title: Laparoscopic re-sleeve gastrectomy as a treatment of weight regain after sleeve gastrectomy.
abstract: OBJECTIVE
  To evaluate laparoscopic re-sleeve gastrectomy as a treatment of weight regain after Sleeve.
  
  
  METHODS
  Laparoscopic sleeve gastrectomy is a common bariatric procedure. Weight regain after long-term follow-up is reported. Patients were considered for laparoscopic re-sleeve gastrectomy when we observed progressive weight regain and persistence of comorbidities associated with evidence of dilated gastric fundus and/or antrum on upper gastro-intestinal series. Follow-up visits were scheduled at 1, 3, 6 and 12 mo after surgery and every 6 mo thereafter. Measures of change from baseline at different times were analyzed with the paired samples t test.
  
  
  RESULTS
  We observed progressive weight regain after sleeve in 11 of the 201 patients (5.4%) who had a mean follow-up of 21.1 ± 9.7 mo (range 6-57 mo). Three patients started to regain weight after 6 mo following Sleeve, 5 patients after 12 mo, 3 patients after 18 m. Re-sleeve gastrectomy was always performed by laparoscopy. The mean time of intervention was 55.8 ± 29.1 min. In all cases, neither intra-operative nor post-operative complications occurred. After 1 year follow-up we observed a significant (P < 0.05) mean body mass index reduction (-6.6 ± 2.7 kg/m(2)) and mean % excess weight loss (%EWL) increase (+31.0% ± 15.8%). An important reduction of antihypertensive drugs and hypoglycemic agents was observed after re-sleeve in those patients affected by hypertension and diabetes. Joint problems and sleep apnea syndrome improved in all 11 patients.
  
  
  CONCLUSIONS
  Laparoscopic re-sleeve gastrectomy is a feasible and effective intervention to correct weight regain after sleeve.
authors: Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Domenico Carrieri, Giorgio Castello, Stefano Olmi, Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco, 24040 Zingonia-Osio Sotto, Italy.
authors: Giovanni
authors: G
authors: Cesana
authors: Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Domenico Carrieri, Giorgio Castello, Stefano Olmi, Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco, 24040 Zingonia-Osio Sotto, Italy.
authors: Matteo
authors: M
authors: Uccelli
authors: Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Domenico Carrieri, Giorgio Castello, Stefano Olmi, Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco, 24040 Zingonia-Osio Sotto, Italy.
authors: Francesca
authors: F
authors: Ciccarese
authors: Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Domenico Carrieri, Giorgio Castello, Stefano Olmi, Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco, 24040 Zingonia-Osio Sotto, Italy.
authors: Domenico
authors: D
authors: Carrieri
authors: Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Domenico Carrieri, Giorgio Castello, Stefano Olmi, Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco, 24040 Zingonia-Osio Sotto, Italy.
authors: Giorgio
authors: G
authors: Castello
authors: Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Domenico Carrieri, Giorgio Castello, Stefano Olmi, Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco, 24040 Zingonia-Osio Sotto, Italy.
authors: Stefano
authors: S
authors: Olmi
keywords: Bariatric surgery; Gastrectomy; Laparoscopic surgery; Obesity; Repeat; Stomach stapling; Surgery