Journal article
Outcomes of primary versus revisional robotically assisted laparoscopic Roux-en-Y gastric bypass: a multicenter analysis of ten-year experience
Surgical endoscopy, v 35(10), pp 5766-5773
01 Oct 2021
PMID: 33026516
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Postoperative morbidity after laparoscopic bariatric surgery is considered higher for patients undergoing revisional versus primary procedures. The objective of this retrospective cohort study was to compare outcomes between patients undergoing primary versus revisional robotically assisted laparoscopic (RAL) Roux-en-Y gastric bypass (RYGB).
Data of all patients who underwent RAL primary and revisional RYGB between 2009 and 2019 at two accredited, high-volume bariatric surgery centers-the Memorial Hermann - Texas Medical Center, Houston, TX, and the Tower Health, Reading Hospital, Reading, PA, were analyzed. Primary outcomes were early (< 30 days) and overall postoperative complications. Secondary outcomes included intraoperative complications, operative times, conversions to laparotomy, length of hospital stay, early (< 30 days) postoperative readmissions and deaths.
Data of 1072 patients were analyzed, including 806 primary and 266 revisional RAL RYGB procedures. Longer operative times (203 versus 154 min, P < 0.001), increased number of readmissions for oral intolerance (10.5% versus 6.7%, P = 0.046) and higher rate of gastrojejunal stricture (6.4% versus 2.7%, P = 0.013) were found in the revisional group. Gastrointestinal leak rates were 0.2% for the primary versus 1.1% for the revisional group (P = 0.101). Early (< 30 days) reoperations rates were 2.2% for the primary versus 1.1% for the revisional group (P = 0.318). There were no statistically significant differences between groups in overall and severe complication rates.
Patients undergoing RAL primary and revisional RYGB had comparable overall outcomes, with a non-significant higher early complication rate in the revisional group. Despite the study being underpowered to detect differences in specific complication rates, the morbidity seen in the revisional RYGB group remains markedly below literature reports of revisional laparoscopic RYGB and might suggest a benefit of robotic assistance. Further prospective studies are needed to confirm these results.
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Details
- Title
- Outcomes of primary versus revisional robotically assisted laparoscopic Roux-en-Y gastric bypass: a multicenter analysis of ten-year experience
- Creators
- Pouya Iranmanesh - The University of Texas Health Science Center at HoustonJohn Fam - Reading HospitalThomas Nguyen - The University of Texas Health Science Center at HoustonDavid Talarico - Reading HospitalKavita D Chandwani - The University of Texas Health Science Center at HoustonKulvinder S Bajwa - The University of Texas Health Science Center at HoustonMelissa M Felinski - The University of Texas Health Science Center at HoustonLeon V Katz - Reading HospitalSheilendra S Mehta - Texas Laparoscopic Consultants, Houston, TX, USAStephan R Myers - Reading HospitalBrad E Snyder - The University of Texas Health Science Center at HoustonPeter A Walker - Health FirstTodd D Wilson - The University of Texas Health Science Center at HoustonAngielyn R Rivera - The University of Texas Health Science Center at HoustonConnie L Klein - The University of Texas Health Science Center at HoustonShinil K Shah - Texas A&M UniversityErik B Wilson - The University of Texas Health Science Center at Houston
- Publication Details
- Surgical endoscopy, v 35(10), pp 5766-5773
- Publisher
- Springer Nature
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000576102700006
- Scopus ID
- 2-s2.0-85092196203
- Other Identifier
- 991021930435304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery