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Obesity Surgery
Published in: Obesity Surgery 4/2020

01-04-2020 | Bariatric Surgery | Original Contributions

One Anastomosis Gastric Bypass–Mini-Gastric Bypass (OAGB-MGB) Versus Roux-en-Y Gastric Bypass (RYGB)—a Mid-Term Cohort Study with 612 Patients

Authors: Karl P. Rheinwalt, Andreas Plamper, Marcia V. Rückbeil, Andreas Kroh, Ulf P. Neumann, Tom F. Ulmer

Published in: Obesity Surgery | Issue 4/2020

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Abstract

Background

OAGB-MGB emerged as a standard procedure, albeit RYGB remains the most frequently performed gastric bypass. Comparative studies are scarce.

Methods

Prospectively collected data (July 2006 to November 2017) from a large sample size and adequate follow-up were analyzed using logistic regression and linear mixed models. Total weight loss (TWL) within the first 3 years was defined as primary outcome and duration of operation, perioperative, and late complications and comorbidity remission as secondary outcomes.

Results

Three hundred twenty-four OAGB-MGBs (age 42.51 ± 11.36 years, 74.69% females) presented with higher preoperative BMI (53.75 ± 6.51 kg/m2 vs. 44.53 ± 3.65 kg/m2, p < 0.0001) and higher comorbidity prevalence than 288 RYGBs (age 41.4 ± 10.04 years, 79.86% females). Duration of operation was 80.28 ± 20.31 min in OAGB-MGB and 103.36 ± 29.69 min in RYGB (p < 0.0001). Intraoperative complications (4.63% resp. 8.68%), early re-laparoscopy (0.62% resp. 0.69%), leakage (1.23% resp. 1.74%), internal hernias (IH) (0.32% resp. 3.85%), marginal ulcers (3.23% resp. 5.59%), gastroesophageal reflux (3.55% resp. 0.70%), and insufficient weight loss at 3 years (4.19% resp. 5.59 %) were comparable in OAGB-MGB resp. RYGB. Follow-up rates at 1 and 3 years declined from 76.71 to 42.86% (OAGB-MGB) resp. 79.15 to 50.00% (RYGB). TWL (OAGB-MGB, 36.18 ± 9.18%; RYGB, 33.8 ± 8.75%), malnutrition (OAGB-MGB, 4.19%; RYGB, 2.45%), and comorbidity remission 3 years postoperatively revealed comparable robust data. Anastomotic stenosis (1.94% resp. 14.69%) and dumping syndrome (3.55% resp. 6.64%) were less frequent in OAGB-MGB.

Conclusions

TWL, malnutrition, and comorbidity remission 3 years postoperatively were comparable. Gastroesophageal reflux was less frequent after RYGB (p = 0.0729), whereas shorter operation times (p < 0.0001), less frequent stenosis (p < 0.0001), and dumping syndrome (p = 0.0018) were found in OAGB-MGB. Further RCTs are required.
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Metadata
Title
One Anastomosis Gastric Bypass–Mini-Gastric Bypass (OAGB-MGB) Versus Roux-en-Y Gastric Bypass (RYGB)—a Mid-Term Cohort Study with 612 Patients
Authors
Karl P. Rheinwalt
Andreas Plamper
Marcia V. Rückbeil
Andreas Kroh
Ulf P. Neumann
Tom F. Ulmer
Publication date
01-04-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04250-3

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