Key result
One-anastomosis gastric bypass resulted in comparable ≤30-day complication rates across patients with class III (3.2%), IV (3.5%), and V (4.3%) obesity (p=0.926).
Why the study?
Data are limited and discrepant regarding postoperative complications following one-anastomosis gastric bypass in patients with class IV versus class V obesity.
Does one-anastomosis gastric bypass have comparable early safety outcomes across patients with class III, IV, and V obesity?
Cohort (n=3,229)
No
Does one-anastomosis gastric bypass have comparable early safety outcomes across patients with class III, IV, and V obesity?
p-value: p=0.926
One-anastomosis gastric bypass is a safe procedure in the perioperative term for patients with class III, IV, and V obesity, with comparable ≤30-day morbidity across groups.
Supports perioperative safety of OAGB across BMI classes; leaves open need for long-term data in class IV/V obesity.
Background: Recent studies have reported higher postoperative complication rates in patients with severe obesity who undergo bariatric surgery. The extremely obese patient deserves special consideration: significant comorbidities, technical difficulties, and increased postoperative morbidity and mortality are all expected in this patient population. Current data are limited and discrepant on the relationship between patients with class IV obesity (body mass index (BMI) ≥50-59.9 kg/m2), and class V obesity (BMI ≥60 kg/m2). This study compared early postoperative complications (≤30-day) following one-anastomosis gastric bypass (OAGB) morbidity in patients with class III, IV, and V obesity. Methods: Retrospective analysis of perioperative OAGB outcomes in three BMI groups at a high-volume hospital. Operative time, length of stay (LOS), and overall early postoperative complication rates were studied. Complications were ranked by Clavien-Dindo classification (CDC). Results: Between January 2017-December 2021, consecutive patients with obesity class III (n= 2,950), IV (n= 256), and V (n= 23) underwent OAGB. BMI groups were comparable in gender, age, and associated comorbidities. Mean operative time was significantly longer in the higher BMI groups: class III (66.5±25.6 min), IV (70.5±28.7 min), and V (80.0±34.7 min), respectively (p= 0.018); no difference in LOS. In respective BMI classes, ≤30-day complication rates were 3.2%, 3.5%, and 4.3% (p= 0.926). The respective number of patients with CDC grades of 1-2 were 45 (1.5%), 6 (2.3%), and 1 (4.3%), p= 0.500; and in grade ≥3a, 25 (0.8%), 1 (0.4%), 0 (0.0%), p= 0.669. No significant differences in rates of early complications, reoperations, and readmissions were found in revisional patients across BMI groups. There was 0.06% mortality (n= 2 in 3,229), both in BMI class III. Conclusion: OAGB is a safe metabolic bariatric surgery procedure in patients with class III, IV, and V obesity in the perioperative term with comparable ≤30-day morbidity in the three BMI groups.
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Sakran et al. (2023) conducted a cohort in Class III, IV, and V obesity (n=3,229). Class IV and V obesity vs. Class III obesity was evaluated on ≤30-day complication rates (p=0.926). One-anastomosis gastric bypass resulted in comparable ≤30-day complication rates across patients with class III (3.2%), IV (3.5%), and V (4.3%) obesity (p=0.926).
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