James J Jung1,2,3, Albert K Park4,5, Matthew M Hutter4,5. 1. Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA. James.Jung@unityhealth.to. 2. Harvard Medical School, Boston, MA, USA. James.Jung@unityhealth.to. 3. Division of General Surgery, Department of Surgery, University of Toronto, 30 Bond Street, 16CC-043, Toronto, ON, M5B 1W8, Canada. James.Jung@unityhealth.to. 4. Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA. 5. Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: One anastomosis gastric bypass (OAGB) has emerged as a potentially safe and effective weight-loss procedure. Worldwide, OAGB is the third most commonly performed primary bariatric procedure, comprising 4% of the annual volume. In the USA, OAGB has yet to be endorsed as a primary bariatric procedure and can only be performed under research protocols or as a revision procedure. MATERIALS AND METHODS: We performed an observational cohort study to describe the preoperative, intraoperative, and postoperative characteristics of adult patients who underwent primary or revision OAGB from 2015 to 2019 at MBSAQIP centers. Exclusion criteria included emergent surgery, incomplete 30-day follow-up, and non-laparoscopic- or robotic approach. RESULTS: During the study period, 803,906 bariatric procedures were performed and 645 (0.08%) were OAGB. Among these, 436 (67.6%) were primary and 209 (32.4%) were revision OAGB. The mean operation time was 89 min (SD, 59) and 8% were performed using a robotic approach. The overall complication rate was 7.4% and there was one death (0.2%). The post-operative complication rates were generally higher than the early complication rate (3.4%) reported in the YOMEGA trial, an RCT from France. Revision OAGB had a longer mean operation time of 141 min (SD, 85, p < 0.001). CONCLUSION: Primary OAGB was a rarely performed bariatric procedure at MBSAQIP-accredited centers comprising only 0.05% compared to 4% worldwide. Future studies should compare safety of OAGB to that of established bariatric procedures like Roux-en-Y gastric bypass and sleeve gastrectomy.
PURPOSE: One anastomosis gastric bypass (OAGB) has emerged as a potentially safe and effective weight-loss procedure. Worldwide, OAGB is the third most commonly performed primary bariatric procedure, comprising 4% of the annual volume. In the USA, OAGB has yet to be endorsed as a primary bariatric procedure and can only be performed under research protocols or as a revision procedure. MATERIALS AND METHODS: We performed an observational cohort study to describe the preoperative, intraoperative, and postoperative characteristics of adult patients who underwent primary or revision OAGB from 2015 to 2019 at MBSAQIP centers. Exclusion criteria included emergent surgery, incomplete 30-day follow-up, and non-laparoscopic- or robotic approach. RESULTS: During the study period, 803,906 bariatric procedures were performed and 645 (0.08%) were OAGB. Among these, 436 (67.6%) were primary and 209 (32.4%) were revision OAGB. The mean operation time was 89 min (SD, 59) and 8% were performed using a robotic approach. The overall complication rate was 7.4% and there was one death (0.2%). The post-operative complication rates were generally higher than the early complication rate (3.4%) reported in the YOMEGA trial, an RCT from France. Revision OAGB had a longer mean operation time of 141 min (SD, 85, p < 0.001). CONCLUSION: Primary OAGB was a rarely performed bariatric procedure at MBSAQIP-accredited centers comprising only 0.05% compared to 4% worldwide. Future studies should compare safety of OAGB to that of established bariatric procedures like Roux-en-Y gastric bypass and sleeve gastrectomy.
Authors: Anita P Courcoulas; Steven H Belle; Rebecca H Neiberg; Sheila K Pierson; Jessie K Eagleton; Melissa A Kalarchian; James P DeLany; Wei Lang; John M Jakicic Journal: JAMA Surg Date: 2015-10 Impact factor: 14.766
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Authors: Kamal K Mahawar; Jacques Himpens; Scott A Shikora; Jean-Marc Chevallier; Mufazzal Lakdawala; Maurizio De Luca; Rudolf Weiner; Ali Khammas; Kuldeepak Singh Kular; Mario Musella; Gerhard Prager; Mohammad Khalid Mirza; Miguel Carbajo; Lilian Kow; Wei-Jei Lee; Peter K Small Journal: Obes Surg Date: 2018-02 Impact factor: 4.129