One anastomosis gastric bypass showed no significant difference in excess weight loss compared to Roux-en-Y gastric bypass (p=0.11), but resulted in higher postoperative reflux (16% vs 10.1%).
Meta-Analysis (n=802)
Does one anastomosis gastric bypass improve weight loss compared to Roux-en-Y gastric bypass in patients requiring revisional surgery following sleeve gastrectomy?
OAGB and RYGB provide comparable weight loss as revisional surgeries after sleeve gastrectomy, but RYGB is better for reducing GORD while OAGB is faster to perform.
p-value: p=0.11
Introduction The number of bariatric operations is increasing each year. Sleeve gastrectomy is the most popular procedure; however, it often requires revision surgery because of insufficient weight loss, weight regain or gastro-oesophageal reflux disease (GORD). The most popular revisional procedures are Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB). The primary outcome of this meta-analysis was weight loss after revisional surgery following laparoscopic sleeve gastrectomy and the secondary outcomes were gastro-oesophageal reflux, BMI difference, operative time, bleeding and anastomotic leak. Methods A systematic electronic search was undertaken using PubMed, MEDLINE, Ovid, Cochrane Library and Google Scholar following PRISMA guidelines. The initial search identified 2,546 articles. After screening, seven papers met the inclusion criteria: six retrospective studies and one randomised controlled trial. Results In total, 802 patients met the inclusion criteria: 390 had an OAGB and a further 412 had an RYBG. All patients previously had a sleeve gastrectomy for weight loss. The length of follow-up was 12 months for our primary outcome. We found no statistically significant difference in excess weight loss (%EWL) between OAGB and RYGB (p = 0.11). The incidence of postoperative reflux was statistically significantly higher in the OAGB group (16% vs 10.1%, p < 0.003). Operative time was statistically significantly lower in the OAGB group (p = 0.04). Conclusions This meta-analysis showed no statistically significant difference between the two revision bariatric surgery procedures for %EWL. RYGB was superior to OAGB in reducing the incidence of symptomatic GORD, whereas OAGB had a significant shorter operative time.
Santoro et al. (Wed,) conducted a meta-analysis in Patients requiring revisional bariatric surgery following sleeve gastrectomy (n=802). One anastomosis gastric bypass (OAGB) vs. Roux-en-Y gastric bypass (RYGB) was evaluated on Excess weight loss (%EWL) (p=0.11). One anastomosis gastric bypass showed no significant difference in excess weight loss compared to Roux-en-Y gastric bypass (p=0.11), but resulted in higher postoperative reflux (16% vs 10.1%).