Introduction
Methods
Statistical Analysis
Data Extraction
Results
Author | Type of primary surgery | Number of patients | Interval to revision (month) | Pre-revision BMI (kg/m2) | Post-revision BMI (kg/m2) | Mean follow-up (year) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
At primary | Nadir | At revision | 1 year | ≤ 3 years | ≤ 5 years | |||||||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |||||
Poublon2020 [31] | LSG | 65 | – | 45.7 | – | 40.9 | – | – | – | 30.7 | – | 31.1 | 5.1 | – | – | NA |
Chevallier et al.,2015 [8] | LSG | NA | – | – | – | – | – | 44.5 | 6.4 | – | – | 28.9 | 3.7 | – | – | 2.5 |
Lessing et al., 2017 [32] | LSG | 27 | 105.6 | – | – | – | – | 42.2 | 8.3 | – | – | – | – | – | – | 4 |
Mora Oliver et al., 2019 [33] | LSG | 26 | 70 | – | – | – | – | – | – | – | – | – | – | – | – | 1.6 |
Bruzzi et al., 2016 [24] | LSG | NA | 34 | – | – | – | – | 45.5 | 7 | 33 | 4.5 | 30.5 | 4 | 32 | 5 | 5.5* |
AlSabah et al., 2018 [22] | LSG | 31 | 61 | 49 | 32.2 | – | 42.6 | 32.2 | 5.1 | – | – | – | – | NA | ||
Bhandari et al., 2019 [23] | LSG | 32 | – | 44.04 | 34.22 | – | 38.53 | 34.33 | 37.14 | – | – | NA | ||||
Moszkowicz et al.,2013 [18] | LSG | 21 | 26.3 | 50.6 | 12.3 | – | – | 44 | 7.7 | 34.6 | 5.2 | 35.7 | 4.3 | 1.4 | ||
Poghosyan et al.,2019 [27] | LSG | 72 | 28 | 49.1 | 8 | – | – | 43.6 | 7 | 34.6 | 5 | 33 | 9 | 34.7 | 9 | NA |
Debs et al., 2020 [26] | LSG | 77 | 53.7 | 46.9 | – | – | 40.1 | 29.8 | – | – | 29.1 | 5 | 4.5 | |||
Jamal et al., 2020 [30] | LSG | 56 | – | – | – | 41.9 | 7.9 | 30.5 | 9.4 | – | – | – | – | 1.5 | ||
Chiappetta 2019 [25] | LSG | 34 | 38.5 | 56.5 | 8.8 | – | – | 45.7 | 8 | 36.6 | 6.3 | – | – | – | – | NA |
Musella et al., 2019 [19] | LSG | 104 | 21.8 | 41.25 | 8.34 | – | – | 41.8 | 6.3 | – | – | 30.5 | 5.5 | – | – | 1.7 |
Lessing et al., 2020 [17] | LSG | 4 | 142.8 | 46.7 | 5.9 | – | – | 42.8 | 7 | 31.3 | 5.2 | – | – | – | – | 1-year: 100% 2-year: 71.9% |
Noun et al., 2018 [29] | LSG | 7 | – | 45 | 4.8 | 35 | 5 | 42.9 | 6.5 | 28.5 | 4 | – | – | – | – | NA |
Author | Type of primary surgery | Number of patients | Interval to revision (month) | Pre-revision BMI (kg/m2) | Post-revision BMI (kg/m2) | Mean follow-up (year) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
At primary | Nadir | At revision | 1 year | ≤ 3 years | ≤ 5 years | |||||||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |||||
Noun et al., 2018 [29] | LAGB | 10 | – | 45 | 4.8 | 35 | 5 | 42.9 | 6.5 | 28.5 | 4 | – | – | – | – | NA |
Noun et al., 2012 [40] | LAGB | 77 | – | 41.25 | 8.34 | – | – | – | – | – | – | – | – | – | – | 1-year: 83.6% 1.5-year: 83% 3-years: 81% 4-years: 78% 5-years: 70 |
