One-anastomosis gastric bypass resulted in similar diabetes remission rates at 3 years compared to sleeve gastrectomy (OR 0.82; 95% CI 0.61-1.10), but achieved higher excess weight loss.
Meta-Analysis
Does one-anastomosis gastric bypass improve diabetes remission and excess weight loss compared to sleeve gastrectomy in patients undergoing bariatric surgery?
One-anastomosis gastric bypass provides superior early diabetes remission and sustained greater weight loss compared to sleeve gastrectomy, but with higher late complications and similar long-term diabetes remission.
Odds Ratio: 0.82 (95% CI 0.61–1.1)
BACKGROUND One-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) are surgical procedures increasingly performed for weight loss and to achieve remission of diabetes mellitus. Literature comparing the medium-term efficacy of these two procedures is scarce. As such, a meta-analysis comparing OAGB and SG in terms of diabetes remission (DR) and percentage of excess weight loss (EWL) is warranted. AIM To compare OAGB and SG in terms of DR and EWL% in the medium term. METHODS A comprehensive literature search was conducted in PubMed/MEDLINE, Cochran Library, and Web of Science for relevant articles, from inception through April 2025, using the keywords “one-anastomosis gastric bypass”, “sleeve gastrectomy”, “mini-gastric bypass”, “diabetes remission”, “one-anastomosis”, and “excess weight loss”. Clinical trials, prospective, retrospective and case-control studies were included; cross-sectional studies, case reports, editorials, and opinions were excluded. The Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale were used to assess the quality of included studies, and RevMan version 5.4 was used for data analyses. RESULTS A total of 1360 articles were identified, and 35 studies were retrieved of which 32 were included in the final analysis. Three full texts were excluded as they did not include data on DR or EWL%. OAGB achieved higher DR than SG at 1 year following surgery odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.22-2.57, I 2 = 76%. However, DR rates were similar at 3 years and 5 years following surgery (OR = 0.82, 95%CI: 0.61-1.10, I 2 = 23% and OR = 0.92, 95%CI: 0.31-2.72, I 2 = 75%, respectively). OAGB showed higher EWL% at 1 year (OR = 9.30, 95%CI: 6.45-12.15, I 2 = 91%), 3 years (OR = 10.02, 95%CI: 9.40-10.64, I 2 = 22%), and 5 years (OR = 11.61, 95%CI: 3.74-19.48, I 2 = 97%). OAGB showed higher late complications than adjustable SG. The results were not different in sub-group analysis including only clinical trials, observational studies, and removing studies including super-obese patients and studies contributing most to heterogeneity. CONCLUSION In the medium term, DR rates were similar between OAGB and SG; however, OAGB showed higher EWL% than SG, and late complications were higher in OAGB. Clinical trials investigating the predictors of DR and EWL% are recommended.
Hyder Osman Mirghani (Tue,) conducted a meta-analysis in Diabetes mellitus and obesity. One-anastomosis gastric bypass vs. Sleeve gastrectomy was evaluated on Diabetes remission at 3 years (OR 0.82, 95% CI 0.61-1.10). One-anastomosis gastric bypass resulted in similar diabetes remission rates at 3 years compared to sleeve gastrectomy (OR 0.82; 95% CI 0.61-1.10), but achieved higher excess weight loss.