Key result
One anastomosis gastric bypass and Roux-en-Y gastric bypass as redo-operations after sleeve gastrectomy resulted in comparable total body weight loss at 24 months (23% vs 18%, ns).
Why the study?
Knowledge regarding the best conversional bariatric procedure following sleeve gastrectomy needed improvement.
Does one anastomosis gastric bypass compared to Roux-en-Y gastric bypass improve weight loss and comorbidity remission in patients undergoing redo-operations following sleeve gastrectomy?
Cohort (n=123)
Does one anastomosis gastric bypass compared to Roux-en-Y gastric bypass improve weight loss and comorbidity remission in patients undergoing redo-operations following sleeve gastrectomy?
Absolute Event Rate: 23% vs 18%
p-value: p=ns
Both RYGB and OAGB are effective conversional procedures after sleeve gastrectomy with comparable weight loss and comorbidity remission, though OAGB has a shorter operative time.
Supports both RYGB and OAGB as conversion options after sleeve gastrectomy; leaves open superiority in randomized trials.
BACKGROUND: Aim of this study was to improve knowledge about the best conversional bariatric procedure following sleeve gastrectomy (SG). METHODS: Data of conversional Roux-en-Y gastric bypass (RYGB) and of one anastomosis gastric bypass (OAGB) after SG were collected prospectively and analyzed retrospectively. Weight loss parameters, gastroesophageal reflux disease (GERD) and comorbidities outcomes were recorded. RESULTS: ) had either RYGB (n = 68) or OAGB (n = 55). Perioperative mortality was zero. Mean surgery time was significantly shorter for OAGB (168 ± 7.2 vs. 201 ± 6.8 min). Perioperative complication rates were not significantly (ns) different between RYGB and OAGB. Total body weight loss (TBWL) in RYGB and OAGB was 18 ± 2.2% and 18 ± 1.9% (12 months) and 18 ± 3.0% and 23 ± 2.6% (24 months; ns), respectively. Length of (individualized) biliopancreatic limb (BPL) correlated significantly with weight loss. Remission rates after 12 months of RYGB and OAGB for arterial hypertension (aHt) were 89% and 92%, for obstructive sleep apnea (OSAS) 56% and 82%, for Type 2 diabetes mellitus (T2DM) 100% and 92%, for osteoarthritis 64% and 85% and for GERD 89% versus 87% (ns), respectively. Nutritional deficiencies were comparable in RYGB (n = 11) and OAGB (n = 14) group (ns). CONCLUSION: Both RYGB and OAGB are effective conversional procedures after SG, leading to comparable TBWL, BMI-loss and high remission rates of comorbidities including GERD. Significantly shorter operation times were in favor of OAGB. BPL, which was longer in OAGB was significantly related to higher %TBWL and %BMI-loss compared to RYGB.
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Rheinwalt et al. (2022) conducted a cohort in Sleeve gastrectomy requiring conversional bariatric procedure (n=123). One anastomosis gastric bypass (OAGB) vs. Roux-en-Y gastric bypass (RYGB) was evaluated on Total body weight loss (TBWL) at 24 months (p=ns). One anastomosis gastric bypass and Roux-en-Y gastric bypass as redo-operations after sleeve gastrectomy resulted in comparable total body weight loss at 24 months (23% vs 18%, ns).
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