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A comparison between one- and two-stage revisional gastric bypass

机译：单阶段急性胃旁路之间的比较

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Background The safety of performing a one-stage revision from laparoscopic adjustable gastric banding (LAGB) to lapa-roscopic Roux-en-Y gastric bypass (LRYGB) has been questioned. The objective of this study was to compare safety and outcomes of one-stage versus two-stage revisional LRYGB performed after failed LAGB. Methods A retrospective analysis of all patients undergoing revisional LRYGB after failed LAGB between January 2007 and March 2017 was performed. Patients undergoing one- and two-stage revisions were compared. The primary outcome assessed was the early complication rate, while secondary outcomes included late complications, weight loss, and improvement of comorbidities. Results During the study period, 161 revisional LRYGB's were performed, including 121 one-stage and 40 two-stage procedures. Baseline demographic data, BMI and presence of comorbidities were similar between the groups. In patients undergoing a two-stage procedure, band slippage, port infection, and erosion were more commonly cited as indications for revision. Similar early complication rates were demonstrated between the groups. However, late complications were more common in the two-stage group (20.0% vs. 7.4%, P = 0.03), including higher rates of gastro-gastric fistula (5.0% vs. 0%, P = 0.01) and anemia (10.0% vs. 1.1%, .P = 0.02). Three-fourths of the cohort had a follow-up of more than 6 months, and the two groups demonstrated similar weight loss results and improvement/resolution of comorbidities. Conclusion The performance of one-stage revisional LRYGB after failed LAGB seems to be a safe procedure, with nonin-ferior outcomes when compared to a two-stage revisional procedure. It is a valid option, except in cases of mechanical and infectious band complications.
机译：背景技术已经质疑从腹腔镜可调胃带（LAPAR-ROSPOPIC ROUX-ZE-Y胃旁路（LARRGB）进行从腹腔镜调节胃带（LAGB）进行单阶段修正。本研究的目的是比较失败后失败后的单阶段重入林根的一种阶段的安全性和结果。方法对2007年1月至2017年1月至2017年3月间失败后遗产后的患者的回顾性分析。比较了进行一次和两阶段修订的患者。评估的主要结果是早期并发症率，而二次结果包括晚期并发症，体重减轻和改善合并症。结果在研究期间，进行了161个重新入住林吉，其中包括121阶段和40个两阶段程序。基数基准人口统计数据，BMI和合并症的存在在组之间相似。在接受两阶段手术的患者中，乐队滑移，港口感染和侵蚀更常见为修订的适应症。在组之间证明了类似的早期并发症率。然而，在两阶段组（20.0％与7.4％，P = 0.03）中的后期并发症更常见，包括胃胃瘘的较高速率（5.0％与0％，P = 0.01）和贫血（10.0 ％与1.1％，.p = 0.02）。四分之三的队列的后续行动超过6个月，两组展示了类似的减肥结果和改善/分辨性的合并症。结论失败后的一级撤离火山油的性能似乎是一种安全的程序，与两阶段的常规程序相比，非疾病成果。除了机械和传染性带并发症的情况外，它是一个有效的选择。

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