Lessing et al., 2020 [17] | LAGB | 53 | 142.8 | 46.7 | 5.9 | – | – | 42.8 | 7 | 31.3 | 5.2 | – | – | – | – | 1-year: 100% 2-year: 71.9% |
Poublon 2020 [31] | LAGB | 120 | – | 45.7 | – | 40.9 | – | – | – | 30.7 | – | 31.1 | 5.1 | – | – | NA |
Musella et al., 2019 [19] | LAGB | 196 | 21.8 | 41.25 | 8.34 | – | – | 41.8 | 6.3 | – | – | 30.5 | 5.5 | – | – | 1.7 |
Piazza et al., 2015 [20] | LAGB | 47 | 28.5 | – | – | – | – | 43.4 | 4.2 | 34.1 | 3.77 | – | – | – | – | NA |
Chevallier et al.,2015 [8] | LAGB | 41 | – | – | – | – | – | 44.5 | 6.4 | – | – | 28.9 | 3.7 | – | – | 2.6 |
Lessing et al., 2017 [32] | LAGB | 71 | 105.6 | – | – | – | – | 42.2 | 8.3 | – | – | – | – | – | – | 4 |
Mora Oliver et al.,2019 [33] | LAGB | 26 | 70 | – | – | – | – | – | – | – | – | – | – | – | – | 1.7 |
Chansaenroj et al.,2017 [34] | LAGB | 26 | – | 39.9 | 10.5 | – | – | 39.3 | 8.9 | 27.4 | 5.2 | 26.8 | 4.8 | – | – | 5-year: 34.1% 10-years: 30.6% |
Ghosh et al., 2017 [35] | LAGB | 74 | – | 48.9 | 11.2 | – | – | 46 | 8.9 | 33.2 | 7.34 | – | – | – | – | 6-week: 97% 3-months: 85% 6-months: 69% 1-year: 46% |
Noun et al., 2007 [36] | LAGB | 16 | 36.3 | – | – | 39.5 | 10.4 | 30.6 | 4.77 | – | – | – | – | 0.6 | ||
Rutledge et al., 2006 [37] | LAGB | 3 | – | – | – | – | – | 38.7 | 7 | – | – | – | – | NA | ||
Pujol Rafols et al., 2018 [28] | LAGB | 191 | – | 44.3 | 6.8 | – | – | 39.8 | 6.9 | – | – | – | – | 30.3 | 5.4 | 2.8 |
Carbajo et al. 2017 [9] | LAGB | 13 | – | – | – | – | – | 41.6 | 5.6 | – | – | – | – | 28.5 | 5.2 | 6-years: 87% 12-years: 70% |
Bruzzi et al., 2016 [24] | LAGB | 30 | 34 | – | – | – | – | 45.5 | 7 | 33 | 4.5 | 30.5 | 4 | 32 | 5 | 66.5 |
Author | Type of primary surgery | Number of patients | Interval to revision (month) | Pre-revision BMI (kg/m2) | Post-revision BMI (kg/m2) | Mean follow-up (year) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
At primary | Nadir | At revision | 1 year | ≤ 3 years | ≤ 5 years | |||||||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |||||
Carbajo et al. 2017 [9] | VBG | 14 | – | – | – | – | – | 41.6 | 5.6 | – | – | – | – | 28.5 | 5.2 | 7.5 |
Chevallier et al.,2015 [8] | VBG | NA | – | – | – | – | – | 44.5 | 6.4 | – | – | 28.9 | 3.7 | – | – | 2.6 |
Bruzzi et al., 2016 [24] | VBG | 30 | 34 | – | – | – | – | 45.5 | 7 | 33 | 4.5 | 30.5 | 4 | 32 | 5 | 5.8 |
Mora Oliver et al.,2019 [33] | VBG | 36 | 70 | – | – | – | – | – | – | – | – | – | – | – | – | 1.7 |
Noun et al., 2007 [36] | VBG | 17 | 36.3 | – | – | 39.5 | 10.4 | 30.6 | 4.8 | – | – | – | – | 0.8 | ||
