Key result
One anastomosis gastric bypass had similar major (7% vs 14%; p=0.388) but more minor midterm complications (50% vs 18%; p=0.011) compared to Roux-en-Y gastric bypass at 5 years.
Why the study?
Patients with BMI ≥50 kg/m2 present surgical challenges, and comparative long-term outcomes of OAGB versus RYGB in this population were not well established.
Does one anastomosis gastric bypass result in similar weight loss, comorbidity remission, and complication rates compared to Roux-en-Y gastric bypass in patients with BMI ≥50 kg/m2?
Cohort (n=190)
No
Does one anastomosis gastric bypass result in similar weight loss, comorbidity remission, and complication rates compared to Roux-en-Y gastric bypass in patients with BMI ≥50 kg/m2?
Absolute Event Rate: 7% vs 14%
p-value: p=0.388
One anastomosis gastric bypass provides similar 5-year weight loss and comorbidity remission as Roux-en-Y gastric bypass in patients with BMI ≥50 kg/m2, though with higher rates of minor reflux complications.
INTRODUCTION: Body mass index (BMI) ≥50 kg/m2 is more challenging for the metabolic bariatric surgeon because of a thicker abdominal wall, more visceral fat, and hepatomegaly by liver steatosis. This study aimed to give an overview of 5-year outcomes after one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) in these patients in terms of weight loss, remission of comorbidities, and complications. METHODS: This retrospective single-center cohort study focused on patients with BMI ≥50 kg/m2 undergoing OAGB or RYGB between 2015 and 2017 at a nonacademic teaching hospital in the Netherlands. A 1:1 propensity score-matched (PSM) comparison was conducted. RESULTS: In total, 158 patients underwent OAGB and 32 patients RYGB. After performing a 1:1 PSM, we obtained two nearly identical cohorts of 28 patients. Follow-up data after 5 years were available in 79% of the patients after OAGB and 82% of the patients after RYGB. Both procedures resulted in equal weight loss, remission of comorbidities, and short-term complications. More minor midterm complications were seen after OAGB (50% versus 18%; p = 0.011) due to reflux complaints (50% versus 7%; p < 0.001). The number of patients with major midterm complications did not differ (7% after OAGB versus 14% after RYGB; p = 0.388). The only major complication after OAGB was conversion to RYGB due to reflux in 7.1% of the patients. In contrast, major complications following RYGB were more diverse. CONCLUSION: Both procedures resulted in similar weight loss, remission of comorbidities, short-term and major midterm complications, making OAGB a suitable alternative to RYGB for patients with a BMI ≥50 kg/m2.
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Laan et al. (2024) conducted a cohort in Body mass index (BMI) ≥50 kg/m2 (n=190). One anastomosis gastric bypass (OAGB) vs. Roux-en-Y gastric bypass (RYGB) was evaluated on major midterm complications (p=0.388). One anastomosis gastric bypass had similar major (7% vs 14%; p=0.388) but more minor midterm complications (50% vs 18%; p=0.011) compared to Roux-en-Y gastric bypass at 5 years.
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