Tien-Chou Soong1, Owaid M Almalki2, Wei-Jei Lee3, Kong-Han Ser4, Jung-Chien Chen4, Chun-Chi Wu4, Shu-Chun Chen4. 1. Center for Weight Loss and Health Management, E-DA Dachang Hospital, Kaohsiung, Taiwan; Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. 2. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan; Department of Surgery, College of Medicine, Taif University, Saudi Arabia. 3. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan. Electronic address: wjlee_obessurg_tw@yahoo.com.tw. 4. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
Abstract
BACKGROUND: Laparoscopic one (single)-anastomosis gastric bypass (OAGB) is an effective and durable treatment for morbidly obese patients. However, the ideal length of the small bowel bypass remains controversial. OBJECTIVES: The study aimed to report the clinical results of using a tailored bypass based on the total length of the small bowel. SETTING: Academic medical center. METHODS: Since 2005, we have performed OAGB with tailored limb according to preoperative body mass index. From July 2014, we modified our technique, measuring the whole small bowel length to keep the common channel at least 400-cm long. Data from 470 patients treated with the new technique (Group II) were compared with those of a matched group treated with tailored bypass only (Group I). The preoperative clinical data and outcomes were analyzed. All clinical data were prospectively collected and stored. RESULTS: Both groups had similar clinical profiles at baseline. All procedures were completed laparoscopically. Group II had a significant longer operation time (161.9 versus 122.6 min; P < .001), but shorter hospital stay (2.9 versus 5.3 d; P < .001) and lower complication rate (.2% versus 1.5%; P = .002) than Group I. One year after surgery, the mean body mass index (27.4 versus 26.8 kg/m2; P = .244), percent total weight loss (32.0% versus 34.0%; P = .877), and diabetes remission rate (84.7% versus 84.1%; P = .876) were comparable between the 2 groups. However, Group II patients had a significantly lower incidence of anemia (5.9% versus 11.1%; P < .001), secondary hyperparathyroidism (21.7% versus 33.8%; P < .001) and hypoalbuminemia (1.5% versus 2.8%; P < .001) than did Group I. CONCLUSION: Routine measurement of the whole bowel length to keep the common channel at least 400-cm long may reduce the incidence of malnutrition after OAGB with tailored limb bypass, without compromising efficacy in weight loss and diabetes resolution.
BACKGROUND: Laparoscopic one (single)-anastomosis gastric bypass (OAGB) is an effective and durable treatment for morbidly obesepatients. However, the ideal length of the small bowel bypass remains controversial. OBJECTIVES: The study aimed to report the clinical results of using a tailored bypass based on the total length of the small bowel. SETTING: Academic medical center. METHODS: Since 2005, we have performed OAGB with tailored limb according to preoperative body mass index. From July 2014, we modified our technique, measuring the whole small bowel length to keep the common channel at least 400-cm long. Data from 470 patients treated with the new technique (Group II) were compared with those of a matched group treated with tailored bypass only (Group I). The preoperative clinical data and outcomes were analyzed. All clinical data were prospectively collected and stored. RESULTS: Both groups had similar clinical profiles at baseline. All procedures were completed laparoscopically. Group II had a significant longer operation time (161.9 versus 122.6 min; P < .001), but shorter hospital stay (2.9 versus 5.3 d; P < .001) and lower complication rate (.2% versus 1.5%; P = .002) than Group I. One year after surgery, the mean body mass index (27.4 versus 26.8 kg/m2; P = .244), percent total weight loss (32.0% versus 34.0%; P = .877), and diabetes remission rate (84.7% versus 84.1%; P = .876) were comparable between the 2 groups. However, Group II patients had a significantly lower incidence of anemia (5.9% versus 11.1%; P < .001), secondary hyperparathyroidism (21.7% versus 33.8%; P < .001) and hypoalbuminemia (1.5% versus 2.8%; P < .001) than did Group I. CONCLUSION: Routine measurement of the whole bowel length to keep the common channel at least 400-cm long may reduce the incidence of malnutrition after OAGB with tailored limb bypass, without compromising efficacy in weight loss and diabetes resolution.
Authors: Nienke Slagter; Loek J M de Heide; Ewoud H Jutte; Mirjam A Kaijser; Stefan L Damen; André P van Beek; Marloes Emous Journal: Trials Date: 2022-06-22 Impact factor: 2.728
Authors: Daniel Moritz Felsenreich; Felix Benedikt Langer; Jakob Eichelter; Julia Jedamzik; Lisa Gensthaler; Larissa Nixdorf; Mahir Gachabayov; Aram Rojas; Natalie Vock; Marie Louise Zach; Gerhard Prager Journal: J Clin Med Date: 2021-02-10 Impact factor: 4.241