INTRODUCTION: Growing number of @entity1 requires revisional bariatric surgery. This study compares perioperative course and outcomes of revisional versus primary bariatric surgery. METHODS: @entity1 who underwent revisional bariatric surgery from Jan 1997 to Sept 2012 were reviewed retrospectively. Every revisional @entity1 with BMI >35 and age <70 was matched with a primary Roux-en-Y @entity356 control @entity1 based on preoperative BMI, age, sex, and year of surgery. @entity1 ' preoperative indications, intraoperative/postoperative course, and complications were analyzed. RESULTS: Two hundred and fifty five @entity1 underwent revisional bariatric surgery with resulting Roux-en-Y @entity356 anatomy while 1,674 @entity1 underwent primary @entity356 in the same time interval. Of 255 @entity1 , 172 @entity1 were paired with 172 primary @entity356 @entity1 . Revisional bariatric group had preoperative BMI 48      9, age 52      9  years, 93  % female, 44  % laparoscopic, 30  % @entity6 , 60  % @entity101 . Primary bypass @entity1 had preoperative BMI 49      8, age 52      9  years, 93  % female, 97  % laparoscopic, 49  % @entity6 , 67  % @entity101 . Compared to primary bypass @entity1 , revisional @entity1 had significantly higher estimated @entity190 (463.7 vs. 113.3  mL), longer operative time (272.5 vs. 175.5  min), greater risk for ICU stay (N  =  24, 14  % vs. N  =  2, 1  %), and longer hospital stay (5.6 vs. 2.5  days). There were significantly more intraoperative liver (N  =  13, 8  % vs. N  =  1, 1  %) and spleen (N  =  18, 10  % vs. N  =  0) injuries, and more enterotomies (N  =  9, 5  % vs. N  =  0) in the revisional group. There were also significantly more @entity260 (N  =  94, 55  % vs. N  =  48, 28  %), readmissions (N  =  27, 16  % vs. N  =  12, 7  %), and reoperations (N  =  16, 9  % vs. N  =  3, 2  %) within 30  days of surgery. Mean percentage @entity353 at 1  year was significantly less for revisional @entity1 (27 vs. 37  %). There was no significant difference in 30  day mortality between the two groups (N  =  6 vs. 0). CONCLUSION: Even in experienced hands, complex revisional bariatric surgery should be approached with significant caution, especially given that @entity353 is less substantial.

Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertensive'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic'] @entity353 :: ('MESH:D015431', 'Disease') :: ['weight loss'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric bypass']
@entity356 :: (MESH:D013274,Disease) :: ['gastric bypass']
