title: Morbidity, mortality, and weight loss outcomes after reoperative bariatric surgery in the USA.
abstract: BACKGROUND
  Obesity is successfully treated by bariatric operations, but some patients need reoperations. No large national studies are available to evaluate the safety and efficacy after reoperative bariatric surgery.
  
  
  METHODS
  Data from June 2007 through March 2012 from the Bariatric Outcomes Longitudinal Database were queried for safety and efficacy of reoperations and compared to those who had initial bariatric operations but did not undergo reoperations. Reoperations were subdivided into corrective operations and conversions.
  
  
  RESULTS
  Out of 449,753 bariatric operations, 28,720 (6.3%) underwent reoperations of which 19,970 (69.5%) were corrective and 8,750 (30.5%) were conversions. The conversion group compared to primary operations was older (47.63 ± 10.8 vs. 45.5 ± 11.8 years), had less males (13.5 vs. 21.3%), and had more African Americans (14.6 vs. 12%). Comparing primary operations to corrective and conversions operations, respectively, the following were observed: length of stay (1.78 ± 4.95 vs. 2.04 ± 6.44 and 2.86 ± 4.58 days), severe adverse events at 30 days (1.6 vs. 1.7 and 3.3%), severe adverse events at 1 year (2.15 vs. 1.9 and 3.61%), percent excess weight loss at 1 year (43.2 vs. 35.9 ± 92.4 and 39.3 ± 39.9%), 30-day mortality rate (0.1 vs. 0.12 and 0.21%), and 1-year mortality rate (0.17 vs. 0.24 and 0.31%). Comorbidities were resolved after both primary operations and reoperations.
  
  
  CONCLUSIONS
  Most bariatric surgery patients do not need reoperations. Among those who do, the complication rate is low and outcomes are clinically comparable to primary procedures.
authors.affiliation: Department of Surgery, Duke University Medical Center, Box 2834, Durham, NC, 27710, USA, ranjan.sudan@duke.edu.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Sudan
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hutter
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
authors.forename: Jaime
authors.initials: J
authors.lastname: Ponce
authors.forename: John M
authors.initials: JM
authors.lastname: Morton
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009767:Obesity, Morbid / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D015431:Weight Loss