title: Quality of life, weight loss and improvement of co-morbidities after primary and revisional laparoscopic roux Y gastric bypass procedure-comparative match pair study.
abstract: BACKGROUND
  The prevalence of morbid obesity and its co-morbidities is dramatically increasing, as is the extent of weight loss surgery. A large number of patients after various bariatric procedures need revisional intervention for various reasons. We investigated the efficacy and the safety of revisional laparoscopic Roux Y gastric bypass (LRYGB) among our patients, who were revised as a consequence of inadequate weight loss or weight regain after previous bariatric interventions.
  
  
  METHODS
  A comparative, double-centre, match pair study was performed comparing the data of 44 patients after revisional surgery with 44 patients after primary gastric bypasses, focusing on weight loss, life quality and improvement of co-morbidities. Matching criteria were age, gender, preoperative BMI and follow-up period. Previous procedures consisted of 23 gastric bandings, 13 sleeve resections, 4 LRYGB and 4 vertical banded gastroplasties.
  
  
  RESULTS
  Extra weight loss (EWL) was significantly reduced after revisional gastric bypasses compared to primary intervention (EWL 66 vs. 91 %, p<0.05). Life quality scores were also decreased in the revisional group compared to the control group without statistical significance (SF 36 score 635 vs. 698.5, p=0.22; Moorehead-Aldert II score 1.4 vs. 2.0, p=0.10). The resolution rate of co-morbidities (T2DM, hypertension, gastro-oesophageal reflux (GER), osteoarthrosis, sleep apnoea) was also higher after primary gastric bypasses.
  
  
  CONCLUSIONS
  Revisional LRYGB is an effective and safe method for patients with inadequate weight loss after previous bariatric surgery concerning weight reduction, life quality and improvement of co-morbidities. Our results indicate lower efficacy of revisional compared to primary LRYGB reaching statistical significance in regard to weight loss.
authors.affiliation: Department of General Surgery, Territory Hospital Veszprém, Kórház street 1, Veszprém, 8200, Hungary, mohose@freemail.hu.
authors.forename: Elemer
authors.initials: E
authors.lastname: Mohos
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Jánó
authors.forename: Doris
authors.initials: D
authors.lastname: Richter
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Schmaldienst
authors.forename: Gábor
authors.initials: G
authors.lastname: Sándor
authors.forename: Petra
authors.initials: P
authors.lastname: Mohos
authors.forename: Miroslav
authors.initials: M
authors.lastname: Horzov
authors.forename: Gábor
authors.initials: G
authors.lastname: Tornai
authors.forename: Manfred
authors.initials: M
authors.lastname: Prager
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D001317:Austria; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D006814:Hungary; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D010003:Osteoarthritis / Q000150:complications; D011788:Quality of Life; D012086:Reoperation; D012891:Sleep Apnea Syndromes / Q000150:complications; D016896:Treatment Outcome; D015431:Weight Loss