Top

Langenbeck's Archives of Surgery

Published in:

Open Access 01-12-2023 | Gastroesophageal Reflux Disease | Review

One-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after failed laparoscopic sleeve gastrectomy (LSG): systematic review and meta-analysis of comparative studies

Authors: Antonio Vitiello, Giovanna Berardi, Roberto Peltrini, Pietro Calabrese, Vincenzo Pilone

Published in: Langenbeck's Archives of Surgery | Issue 1/2023

Abstract

Introduction

The aim of this study was to compare weight loss and gastroesophageal reflux disease (GERD) remission after one-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after laparoscopic sleeve gastrectomy (LSG).

Methods

In PubMed, Embase, and Cochrane Library, a search was performed using the terms “Roux-en-Y gastric bypass versus one anastomosis gastric bypass,” “revisional surgery,” and “sleeve gastrectomy.” Only original articles in English language comparing OAGB and RYGB were included. No temporal interval was set. The primary outcome measure was weight loss (%TWL). The secondary endpoints were leak, bleeding, marginal ulcer, and GERD. PRISMA flowchart was used. Differences in continuous and dichotomous outcome variables were expressed as mean difference (MD) and risk difference (RD) with 95% CI, respectively. Heterogeneity was assessed by using I² statistic.

Results

Six retrospective comparative articles were included in the present meta-analysis. Weight loss analysis showed a MD = 5.70 (95% CI 4.84–6.57) in favor of the OAGB procedure with a statistical significance (p = 0.00001) and no significant statistical heterogeneity (I² = 0.00%). There was no significant RD for leak, bleeding, or marginal ulcer after the two revisional procedures. After conversion to OAGB, remission from GERD was 68.6% (81/118), and it was 80.6% (150/186) after conversion to RYGB with a RD = 0.10 (95% CI −0.04, 0.24), no statistical significance (p = 0.19), and high heterogeneity (I² = 96%). De novo GERD was 6.3% (16/255) after conversional OAGB, and it was 0.5% (1/180) after conversion to RYGB with a RD = −0.23 (95% CI −0.57, 0.11), no statistical significance (p = 0.16), and high heterogeneity (I² = 92%).

Available only for authorised users

Angrisani L, Santonicola A, Iovino P et al (2017) Erratum to: Bariatric surgery and endoluminal procedures: IFSO Worldwide Survey 2014. Obes Surg 27(9):2290–2292. https://doi.org/10.1007/s11695-017-2773-8PubMedPubMedCentralCrossRef

Felsenreich DM, Langer FB, Kefurt R et al (2016) Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 12(9):1655–1662PubMedCrossRef

Genco A, Soricelli E, Casella G et al (2017) Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis 13(4):568–574PubMedCrossRef

Felsenreich DM, Kefurt R, Schermann M et al (2017) Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg 27(12):3092–3101PubMedCrossRef

Iannelli A, Debs T, Martini F, Benichou B, Ben Amor I, Gugenheim J (2016) Laparoscopic conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: indications and preliminary results. Surg Obes Relat Dis 8:1533–1538CrossRef

Parmar CD, Mahawar KK, Boyle M (2017) Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass is effective for gastro-oesophageal reflux disease but not for further weight loss. Obes Surg 27(7):1651–1658. https://doi.org/10.1007/s11695-017-2542-8PubMedCrossRef

Kermansaravi M, Shahmiri SS, DavarpanahJazi AH et al (2021) One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive bariatric procedures: a systematic review and meta-analysis. Obes Surg 1:370–383. https://doi.org/10.1007/s11695-020-05079-xCrossRef

Hamseer L, Moher D, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ Br Med J 349:7647CrossRef

Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605PubMedCrossRef

10.

Felsenreich DM, Steinlechner K, Langer FB et al (2022) Outcome of sleeve gastrectomy converted to Roux-en-Y gastric bypass and one-anastomosis gastric bypass. Obes Surg 32(3):643–651. https://doi.org/10.1007/s11695-021-05866-0PubMedPubMedCentralCrossRef

11.

Chiappetta S, Stier C, Scheffel O et al (2019) Mini/one anastomosis gastric bypass versus Roux-en-Y gastric bypass as a second step procedure after sleeve gastrectomy-a retrospective cohort study. Obes Surg 29(3):819–827. https://doi.org/10.1007/s11695-018-03629-yPubMedCrossRef

12.

