Chetan D Parmar1, Jonathan Gan2, Christine Stier3, Zhiyong Dong4, Sonja Chiappetta5, Luciana El-Kadre6, Moataz M Bashah7, Cunchuan Wang4, Nasser Sakran8. 1. Consultant Surgeon, Whittington Hospital, London, United Kingdom; Honorary Associate Professor, University College London, United Kingdom. Electronic address: cparmar@nhs.net. 2. Speciality Surgical Registrar, Whittington Hospital, London, United Kingdom. 3. Sana Obesity Center, NRW, Germany. 4. Bariatric Surgery Department, First Affiliated Hospital of Jinan University, Guangzhou, China. 5. Ospedale Evangelico Betania, Via Argine 604, 80147, Naples, Italy. 6. São Lucas Copacabana Hospital, Rio de Janeiro, RJ, Brazil. 7. Department of Bariatric Surgery, Hamad General Hospital, Doha, Qatar. 8. Department of Surgery A, Emek Medical Center, Afula, Israel.
Abstract
BACKGROUND: One Anastomosis/Mini Gastric Bypass (OAGB-MGB) is rapidly gaining popularity and is now the third common bariatric procedure performed in the world. The aim of this review is to look at the role of this operation as a revisional bariatric surgery (RBS). METHODS: Literature review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Total 17 studies were eligible. RESULTS: This review reports cumulative results of 1075 revisional OAGB-MGB procedures. Primary procedures included gastric banding (LAGB), Sleeve gastrectomy (SG), vertical banded gastroplasty (VBG) and gastric plication. The mean age was 43.1 years and female to male ratio was 3.04: 1. The body mass index (BMI) at primary procedure was 47.05 kg/m2. The mean BMI at revisional surgery was 41.6 kg/m2 (range 28-70.8). The mean time between the primary and the secondary operation was 46.5 months (3-264). The mean follow-up was 2.44 years (6-60 months). The mean operative time was 119.3 min. The mean length of hospital stay was 4.01 days (2-28). The median limb length was 200 cm (range 150-250 cm). Leak rate was 1.54%. Marginal ulcer rate was 2.44%. Anemia rate was 1.9%. Mortality was 0.3%. The excess weight loss (%EWL) at 1 year and 2 years was 65.2% and 68.5% respectively. CONCLUSION: We conclude that there is evidence to consider OAGB-MGB as a safe and effective choice for RBS. Randomised studies with long term follow-up are suggested for the future.
BACKGROUND: One Anastomosis/Mini Gastric Bypass (OAGB-MGB) is rapidly gaining popularity and is now the third common bariatric procedure performed in the world. The aim of this review is to look at the role of this operation as a revisional bariatric surgery (RBS). METHODS: Literature review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Total 17 studies were eligible. RESULTS: This review reports cumulative results of 1075 revisional OAGB-MGB procedures. Primary procedures included gastric banding (LAGB), Sleeve gastrectomy (SG), vertical banded gastroplasty (VBG) and gastric plication. The mean age was 43.1 years and female to male ratio was 3.04: 1. The body mass index (BMI) at primary procedure was 47.05 kg/m2. The mean BMI at revisional surgery was 41.6 kg/m2 (range 28-70.8). The mean time between the primary and the secondary operation was 46.5 months (3-264). The mean follow-up was 2.44 years (6-60 months). The mean operative time was 119.3 min. The mean length of hospital stay was 4.01 days (2-28). The median limb length was 200 cm (range 150-250 cm). Leak rate was 1.54%. Marginal ulcer rate was 2.44%. Anemia rate was 1.9%. Mortality was 0.3%. The excess weight loss (%EWL) at 1 year and 2 years was 65.2% and 68.5% respectively. CONCLUSION: We conclude that there is evidence to consider OAGB-MGB as a safe and effective choice for RBS. Randomised studies with long term follow-up are suggested for the future.
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