blood loss (median 100 versus <50 mL, P <.0001). Adverse outcomes were more likely after revisional surgery (15.1% versus 5.3%, P <.0001, odds ratio 2.4, 95% confidence interval 1.6-3.6). After adjusting for patient characteristics previously shown to be associated with adverse outcomes, this difference remained statistically significant (odds ratio 2.3, 95% confidence interval 1.5-3.8). The 30-day mortality rate was similar in the 2 groups (.4%).Conclusion Revisional surgery was performed without substantial mortality but with a greater incidence of adverse outcomes than was primary bariatric surgery.
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Revisional bariatric surgery confers a higher risk of perioperative complications than primary bariatric surgery.
“On the other hand, revisional bariatric surgery confers a higher risk of perioperative complications than primary bariatric surgery [127].”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [127]
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Safety and efficacy of bariatric surgery: Longitudinal Assessment of Bariatric Surgery
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Self-citationAccelerated Growth of Bariatric Surgery With the Introduction of Minimally Invasive Surgery
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Self-citationWeight Loss Outcome of Revisional Bariatric Operations Varies According to the Primary Procedure
Brolin, R. E., & Cody, R. P. (2008) · Annals of Surgery · doi:10.1097/sla.0b013e3181820cdf · Cited by 93
Reoperative Laparoscopic Roux-en-Y Gastric Bypass: An Experience with 49 Cases
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Revisional bariatric surgery for failed restrictive procedures
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The NIDDK Bariatric Surgery clinical Research Consortium (LABS)
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Self-citationLaparoscopic conversion of vertical banded gastroplasty to a Roux-en-Y gastric bypass
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Di Lorenzo, N., Antoniou, S. A., Batterham, R. L., Busetto, L., Godoroja, D., Iossa, A., Carrano, F. M., Agresta, F., Alarçon, I., Azran, C., et al. (2020) · Surgical Endoscopy · doi:10.1007/s00464-020-07555-y · Cited by 465
Systematic review on reoperative bariatric surgery
Brethauer, S. A., Kothari, S., Sudan, R., Williams, B., English, W. J., Brengman, M., Kurian, M., Hutter, M., Stegemann, L., Kallies, K., et al. (2014) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2014.02.014 · Cited by 392
Metadata
- Authors
- Inabnet, W. B., Belle, S. H., Bessler, M., Courcoulas, A., Dellinger, P., Garcia, L., Mitchell, J., Oelschlager, B., O'Rourke, R., Pender, J., Pomp, A., Pories, W., Ramanathan, R., Wahed, A., & Wolfe, B.
- Affiliations
- Columbia University Irving Medical Center (US)
- University of Pittsburgh (US)
- Virginia Mason Medical Center (US)
- Neuropsychiatric Research Institute (US)
- East Carolina University (US)
- Cornell University (US)
- Corresponding author
- Inabnet, William B.
- ORCID
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 6
- Issue
- 1
- Pages
- 22-30
- ISSN
- 1550-7289 (ISSN-L)
- PMC
- PMC2836857
- OpenAlex
- W2053075612
- Cited by
- 76
- References
- 15
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 8 · 2018: 5 · 2017: 1 · 2016: 5 · 2015: 5 · 2014: 9 · 2013: 3 · 2012: 6
- FWCI
- 5.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Surgery for Obesity and Related Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK066471, U01DK066557, U01DK066526, U01DK066568, U01DK066555, U01DK066667, U01DK066585)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- revisional bariatric surgery
- MeSH terms
- Adult, Aged, Female, Humans, Male, Middle Aged, Obesity, Morbid, Postoperative Complications, Prospective Studies, Registries, Reoperation, United States, Comorbidity, Body Mass Index, Multivariate Analysis, Logistic Models, Treatment Outcome, Bariatric Surgery
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