Salama et al., 2016 [38] | VBG | 39 | – | – | – | – | – | 39.7 | 8.2 | 30.2 | 5.4 | – | – | – | – | NA |
Wang et al., 2004 [39] | VBG | 29 | 58.5 | – | – | – | – | 41.7 | 32.1 | – | – | – | – | NA | ||
Almalki et al., 2018 [21] | VBG | 81 | 58.8 | – | – | – | – | 37.8 | 9.6 | 27.2 | 6.2 | – | – | 27.8 | 6.7 | 1-year: 60% 5-years: 37% |
Weight Regain Definition
Weight regain definition | Frequency | Rate % |
---|---|---|
BMI ≥ 35 or EWL ≤ 50% | 7 | 33.3 |
BMI ≥ 35 | 2 | 9.5 |
EWL 2 years < 50% or > 25% EWL regain compared with minimal weight | 1 | 4.8 |
EWL 2 years < 50% | 1 | 4.8 |
EBMIL < 50% | 3 | 14.3 |
EBMIL ≤ 25% | 3 | 14.3 |
EWL < 50% 18 months after surgery | 1 | 4.8 |
EWL < 50% at 18-month follow-up and EWL < 30% at any time | 1 | 4.8 |
EWL < 50%, and BMI ≥ 50 | 1 | 4.8 |
EWL < 50% and/or TWL < 25% and/or BMI > 40 at 2 years follow-up | 1 | 4.8 |
Conversional OAGB/MGB Etiologies
Biliopancreatic Limb Length
Biliopancreatic limb length | Frequency | Rate % |
---|---|---|
200 cm | 9 | 36 |
180–200 cm | 1 | 4 |
180–240 cm | 1 | 4 |
150 cm and 200 cm | 2 | 8 |
180 cm | 2 | 8 |
150–200 cm | 1 | 4 |
175 -200 cm | 1 | 4 |
250 cm | 1 | 4 |
150 cm | 2 | 8 |
175 cm | 1 | 4 |
150 cm (and increased by 10 cm for each BMI point above 40) | 1 | 4 |
150–250 cm | 1 | 4 |
150–300 cm | 1 | 4 |
250–350 cm tailored | 1 | 4 |
Weight Loss Outcomes at 1-, 3-, and 5-Year Follow-Ups
Variable | Number of patients | Mean ± Std. deviation |
---|---|---|
At revision BMI (kg/m2) | 1584 | 42.3 ± 2.2 |
Post-revision BMI ≤ 1 year (kg/m2) | 761 | 31.6 ± 2.5 |
Post-revision BMI ≤ 3 years (kg/m2) | 658 | 31.4 ± 3.1 |
Post-revision BMI ≤ 5 years (kg/m2) | 505 | 30.6 ± 2.3 |
Comorbidity and Remission
Author/year | Number of patients | Post-revision comorbidities remission | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 year | ≤ 3 years | ≤ 5 years | |||||||||||
HTN | T2DM | OSA | DL | HTN | T2DM | OSA | DL | HTN | T2DM | OSA | DL | ||
AlSabah 2018 [22] | 31 | 50 | – | – | – | – | – | – | – | – | – | – | – |
Bhandari 2019 [23] | 32 | 81.8 | 88.8 | – | – | 81.8 | 88.8 | – | – | 81.8 | 71.4 | – | – |
Chiappetta 2019 [25] | 34 | 100 | 66.7 | 80 | 61.5 | – | – | – | – | – | – | – | – |
Debs 2020 [26] | 77 | – | – | – | – | – | – | – | – | 65 | 62 | 82 | – |
Jamal 2020 [30] | 56 | 42 | 40 | – | – | – | – | – | – | – | – | – | – |
Poghosyan 2019 [27] | 72 | – | – | – | – | 21 | 75 | 70 | – | – | – | – | – |
Musella 2019 [19] | 300 | – | – | – | – | 45 | 12 | – | 11 | – | – | – | – |
Bruzzi 2016 [24] | 30 | – | – | – | – | – | – | – | 58 | 85 | – | 75 | |
