BACKGROUND: Gastric bypass can be technically challenging in super-super obese patients. Both Roux-en-Y gastric bypass (RYGB) and one anastomosis (mini) gastric bypass (OAGB/MGB) have been described in these patients, but direct comparisons are lacking. The purpose of this study was to compare the early outcomes with these two procedures in patients with body mass index (BMI) of ≥60 kg/m2 in our unit. METHODS: We identified all super-super obese patients who underwent either OAGB/MGB or RYGB from our prospectively maintained database. Information was also obtained from the case notes and from hospital computerized records. We obtained data regarding patient demographics, operative details, complications, and weight loss, in both groups, and compared them using standard statistical methods. RESULTS: This study compares our results with 19 OAGB/MGB and 47 RYGB super-super obese patients performed in our unit between October 2012 and June 2015. OAGB/MGB group patients had a significantly higher weight and body mass index. There was no mortality or major complication in either group. There were two late complications in the OAGB/MGB group compared to six in the RYGB group. One patient in the OAGB/MGB group needed conversion to RYGB for persistent reflux symptoms. OAGB/MGB patients achieved a significantly higher EWL of 70.4% at 2 years compared to 57.1% in the RYGB group. The difference between TWL of 44.4 and 33.4%, respectively, was also significant at 2 years. TWL of 43.0 and 29.3%, respectively, in OAGB/MGB and RYGB groups at 18 months was also significantly different, but the difference in EWL at 18 months did not reach significance. CONCLUSION: One anastomosis (mini) gastric bypass yields superior weight loss at 18 and 24 months in comparison with Roux-en-Y gastric bypass in patients with BMI of ≥60 kg/m2. Findings need confirmation in larger randomized studies.
BACKGROUND: Gastric bypass can be technically challenging in super-super obesepatients. Both Roux-en-Y gastric bypass (RYGB) and one anastomosis (mini) gastric bypass (OAGB/MGB) have been described in these patients, but direct comparisons are lacking. The purpose of this study was to compare the early outcomes with these two procedures in patients with body mass index (BMI) of ≥60 kg/m2 in our unit. METHODS: We identified all super-super obesepatients who underwent either OAGB/MGB or RYGB from our prospectively maintained database. Information was also obtained from the case notes and from hospital computerized records. We obtained data regarding patient demographics, operative details, complications, and weight loss, in both groups, and compared them using standard statistical methods. RESULTS: This study compares our results with 19 OAGB/MGB and 47 RYGB super-super obesepatients performed in our unit between October 2012 and June 2015. OAGB/MGB group patients had a significantly higher weight and body mass index. There was no mortality or major complication in either group. There were two late complications in the OAGB/MGB group compared to six in the RYGB group. One patient in the OAGB/MGB group needed conversion to RYGB for persistent reflux symptoms. OAGB/MGBpatients achieved a significantly higher EWL of 70.4% at 2 years compared to 57.1% in the RYGB group. The difference between TWL of 44.4 and 33.4%, respectively, was also significant at 2 years. TWL of 43.0 and 29.3%, respectively, in OAGB/MGB and RYGB groups at 18 months was also significantly different, but the difference in EWL at 18 months did not reach significance. CONCLUSION: One anastomosis (mini) gastric bypass yields superior weight loss at 18 and 24 months in comparison with Roux-en-Y gastric bypass in patients with BMI of ≥60 kg/m2. Findings need confirmation in larger randomized studies.
Entities:
Keywords:
Mini gastric bypass; Omega loop gastric bypass; One anastomosis gastric bypass; Roux-en-Y gastric bypass; Single anastomosis gastric bypass; Super–super obese
Authors: J Hunter Mehaffey; Damien J LaPar; Florence E Turrentine; Michael S Miller; Peter T Hallowell; Bruce D Schirmer Journal: Surg Obes Relat Dis Date: 2014-12-08 Impact factor: 4.734
Authors: Kamal K Mahawar; Parveen Kumar; William Rj Carr; Neil Jennings; Norbert Schroeder; Shlok Balupuri; Peter K Small Journal: J Minim Access Surg Date: 2016 Oct-Dec Impact factor: 1.407
Authors: Kamal K Mahawar; Cynthia-Michelle Borg; Kuldeepak Singh Kular; Michael J Courtney; Karim Sillah; William R J Carr; Neil Jennings; Brijesh Madhok; Rishi Singhal; Peter K Small Journal: Obes Surg Date: 2017-09 Impact factor: 4.129
Authors: Almino C Ramos; Jean-Marc Chevallier; Kamal Mahawar; Wendy Brown; Lilian Kow; Kevin P White; Scott Shikora Journal: Obes Surg Date: 2020-05 Impact factor: 4.129
Authors: Karl Rheinwalt; Tom F Ulmer; Sophia M-T Schmitz; Patrick H Alizai; Andreas Kroh; Sandra Schipper; Jonathan F Brozat; Andreas Plamper; Ulf P Neumann Journal: Surg Endosc Date: 2021-10-26 Impact factor: 3.453