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. 2023 Jun;75(4):959-965.
doi: 10.1007/s13304-023-01471-1. Epub 2023 Feb 28.

Re-sleeve gastrectomy: weight loss, comorbidities and gerd evaluation in a large series with 5 years of follow-up

Marta Bonaldi  1 , Carolina Rubicondo  2 , Riccardo Giorgi  2 , Giovanni Cesana  2 , Francesca Ciccarese  2 , Matteo Uccelli  2 , Adelinda Zanoni  2 , Roberta Villa  2 , Stefano De Carli  2 , Alberto Oldani  2 , Ayman Ismail  2 , Francesco Di Capua  2 , Stefano Olmi  2
Affiliations

Re-sleeve gastrectomy: weight loss, comorbidities and gerd evaluation in a large series with 5 years of follow-up

Marta Bonaldi et al. Updates Surg. 2023 Jun.

Abstract

Introduction: Laparoscopic sleeve gastrectomy (SG) has rapidly become one of the most commonly performed procedures in bariatric surgery. Weight regain and insufficient weight loss are the most common causes for surgical failure. Re-sleeve gastrectomy (ReSG) can represent an option when there is evidence of a dilated gastric tube.

Objectives: The aim of the study is to evaluate safety, efficacy and rate of gastro-esophageal reflux disease (GERD) after ReSG in one of the largest series present in literature with long-term follow up.

Methods and study design: Retrospective study design. From February 2010 to August 2018, 102 patients underwent ReSG at our Centre. We divided patients into two groups, according to the main reason for surgical failure: insufficient weight loss or progressive weight regain.

Results: One hundred-two patients (78 women, 24 men) with BMI 38 ± 6 kg/m2 underwent ReSG (mean age 44 years). Rate of postoperative complications was 3.9% (4/102). After a mean follow-up of 55 months, mean BMI decreased to 30,4 kg/m2 and the mean percentage of excess weight loss (%EWL) was 51 ± 38.6. Symptoms of GERD were present in 35/102 patients (34.3%) and the need for a new operation occurred in six patients. Forty-five patients were submitted to ReSG for progressive weight regain (group A) and 57 for insufficient weight loss (group B). No differences were found in terms of postoperative BMI and %EWL.

Conclusion: ReSG is a feasible procedure after primary SG failure in selected patients, but its efficacy in reducing the BMI under 30 kg/m2 is still unclear. In addition, over 30% of patients suffer from long-term gastro-esophageal reflux.

Keywords: Residual fundus; Revisional surgery; Sleeve gastrectomy; Weight regain. Re-sleeve gastrectomy. failed sleeve.

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