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Roriz-Silva R, Vilallonga R, Fort JM, Khoraki J, de Gordejuela AGR, Gonzalez O, Caubet E, Rodríguez-Luna MR, Armengol M. Robotic and laparoscopic Roux-en-Y gastric bypass after learning curve: 30-day and 12-month outcomes. J Robot Surg 2022; 16:1257-1263. [PMID: 35218480 DOI: 10.1007/s11701-022-01384-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/06/2022] [Indexed: 01/01/2023]
Abstract
This study compares laparoscopic RYGB (L-RYGB) and robotic RYGB (R-RYGB) performed by the same team after the learning curve in both approaches. A retrospective cohort study was done, and the surgical outcome was analyzed in 30 days and 12 months for patients with similar characteristics and an equal number of cases in each group (233 cases). Four hundred and sixty-six patients were included in this study. Mean age was 46.8 ± 8.3 years and 2/3 were women. R-RYGB presented a longer operative time (150.7 versus 135.4 min; p < 0.001) with no differences in the length of hospital stay. The main 30-day complications were G-J stricture, leakage, and intraluminal bleeding. The reoperation rate was 1.6% by leakage (G-J anastomosis) and was higher in R-RYGB (2.1 versus 0.4; p = 0.108). The multivariate analysis identified that L-RYGB was the factor independently associated with a LOS longer than 2 days (odds ratio: 4.7, 95% CI: 2.6-8.2, p value < 0.001). At the FU time (12 months), no differences between the groups were found. The outcomes between the groups after the learning curve did not present differences in terms of 30 days and 12 months of FU when same preoperative characteristics and an equal number of cases in each group are considered. L-RYGB was the unique independent factor associated with long LOS.
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Affiliation(s)
- Renato Roriz-Silva
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. .,Division of Bariatric and Gastrointestinal Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University School of Medicine, Richmond, USA. .,Department of Medicine, Federal University of Rondônia, Porto Velho, Brazil.
| | - Ramon Vilallonga
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jose Manuel Fort
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jad Khoraki
- Division of Bariatric and Gastrointestinal Surgery, Department of Surgery, Medical College of Virginia, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Amador Garcia Ruiz de Gordejuela
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Oscar Gonzalez
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Enric Caubet
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | - Manel Armengol
- Endocrine, Metabolic and Bariatric Unit, Department of General and Digestive Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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What Is Weight Loss After Bariatric Surgery Expressed in Percentage Total Weight Loss (%TWL)? A Systematic Review. Obes Surg 2021; 31:3833-3847. [PMID: 34002289 DOI: 10.1007/s11695-021-05394-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022]
Abstract
Percentage total weight loss (%TWL) might be better than percentage excess weight loss to express weight loss in bariatric surgery. In this systematic review, performed according to the PRISMA statement, results of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) are assessed in %TWL. A total of 13,426 studies were screened and 49 included, reporting data of 24,760 patients. The results show that, despite limiting data, LRYGB is favorable over LSG in terms of weight loss in short-term follow-up. Although recent guidelines recommend to use %TWL when reporting outcome in bariatric surgery, this study shows that there is still insufficient quality data in %TWL, especially on LSG. The use of %TWL as the primary outcome measure in bariatric surgery should be encouraged.
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