Key result
Sleeve gastrectomy plus one anastomosis bipartition achieved greater total weight loss than gastric bypass at 6 months (31.05% vs 28.14%, p=0.015) but had more major complications (6.7% vs 0%).
Why the study?
One anastomosis gastric bypass excludes the stomach from screening, and it was unknown whether sleeve gastrectomy plus one anastomosis bipartition could solve this dilemma while maintaining surgical efficacy.
Does sleeve gastrectomy plus one anastomosis bipartition improve weight loss and diabetes remission compared to one anastomosis gastric bypass in patients with obesity?
Cohort (n=90)
No
Does sleeve gastrectomy plus one anastomosis bipartition improve weight loss and diabetes remission compared to one anastomosis gastric bypass in patients with obesity?
Absolute Event Rate: 31.05% vs 28.14%
p-value: p=0.015
SG + OAB provides superior weight loss compared to OAGB at 6 months, but is associated with a higher rate of major surgical complications.
SG+OAB was associated with greater short-term weight loss but more complications; leaves open comparative long-term efficacy and safety versus OAGB.
BACKGROUND: One anastomosis gastric bypass (OAGB) is a new recognized metabolic surgery, but the problem that we cannot screen the excluded stomach is a troubling issue in China. The emergence of sleeve gastrectomy plus one anastomosis bipartition (SG + OAB) makes us see a hope to solve this problem. OBJECTIVES: By comparing the efficacy of the two surgical methods, to evaluate whether SG + OAB surgery can solve the dilemma faced by OAGB that the excluded stomach cannot be screened. METHODS: A retrospective study to compare the patients who underwent OAGB and SG + OAB was conducted. The main outcome measures were (1) operation risk, (2) weight loss, and (3) diabetes remission at 6 months. RESULTS: This study was conducted in the bariatric/metabolic surgical center. From November 2021 to February 2022, a total of 30 patients with obesity who received SG + OAB surgery were recruited. Another matched 60 patients undergoing OAGB were recruited as control group. There was no difference in preoperative age (32.15 ± 9.02 vs. 34.47 ± 7.22; p = .224), female ratio (83% vs. 85%; p = .837), and BMI (36.18 ± 5.30 vs. 34.68 ± 5.58; p = .217) between the two groups. OAGB had a shorter mean operation time (121.67 ± 20.41 vs. 143.50 ± 25.07 min; p < .001) and a lower intraoperative blood loss (21.92 ± 12.35 vs. 32.43 ± 22.01 mL; p = .005), but a longer postoperative flatus passage (2.13 ± 0.43 vs. 1.87 ± 0.43 days; p = .007) compared with the SG + OAB group. Two patients (6.7%) developed major surgical complication in SG + OAB group but no major complication developed in OAGB group. At 6 months after surgery, SG + OAB had a higher %total weight loss than OAGB (31.05 ± 3.12 vs. 28.14 ± 5.43%; p = .015), but diabetes remission rate was similarly high in both groups. CONCLUSIONS: SG + OAB operation had a non-inferior or even better weight loss than OAGB, with a similar glycemic control efficacy. However, the high complication rate of SG + OAB is the major drawback that needs attention.
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Qin et al. (2023) conducted a cohort in Obesity (n=90). Sleeve gastrectomy plus one anastomosis bipartition (SG + OAB) vs. One anastomosis gastric bypass (OAGB) was evaluated on %total weight loss at 6 months (p=0.015). Sleeve gastrectomy plus one anastomosis bipartition achieved greater total weight loss than gastric bypass at 6 months (31.05% vs 28.14%, p=0.015) but had more major complications (6.7% vs 0%).
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