title: Primary sleeve gastrectomy compared to sleeve gastrectomy as revisional surgery: weight loss and complications at intermediate follow-up.
abstract: BACKGROUND
  The laparoscopic adjustable gastric band (LAGB) can be revised to sleeve gastrectomy (LSG) for various reasons. Data are limited on the safety and efficacy of single-stage removal of LAGB and creation of LSG.
  
  
  METHODS
  A retrospective review of cases was performed from 2010 to 2013. From the primary LSG group, a control group was matched in a 2:1 ratio.
  
  
  RESULTS
  Thirty-two patients underwent single-stage revision from LAGB to LSG, with a control group of 64. The most common indication for revision was insufficient weight loss (62.5%). Operative time for revision and control groups was 134 and 92 min, respectively (p < 0.0001). Hospital stay was 3.22 and 2.59 days, respectively (p = 0.02). Overall, the 30-day complication rate for revision and control patients was 14.71 and 6.25%, respectively (p = 0.20). There were no leaks, one stricture (3.13%) in the revision group, and one reoperation for bleeding in the control group (1.56%). For patients with BMI >30 at surgery, change in BMI at 12 months for revision and control was 8.77 and 11.58, respectively (p = 0.02).
  
  
  CONCLUSIONS
  Single-stage revision can be performed safely, with minimal increases in hospital stay and 30-day complications. Weight loss is greater in those who undergo primary LSG compared to those who undergo LSG as revision.
authors.affiliation: Cedars-Sinai Medical Center, 8635 W 3rd St, Ste 770W, Los Angeles, CA, 90048, USA, amb809@gmail.com.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Barrett
authors.forename: Kim T
authors.initials: KT
authors.lastname: Vu
authors.forename: Kulmeet K
authors.initials: KK
authors.lastname: Sandhu
authors.forename: Edward H
authors.initials: EH
authors.lastname: Phillips
authors.forename: Scott A
authors.initials: SA
authors.lastname: Cunneen
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Burch
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D015431:Weight Loss / Q000502:physiology*