Ashraf Haddad1, Mathias Fobi2, Ahmad Bashir3, Mohamed Al Hadad4, Mohamad Hayssam ElFawal5, Basem Safadi6, Osama Taha7, Mohamed Abouzeid8, Aayed Alqahtani9, Abdelrahman Nimeri10. 1. Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan. drajhaddad@gmail.com. 2. Mohak Bariatric and Robotics, SAIMS Campus, Indore - Ujjain State Highway, Indore, India. 3. Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC)-Jordan Hospital, Queen Noor Street, Amman, 11152, Jordan. 4. Bariatric Surgery, Healthpoint Hospital, Abu Dhabi, United Arab Emirates. 5. Bariatric Surgery Clinic "BSC," Bariatric and Metabolic Unit, Makassed General Hospital Beirut, Beirut, Lebanon. 6. Department of Surgery, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon. 7. Bariatric and General Surgery, Assiut University, Assiut, Egypt. 8. General Surgery Department, Ain Shams University, Cairo, Egypt. 9. New You Medical Center, Riyadh, Saudi Arabia. 10. Carolinas Bariatic/MIS Fellowship Program, Carolinas Weight Management, Carolinas Medical Center, Charlotte, NC, USA.
Abstract
INTRODUCTION: Since it was first described in 2001, the one anastomosis gastric bypass (OAGB) has been gaining popularity in the Middle East region and worldwide. We designed a survey to evaluate the trends, techniques, and outcomes of OAGB in our region. METHODS: A questionnaire to study OAGB was sent to the members of the IFSO MENA chapter. RESULTS: One-hundred and forty-eight surgeons (74%) responded. Forty-six percent of all respondents (64 surgeons) performed OAGB routinely. The most commonly performed procedures were the laparoscopic sleeve gastrostomy (LSG), followed by OAGB, and then Roux-en-Y (RYGB). Of the surgeons who responded, 65% did not perform routine pre-operative endoscopy. Seventy-two percent believed that OAGB produces better weight loss than the LSG while 58% did not believe it produced better results to RYGB. The most common length of biliopancreatic limb utilized was 200 cm, and 72% of surgeons did not measure the total length of the small bowel. Fifty percent of the surgeons offered OAGB as a treatment for acid reflux and 33% offered it to active smokers. Early complications included leak (< 1%), venous thromboembolism (< 1%), and mortality (< 0.5%) in most centers. Leaks were managed conservatively (23%), by conversion to RYGB (20%), reinforcing the anastomosis (19%), reversal to normal anatomy (6%), and others (32%). Of the total surgeons, 41% reported revising at least one patient for malnutrition and steatorrhea, and 32% reported revising at least one patient for sever bile reflux. CONCLUSION: OAGB is a commonly performed and safe procedure in the MENA region. Malnutrition and bile reflux requiring surgical intervention are serious long-term concerns.
INTRODUCTION: Since it was first described in 2001, the one anastomosis gastric bypass (OAGB) has been gaining popularity in the Middle East region and worldwide. We designed a survey to evaluate the trends, techniques, and outcomes of OAGB in our region. METHODS: A questionnaire to study OAGB was sent to the members of the IFSO MENA chapter. RESULTS: One-hundred and forty-eight surgeons (74%) responded. Forty-six percent of all respondents (64 surgeons) performed OAGB routinely. The most commonly performed procedures were the laparoscopic sleeve gastrostomy (LSG), followed by OAGB, and then Roux-en-Y (RYGB). Of the surgeons who responded, 65% did not perform routine pre-operative endoscopy. Seventy-two percent believed that OAGB produces better weight loss than the LSG while 58% did not believe it produced better results to RYGB. The most common length of biliopancreatic limb utilized was 200 cm, and 72% of surgeons did not measure the total length of the small bowel. Fifty percent of the surgeons offered OAGB as a treatment for acid reflux and 33% offered it to active smokers. Early complications included leak (< 1%), venous thromboembolism (< 1%), and mortality (< 0.5%) in most centers. Leaks were managed conservatively (23%), by conversion to RYGB (20%), reinforcing the anastomosis (19%), reversal to normal anatomy (6%), and others (32%). Of the total surgeons, 41% reported revising at least one patient for malnutrition and steatorrhea, and 32% reported revising at least one patient for sever bile reflux. CONCLUSION: OAGB is a commonly performed and safe procedure in the MENA region. Malnutrition and bile reflux requiring surgical intervention are serious long-term concerns.
Entities:
Keywords:
MENA; One anastomosis gastric bypass; RYGB
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