Rayman S, Assaf D, Azran C et al (2021) Sleeve gastrectomy failure-revision to laparoscopic one-anastomosis gastric bypass or Roux-n-Y gastric bypass: a multicenter study. Obes Surg 31(7):2927–2934. https://doi.org/10.1007/s11695-021-05334-9PubMedCrossRef

13.

Rheinwalt KP, Schipper S, Plamper A et al (2022) Roux-en-Y versus one anastomosis gastric bypass as redo-operations following sleeve gastrectomy: a retrospective study. World J Surg 46(4):855–864. https://doi.org/10.1007/s00268-021-06424-6PubMedCrossRef

14.

Wilczyński M, Spychalski P, Proczko-Stepaniak M et al (2022) Comparison of the long-term outcomes of RYGB and OAGB as conversion procedures after failed LSG — a case–control study. J Gastrointest Surg 26:2255–2265. https://doi.org/10.1007/s11605-022-05395-wPubMedPubMedCentralCrossRef

15.

Hany M, Zidan A, Elmongui E et al (2022) Revisional Roux-en-Y gastric bypass versus revisional one-anastomosis gastric bypass after failed sleeve gastrectomy: a randomized controlled trial. Obes Surg 11:3491–3503. https://doi.org/10.1007/s11695-022-06266-8CrossRef

16.

Auricchio P, Tanay E, Kieninger C et al (2022) Re-do surgery after sleeve gastrectomy: a single center comparison between Roux-en-Y gastric bypass and one anastomosis gastric bypass. Surgeries 3(2):126–133CrossRef

17.

Marceau P, Biron S, Bourque RA, Potvin M, Hould FS, Simard S (1993) Biliopancreatic diversion with a new type of gastrectomy. Obes Surg 3(1):29–35. https://doi.org/10.1381/096089293765559728PubMedCrossRef

18.

Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 13(6):861–864. https://doi.org/10.1381/096089203322618669PubMedCrossRef

19.

Gumbs AA, Gagner M, Dakin G, Pomp A (2007) Sleeve gastrectomy for morbid obesity. Obes Surg 17(7):962–969. https://doi.org/10.1007/s11695-007-9151-xPubMedCrossRef

20.

Leyba JL, Aulestia SN, Llopis SN (2011) Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg 2:212–6. https://doi.org/10.1007/s11695-010-0279-8CrossRef

21.

Hirth DA, Jones EL, Rothchild KB, Mitchell BC, Schoen JA (2015) Laparoscopic sleeve gastrectomy: long-term weight loss outcomes. Surg Obes Relat Dis 11(5):1004–1007. https://doi.org/10.1016/j.soard.2015.02.016PubMedCrossRef

22.

Jain M, Tantia O, Goyal G, Chaudhuri T, Khanna S, Poddar A, Majumdar K, Gupta S (2021) LSG vs MGB-OAGB: 5-year follow-up data and comparative outcome of the two procedures over long term-results of a randomised control trial. Obes Surg 31(3):1223–1232. https://doi.org/10.1007/s11695-020-05119-6PubMedCrossRef

23.

Peterli R, Wölnerhanssen BK, Peters T et al (2018) Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA 319(3):255–265. https://doi.org/10.1001/jama.2017.20897PubMedPubMedCentralCrossRef

24.

Musella M, Berardi G, Velotti N et al (2021) Ten-year results of laparoscopic sleeve gastrectomy: retrospective matched comparison with laparoscopic adjustable gastric banding-is there a significant difference in long term? Obes Surg 12:5267–5274. https://doi.org/10.1007/s11695-021-05735-wCrossRef

25.

Vitiello A, Berardi G, Velotti N et al (2020) Should sleeve gastrectomy be considered only as a first step in super obese patients? 5-year results from a single center. Surg Laparosc Endosc Percutan Tech 31(2):203–207. https://doi.org/10.1097/SLE.0000000000000866PubMedCrossRef

26.

Milone M, Di Minno MND, Lupoli R et al (2014) Wernicke encephalopathy in subjects undergoing restrictive weight loss surgery: a systematic review of literature data. Eur Eat Disorders Rev 22:223–229. https://doi.org/10.1002/erv.2292CrossRef

27.

