title: Vertical banded gastroplasty converted to Roux-en-Y gastric bypass: little impact on nutritional status after 5-year follow-up.
abstract: BACKGROUND
  Conversion to a Roux-en-Y gastric bypass (RYGBP) has been advocated after the failure of vertical banded gastroplasty (VBG). The aim of this study was to analyze the differences in anthropometric and nutritional parameters between patients with VBG and those converted to RYGBP.
  
  
  METHODS
  45 patients initially underwent VBG. 22 of these patients have maintained this operation for more than 5 years (Group A) and 23 have been converted to RYGBP (Group B), after 2 years of follow-up. We analyzed anthropometric and nutritional parameters (macronutrients,micronutrients and lipid profile), and postoperative morbidity after both procedures. Data were recorded before the first operation and at 6 months, 1, 2 and 5 years follow-up.
  
  
  RESULTS
  VBG failure rate was 51%. The 23 patients converted to RYGBP have maintained an excess weight loss (EWL) of 70% 3 years after the revision, and all the complications related to VBG disappeared. Anthropometric parameters were significantly better after RYGBP. We found no significant differences in nutritional status between both groups except for levels of iron, vitamin B(12) and transferrin saturation index, which significantly decreased in converted patients. The redo procedure had a low morbidity rate, with no mortality.
  
  
  CONCLUSIONS
  More than 50% of VBGs failed after 2-year follow-up. Patients converted to RYGBP maintained mean EWL 73% at 5 years. The only significant nutritional deficiencies were iron and vitamin B(12), in patients converted to RYGBP.
authors.affiliation: Department of Surgery, Clinic University Hospital, University of Valencia, Valencia, Spain. joaquin.ortega@uv.es
authors.forename: Joaquin
authors.initials: J
authors.lastname: Ortega
authors.forename: Carlos
authors.initials: C
authors.lastname: Sala
authors.forename: Blas
authors.initials: B
authors.lastname: Flor
authors.forename: Elsa
authors.initials: E
authors.lastname: Jiménez
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Escudero
authors.forename: Jose
authors.initials: J
authors.lastname: Martinezvalls
authors.forename: Salvador
authors.initials: S
authors.lastname: Lledo
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D008297:Male; D009752:Nutritional Status; D011184:Postoperative Period; D014168:Transferrin / Q000032:analysis; D017211:Treatment Failure; D014805:Vitamin B 12 / Q000097:blood; D015431:Weight Loss
chemical_list: D014168:Transferrin; D014805:Vitamin B 12