Health science reports · 2026
Clinical Outcomes, Risks, and Individualized Treatment Selection in Revisional Metabolic and Bariatric Surgery: A Narrative Review.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Ebrahimian Jektaji Ramin, Moghaddam Ahmadi Mahta, Shokrgozar Leila, Moghaddam Ahmadi Moein
Аннотация
BACKGROUND AND AIMS: As the use of metabolic and bariatric surgery (MBS) expands, clinicians increasingly encounter weight recurrence, suboptimal response, gastroesophageal reflux disease (GERD), nutritional problems, and procedure-related complications. Revisional metabolic and bariatric surgery (RMBS) offers several corrective and conversion strategies, but outcomes vary by indication, prior anatomy, procedure, and patient characteristics. This narrative review summarizes current evidence on the benefits, risks, and clinical determinants of RMBS.
METHODS: Evidence on indications, procedure selection, weight-related and metabolic outcomes, GERD, complications, nutritional consequences, reoperation, mortality, and patient-reported outcomes was narratively synthesized. Greater emphasis was placed on systematic reviews, meta-analyses, comparative studies, registry analyses, and contemporary consensus guidance.
RESULTS: RMBS can provide additional weight reduction, improve selected obesity-related comorbidities, and address complications of previous surgery. Roux-en-Y gastric bypass is particularly relevant when GERD is a major indication after sleeve gastrectomy, whereas more malabsorptive procedures may provide greater weight-related benefit in selected patients at the cost of greater nutritional surveillance. Outcomes are influenced by the indication for revision, existing anatomy, nutritional and metabolic status, prior procedures, and procedural complexity. Quality of life improvement is possible but remains inconsistently reported. Pharmacological and endoscopic therapies may also serve as alternatives or adjuncts in selected patients with weight recurrence or suboptimal response.
CONCLUSION: RMBS should be individualized rather than approached as a uniform treatment. Optimal management requires matching the intervention to the underlying indication, balancing expected benefits against procedural and nutritional risks, and providing multidisciplinary long-term follow-up.
METHODS: Evidence on indications, procedure selection, weight-related and metabolic outcomes, GERD, complications, nutritional consequences, reoperation, mortality, and patient-reported outcomes was narratively synthesized. Greater emphasis was placed on systematic reviews, meta-analyses, comparative studies, registry analyses, and contemporary consensus guidance.
RESULTS: RMBS can provide additional weight reduction, improve selected obesity-related comorbidities, and address complications of previous surgery. Roux-en-Y gastric bypass is particularly relevant when GERD is a major indication after sleeve gastrectomy, whereas more malabsorptive procedures may provide greater weight-related benefit in selected patients at the cost of greater nutritional surveillance. Outcomes are influenced by the indication for revision, existing anatomy, nutritional and metabolic status, prior procedures, and procedural complexity. Quality of life improvement is possible but remains inconsistently reported. Pharmacological and endoscopic therapies may also serve as alternatives or adjuncts in selected patients with weight recurrence or suboptimal response.
CONCLUSION: RMBS should be individualized rather than approached as a uniform treatment. Optimal management requires matching the intervention to the underlying indication, balancing expected benefits against procedural and nutritional risks, and providing multidisciplinary long-term follow-up.