Chevallier 2015 [8] | 177 | – | – | – | – | 52.1 | 85.7 | 50 | 80.6 | – | – | – | – |
Carbajo 2017 [9] | 27 | – | – | – | – | – | – | – | – | 94 | 94 | 90 | 96 |
Poublon 2020 [31] | 185 | – | – | – | – | – | 96.9 | 87.5 | 80 | – | – | – | – |
Post-revision remission rate range | Minimum (%) | Maximum (%) | Mean ± Std. deviation |
---|---|---|---|
HTN at 1-year follow-up | 42 | 100 | 68.5 ± 27.2 |
T2DM1 at 1-year follow-up | 40 | 88.8 | 65.2 ± 24.4 |
OSA at 1-year follow-up | 80 | 80.0 | 80 ± 0 |
DL at 1-year follow-up | 61 | 61.5 | 61.5 ± 0 |
HTN at 3-year follow-up | 21 | 81.8 | 49.9 ± 25 |
T2DM at 3-year follow-up | 12 | 88.8 | 65.4 ± 36.1 |
OSA at 3-year follow-up | 50 | 70.0 | 60 ± 14.1 |
DL at 3-year follow-up | 11 | 80.6 | 45.8 ± 49.2 |
HTN at 5-year follow-up | 58 | 94.0 | 74.7 ± 16.3 |
T2DM at 5-year follow-up | 62 | 94.0 | 78.1 ± 14.2 |
OSA at 5-year follow-up | 82 | 90.0 | 86 ± 5.7 |
DL at 5-year follow-up | 75 | 96.00 | 85.5 ± 14.8 |
Diabetes Outcomes
HTN Outcomes
Dyslipidemia Outcomes
OSA Outcomes
GERD Outcomes
Author/year | Pre-revisionGERD (%) | Post-revision GERD (%) | Remission (%) | Remission mean ± SD |
---|---|---|---|---|
Noun 2007 [36] | 18.2 | 0 | 100 | 81.8 ± 29.7 |
Piazza 2015 [20] | 8.3 | 0 | 100 | |
Chiappetta 2019 [25] | 14.7 | 11.8 | 19.7 | |
Almalki 2018 [21] | 18.5 | – | – | |
Musella 2019 [19] | 4.6 | 2 | 56.5 | |
Lessing 2020 [17] | 29.8 | 0 | 100 | |
Bruzzi 2016 [24] | 13 | – | – | |
Lessing 2017 [32] | 9.1 | 0 | 100 | |
Carbajo 2017 [9] | 29.6 | 0 | 100 | |
Poublon 2020 [31] | 10.2 | 2.2 | 78 |
Major Complications
Complication | Total complication in 1771 patients | Rate % |
---|---|---|
Leakage | 29 | 1.6 |
Bleeding | 23 | 1.2 |
Hematoma and abscess | 12 | 0.6 |
GIB | 2 | 0.1 |
Hypoalbuminaemia | 4 | 0.2 |
Reoperation | 2 | 0.1 |
Strangulated hernia at trocar port | 2 | 0.1 |
Late incisional hernia | 4 | 0.2 |
Colonic necrosis | 1 | 0.06 |
Bowel obstruction | 3 | 0.1 |
Respiratory failure | 1 | 0.06 |
Stricture | 4 | 0.2 |
Intractable bile reflux | 2 | 0.1 |
Small bowel ileus | 2 | 0.1 |
Pneumonia | 1 | 0.06 |
GJ stoma fistula | 1 | 0.06 |
Hematemesis | 1 | 0.06 |
Port site infection | 1 | 0.06 |
Ulceration | 4 | 0.2 |
Publication Bias
Discussion
Variable | Remnant resection (n = 319) | Mean | t | P value |
---|---|---|---|---|
Post-revision BMI ≤ 1 year (kg/m2( | Yes | 31.6 ± 3.7 | − 0.19 | 0.86 |
No | 31.9 ± 2.2 | |||
Post-revision BMI ≤ 3 years (kg/m2) | Yes | 37.1 ± 0 | 1.85 | 0.12 |
No | 30.9 ± 3.1 | |||
Post-revision BMI ≤ 5 years (kg/m2) | Yes | 28.5 ± 0.9 | − 2.25 | 0.11 |
No | 32.3 ± 2.2 |