Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force.
BACKGROUND
Reoperative bariatric surgery has become a common practice in many bariatric surgery programs. There is currently little evidence-based guidance regarding specific indications and outcomes for reoperative bariatric surgery. A task force was convened to review the current evidence regarding reoperative bariatric surgery. The aim of the review was to identify procedure-specific indications and outcomes for reoperative procedures.


METHODS
Literature search was conducted to identify studies reporting indications for and outcomes after reoperative bariatric surgery. Specifically, operations to treat complications, failed weight loss, and weight regain were evaluated. Abstract and manuscript reviews were completed by the task force members to identify, grade, and categorize relevant studies.


RESULTS
A total of 819 articles were identified in the initial search. After review for inclusion criteria and data quality, 175 articles were included in the systematic review and analysis. The majority of published studies are single center retrospective reviews. The evidence supporting reoperative surgery for acute and chronic complications is described. The evidence regarding reoperative surgery for failed weight loss and weight regain generally demonstrates improved weight loss and co-morbidity reduction after reintervention. Procedure-specific outcomes are described. Complication rates are generally reported to be higher after reoperative surgery compared to primary surgery.


CONCLUSIONS
The indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, co-morbid disease, and complications.
Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: brethas@ccf.org.
Stacy A
SA
Brethauer
Department of Surgery, Gunderson Health System, La Crosse, Wisconsin.
Shanu
S
Kothari
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Ranjan
R
Sudan
Vanderbilt Center for Surgical Weight Loss, Nashville, Tennessee.
Brandon
B
Williams
Department of Surgery, Marquette General Hospital, Marquette, Michigan.
Wayne J
WJ
English
Advanced Surgical Partners of Virginia, Richmond, Virginia.
Matthew
M
Brengman
Department of Surgery, New York University Bariatric Surgery Associates, New York, New York.
Marina
M
Kurian
Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
Matthew
M
Hutter
Better Weigh Center, Corpus Christi, Texas.
Lloyd
L
Stegemann
Department of Surgery, Gunderson Health System, La Crosse, Wisconsin.
Kara
K
Kallies
Department of Surgery, University of California Irvine Medical Center, Orange, California.
Ninh T
NT
Nguyen
Dalton Surgical Group, Dalton, Georgia.
Jaime
J
Ponce
Department of Surgery, Stanford University, Palo Alto, California.
John M
JM
Morton
D050110:Bariatric Surgery / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009767:Obesity, Morbid / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D009626:Terminology as Topic; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology
Bariatric; Complications; Reoperative; Revisional; Weight regain