30-day morbidity and mortality of revisional bariatric surgery - An international multi-centre collaborative (BROAD) study

Nasta AM 1 , Goel R 2 , Singhal R 3 , Lemmens L 4 , Baig S 5 , Seki Y 6 Show all authors , Prasad A 7 , Chiappetta S 8 , Kermansaravi M 9 , Vertruyen M 10 , Pascotto B 11 , Azagra JS 12 , Al-Khyatt W 13 , Martines G 14 , Villao DY 15 , Revello L 16 , Rioseco M 17 , Martini F 18 , Liagre A 19 , Juglard G 20 , Dapri G 21 , Proczko-Stepaniak MA 22 , Abou-Mrad AK 23 , Elghadban HM 24 , Stier C 25 , Van Herck JLE 26 , Taha SA 27 , Şen O 28 , Dillemans B 29 , Van Hoef S 30 , Vandeputte M 31 , Viskens S 32 , Gentileschi P 33 , Palaniappan R 34 , Sakran N 35 , Shin TH 36 , Aminian A 37 , Uccelli M 38 , Olmi S 39 , Cesana GC 40 , Anselmino M 41 , Debergh NPA 42 , Gärtner D 43 , Yang W 44 , Bedi DS 45 , Mahawar K 46 , BROAD study collaborative group

Affiliations 

  • 1 Wockhardt Hospitals, Mumbai, India. Electronic address: amritnasta@hotmail.com
  • 2 Center for metabolic Surgery, Wockhardt Hospitals, Mumbai, India. Electronic address: ramengoel@gmail.com
  • 3 University Hospitals Birmingham NHS Trust (1), Healthier Weight (2), Birmingham, United Kingdom. Electronic address: drrishisinghal@gmail.com
  • 4 AZ RIVIERENLAND, Bornem, Belgium. Electronic address: luc@dr-lemmens.be
  • 5 Digestive Surgery Clinic, Belle Vue Clinic, Kolkata, India. Electronic address: docsarfarazbaig2@gmail.com
  • 6 Yotsuya Medical Cube, Tokyo, Japan. Electronic address: y-seki@mcube.jp
  • 7 Indraprastha Apollo Hospital, New Delhi, India. Electronic address: surgerytimes@gmail.com
  • 8 head obesity and metabolic surgery unit, Ospedale Evangelico Betania, Naples, Italy. Electronic address: drschiappetta@gmail.com
  • 9 Iran University of Medical Sciences, Iran. Electronic address: mkermansaravi@yahoo.com
  • 10 Europe clinics of Brussels, Brussels, Belgium. Electronic address: marcvertruyen@skynet.be
  • 11 Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg. Electronic address: ben.pascotto@gmail.com
  • 12 Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg. Electronic address: Azagra.js@chl.lu
  • 13 East Midland Bariatric & Metabolic Institute (EMBMI), Derby, United Kingdom. Electronic address: waleed.al-khyatt@nhs.net
  • 14 Azienda Ospedaliero Universitaria Policlinico, Bari, Italy. Electronic address: gennaromartines@gmail.com
  • 15 Clinica Vespucio, Santiago, Chile. Electronic address: divavillao@gmail.com
  • 16 Clinica Vespucio, Santiago, Chile. Electronic address: revelloch@gmail.com
  • 17 Clinica Vespucio, Santiago, Chile. Electronic address: mriosecov@gmail.com
  • 18 Clinique des Cedres, Cornebarrieu, France. Electronic address: framartini77@hotmail.com
  • 19 Clinique des Cedres, Cornebarrieu, France. Electronic address: arnaud.liagre@orange.fr
  • 20 Clinique des Cedres, Cornebarrieu, France. Electronic address: drjuglard@orange.fr
  • 21 Head of Minimally Invasive General & Oncologic Surgery Center, Humanitas Gavazzeni University Hospital, Bergamo, Italy. Electronic address: giovanni@dapri.net
  • 22 Medical University of Gdansk, Poland. Electronic address: mproczko@gumed.edu.pl
  • 23 Centre Hospitalier Regional d'ORLEANS, ORLEANS, France. Electronic address: adel.abou-mrad@orange.fr
  • 24 Mansoura University, Eldakahlia, Egypt. Electronic address: drhelghadban@mans.edu.eg
  • 25 Interdisciplinary Endoscopy University hospital Mannheim., Germany. Electronic address: christinestier@gmail.com
  • 26 Abdominal and bariatric surgery, AZ Rivierenland, Antwerp, Belgium. Electronic address: jasper@drvanherck.com
  • 27 Abu Dhabi, UAE. Electronic address: Safwan.Taha@Mediclinic.ae
  • 28 Nisantasi University/Türkçapar Bariatrics, İstanbul, Turkey. Electronic address: ozansen77@gmail.com
  • 29 AZ Sint Jan, Brugge, Belgium. Electronic address: bruno.dillemans@azsintjan.be
  • 30 AZ Sint Jan, Brugge, Belgium. Electronic address: stijnvanhoef@gmail.com
  • 31 AZ Sint Jan, Brugge, Belgium. Electronic address: mathieu.vandeputte@azsintjan.be
  • 32 AZ Sint Jan, Brugge, Belgium. Electronic address: sofie.viskens@gmail.com
  • 33 Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and University of Rome Tor Vergata, ROME, ITALY. Electronic address: gentileschi.paolo@gmail.com
  • 34 Apollo Hospitals, chennai, india. Electronic address: docraj@me.com
  • 35 Faculty of medicine, Bar-Ilan University, Holy Family Hospital, Nazareth, Israel. Electronic address: sakranas@gmail.com
  • 36 Cleveland Clinic Foundation, Cleveland, OH, United States. Electronic address: thshin@bwh.harvard.edu
  • 37 Cleveland Clinic Foundation, Cleveland, OH, United States. Electronic address: aminiaa@ccf.org
  • 38 San Marco Hospital GSD, Zingonia (BG), Italy. Electronic address: matteo.uccelli@gmail.com
  • 39 San Marco Hospital GSD, Zingonia (BG), Italy. Electronic address: stefano.olmi@gmail.com
  • 40 San Marco Hospital GSD, Zingonia (BG), Italy. Electronic address: giovanni.cesana@gmail.com
  • 41 San Marco Hospital GSD, Zingonia (BG), Italy. Electronic address: m.anselmino@me.com
  • 42 CHC Montlégia, Liège, Belgium. Electronic address: nicolas.debergh@chc.be
  • 43 Head of the Obesity Center, Obesity Center Karlsruhe, Karlsruhe, Germany. Electronic address: daniel.gaertner@klinikum-karlsruhe.de
  • 44 The First Affiliated Hospital of Jinan University, Guangzhou, China. Electronic address: yangwah@qq.com
  • 45 Hope Obesity Centre, Ahmedabad, India. Electronic address: dbedi72@gmail.com
  • 46 South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK. Electronic address: kmahawar@gmail.com
Obes Res Clin Pract, 2024;18(3):195-200.
PMID: 38955573 DOI: 10.1016/j.orcp.2024.06.001