Oor JE, Roks DJ, Ünlü Ç et al (2016) Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Surg 211(1):250–267PubMedCrossRef

28.

Yeung KTD, Penney N, Ashrafian L, Darzi A, Ashrafian H (2020) Does sleeve gastrectomy expose the distal esophagus to severe reflux? A systematic review and meta-analysis. Ann Surg 271(2):257–265. https://doi.org/10.1097/SLA.0000000000003275PubMedCrossRef

29.

Parmar CD, Bryant C, Luque-de-Leon E et al (2019) One anastomosis gastric bypass in morbidly obese patients with BMI ≥ 50 kg/m2: a systematic review comparing it with Roux-En-Y gastric bypass and sleeve gastrectomy. OBES SURG 29:3039–3046. https://doi.org/10.1007/s11695-019-04034-9PubMedCrossRef

30.

Clapp B, Hahn J, Dodoo C et al (2019) Evaluation of the rate of marginal ulcer formation after bariatric surgery using the MBSAQIP database. Surg Endosc 33(6):1890–1897. https://doi.org/10.1007/s00464-018-6468-6PubMedCrossRef

31.

Gibril F, Lindeman RJ, Abou-Saif A et al (2001) Case report: retained gastric antrum syndrome. Dig Dis Sci 46:610–617. https://doi.org/10.1023/A:1005667719847PubMedCrossRef

32.

Abou Hussein B, Al Marzouqi O, Khammas A (2020) Anastomotic gastro-jejunal ulcer perforation following one anastomosis gastric bypass: clinical presentation and options of management—case series and review of literature. OBES SURG 30:2423–2428. https://doi.org/10.1007/s11695-020-04423-5PubMedCrossRef

33.

Dantas ACB, Branco LT, Tustumi F, de Oliveira DRCF, Pajecki D, Santo MA (2022) One-anastomosis gastric bypass versus Roux-en-Y gastric bypass as revisional surgery after sleeve gastrectomy: a systematic review and meta-analysis. Obes Surg 32(12):4082–4088. https://doi.org/10.1007/s11695-022-06326-zPubMedCrossRef

34.

Sakata S, Grove PM, Stevenson AR (2016) Effect of 3-dimensional vision on surgeons using the da vinci robot for laparoscopy: more than meets the eye. JAMA Surg 151:793–794. https://doi.org/10.1001/jamasurg.2016.0412PubMedCrossRef

35.

Angrisani L, Santonicola A, Borrelli V et al (2020) Sleeve gastrectomy with concomitant hiatal hernia repair in obese patients: long-term results on gastroesophageal reflux disease. Surg Obes Relat Dis 16(9):1171–1177. https://doi.org/10.1016/j.soard.2020.04.049PubMedCrossRef

Title: One-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after failed laparoscopic sleeve gastrectomy (LSG): systematic review and meta-analysis of comparative studies
Authors: Antonio Vitiello
Giovanna Berardi
Roberto Peltrini
Pietro Calabrese
Vincenzo Pilone
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Gastroesophageal Reflux Disease
Sleeve Gastrectomy
Published in: Langenbeck's Archives of Surgery / Issue 1/2023
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-023-03175-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

One-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after failed laparoscopic sleeve gastrectomy (LSG): systematic review and meta-analysis of comparative studies

Abstract

Introduction

Methods

Results

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Please log in to get access to this content

Other articles of this Issue 1/2023

Reconstruction, oversewing, or taking the anastomosis down – which surgical intervention is most potent in the treatment of anastomotic leaks following colorectal resections?

Pancreaticoduodenectomy with preoperative total embolization of the hepatic arteries (PD-HAE)—a novel treatment with sacrifice of the hepatic arterial blood supply without the need for arterial reconstruction

Open vs robotic gastrectomy with D2 lymphadenectomy: a propensity score-matched analysis on 1469 patients from the IMIGASTRIC prospective database

A comparative study on laparoscopic and open surgical approaches for perforated peptic ulcer repair: efficacy and outcomes analysis

Waiting for bile duct dilation before repair of bile duct injury: a worthwhile strategy?

An audit of Complicated Choledochal Cysts- 15-years' experience at a tertiary care center