title: Weight loss and weight regain-5-year follow-up for circular- vs. linear-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Weight regain (WR) occurs in some patients after laparoscopic Roux-en-Y gastric bypass (LRYGBP). Loss of restriction due to dilation of the gastrojejunostomy (GJS) or the gastric pouch might be the main cause for WR. With different techniques available for the establishment of the GJS, the surgical technique might influence long-term success.
  
  
  METHODS
  We present a 5-year follow-up for weight loss and WR of a matched-pair study comparing circular stapled (CSA) to linear stapled (LSA) GJS in a series of 150 patients who underwent primary antecolic antegastric LRYGBP. Complete 5-year follow-up was obtained for 79 % of the patients.
  
  
  RESULTS
  Excess BMI loss (EBL) at 3 months was better with the CSA (p = 0.02) and comparable thereafter. The 5-year %EBL was 67.3 ± 23.2 vs. 73.3 ± 24.3 % (CSA vs. LSA, p = 0.19) WR of > 10 kg from nadir was found in 24 patients (16 %) with higher incidence in CSA than in LSA patients (20 % vs. 12 %). The %WR was comparable for both groups, 16 ± 13 vs. 15 ± 19 % (CSA vs. LSA, p = 0.345). Eleven patients underwent surgical re-intervention for WR by placement of a non-adjustable band (n = 2), adjustable band (n = 7) and conversion to distal gastric bypass (n = 2).
  
  
  CONCLUSIONS
  CSA and LSA lead to comparable weight loss in this 5-year follow-up. More patients in the CSA group had WR. Weight regain of more than 10 kg was found in one out of seven patients within 5 years postoperatively.
authors.affiliation: Department of Surgery, Division of General Surgery, Medical University of Vienna, General Hospital Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: F B
authors.initials: FB
authors.lastname: Langer
authors.forename: G
authors.initials: G
authors.lastname: Prager
authors.forename: M
authors.initials: M
authors.lastname: Poglitsch
authors.forename: R
authors.initials: R
authors.lastname: Kefurt
authors.forename: S
authors.initials: S
authors.lastname: Shakeri-Leidenmühler
authors.forename: B
authors.initials: B
authors.lastname: Ludvik
authors.forename: K
authors.initials: K
authors.lastname: Schindler
authors.forename: A
authors.initials: A
authors.lastname: Bohdjalian
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D016555:Matched-Pair Analysis; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D017792:Surgical Stapling; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain; D015431:Weight Loss