Abstract

INTRODUCTION: Revisional bariatric surgery (RBS) for insufficient weight loss/weight regain or metabolic relapse is increasing worldwide. There is currently no large multinational, prospective data on 30-day morbidity and mortality of RBS. In this study, we aimed to evaluate the 30-day morbidity and mortality of RBS at participating centres.

METHODS: An international steering group was formed to oversee the study. The steering group members invited bariatric surgeons worldwide to participate in this study. Ethical approval was obtained at the lead centre. Data were collected prospectively on all consecutive RBS patients operated between 15th May 2021 to 31st December 2021. Revisions for complications were excluded.

RESULTS: A total of 65 global centres submitted data on 750 patients. Sleeve gastrectomy (n = 369, 49.2 %) was the most common primary surgery for which revision was performed. Revisional procedures performed included Roux-en-Y gastric bypass (RYGB) in 41.1 % (n = 308) patients, One anastomosis gastric bypass (OAGB) in 19.3 % (n = 145), Sleeve Gastrectomy (SG) in 16.7 % (n = 125) and other procedures in 22.9 % (n = 172) patients. Indications for revision included weight regain in 615(81.8 %) patients, inadequate weight loss in 127(16.9 %), inadequate diabetes control in 47(6.3 %) and diabetes relapse in 27(3.6 %). 30-day complications were seen in 80(10.7 %) patients. Forty-nine (6.5 %) complications were Clavien Dindo grade 3 or higher. Two patients (0.3 %) died within 30 days of RBS.

CONCLUSION: RBS for insufficient weight loss/weight regain or metabolic relapse is associated with 10.7 % morbidity and 0.3 % mortality. Sleeve gastrectomy is the most common primary procedure to undergo revisional bariatric surgery, while Roux-en-Y gastric bypass is the most commonly performed revision.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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