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Non-response After ...
Non-response After Gastric Bypass and Sleeve Gastrectomy-the Theoretical Need for Revisional Bariatric Surgery : Results from the Scandinavian Obesity Surgery Registry
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- Axer, Stephan (author)
- Faculty of Health and Medicine, Örebro University, Campus USÖ, Örebro, Sweden; Department of Surgery, Torsby Hospital, Box 502, 685 29, Torsby, Sweden
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- Szabo, Eva, PhD, 1973- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Surgery
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- Näslund, Ingmar (author)
- Department of Surgery, Faculty of Health and Medicine, Örebro University, Campus USÖ, Örebro, Sweden
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(creator_code:org_t)
- Springer, 2023
- 2023
- English.
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In: Obesity Surgery. - : Springer. - 0960-8923 .- 1708-0428. ; 33:10, s. 2973-2980
- Related links:
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https://doi.org/10.1...
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Abstract
Subject headings
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- BACKGROUND: Revisional surgery is a second-line treatment option after sleeve gastrectomy (SG) and gastric bypass (GBP) in patients with primary or secondary non-response. The aim was to analyze the theoretical need for revisional surgery after SG and GBP when applying four indication benchmarks. METHOD: Based on data from the Scandinavian Obesity Surgery Registry, SG and GBP were compared regarding four endpoints: 1. excess weight loss (%EWL) < 50%, 2. weight regain of more than 10 kg after nadir, 3. fulfillment of previous IFSO-guidelines, or 4. ADA criteria for bariatric metabolic surgery 2 years after primary surgery.RESULTS: A total of 60,426 individuals were included in the study (SG: n = 7856 and GBP: n = 52,570). Compared to patients in the GBP group, more SG patients failed to achieve a %EWL > 50% (23.0% versus 8.5%, p < .001), regained more than 10 kg after nadir (4.3% versus 2.5%, p < .001), and more often fulfilled the IFSO criteria (8.0% versus 4.5%, p < .001) or the ADA criteria (3.3% versus 1.8%, p < 001) at the 2-year follow-up.CONCLUSION: SG is associated with a higher risk for weight non-response compared to GBP. To offer revisional bariatric surgery to all non-responders exceeds the bounds of feasibility and operability. Hence, individual prioritization and intensified evaluation of alternative second-line treatments are necessary.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Gastric bypass
- Revisional bariatric surgery
- Sleeve gastrectomy
Publication and Content Type
- ref (subject category)
- art (subject category)
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