Re-sleeve gastrectomy is a safe and sensible intervention in selected patients: retrospective cohort study

Int J Surg. 2023 Dec 1;109(12):4145-4150. doi: 10.1097/JS9.0000000000000743.

Abstract

Introduction: Sleeve gastrectomy is a good treatment intervention to control the metabolic syndrome in patients with obesity worldwide. However, weight regain is of great concern and would usually necessitate a reintervention. In recent years, re-sleeve gastrectomy (ReSG) has been proposed to treat weight regain in the context of a large residual stomach. Our objective was to analyze the long-term results and safety profile of this intervention in a large case series.

Methods: From September 2010 to March 2021, a retrospective cohort study in a tertiary nonuniversity hospital was performed. Seventy-nine patients received a ReSG by laparoscopy. Preoperative radiologic imaging showed a dilation of the gastric pouch exceeding 250 cc in all cases.

Results: A total of 79 patients (87% females) with a mean age of 44.8 years old and a mean BMI of 40.0 kg/m 2 were enrolled in the study. The mean follow-up was 44.8 months. The ReSG indication was insufficient weight loss in 37 patients (46.8%) and weight regain in 39 patients (53.2%). The authors noticed a 10.1% complications rate: gastric stenosis (5.1%), bleeding (2.5%), and incisional site hernia in 2.5%, with no death. There was no gastric fistula detected. The mean BMI decreased to 33.1 kg/m 2 after ReSG (a decrease of 6.9 kg/m 2 ).

Conclusion: After insufficient weight loss or weight regain following sleeve gastrectomy and in the presence of localized or global gastric tube dilation, ReSG seems to be a good treatment choice and a safe procedure.

MeSH terms

  • Adult
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Gastric Bypass* / methods
  • Humans
  • Incisional Hernia* / surgery
  • Laparoscopy* / methods
  • Male
  • Obesity, Morbid* / surgery
  • Reoperation / methods
  • Retrospective Studies
  • Treatment Outcome
  • Weight Gain
  • Weight Loss