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Published in: Obesity Surgery 4/2019

01-04-2019 | Sleeve Gastrectomy | Original Contributions

Outcomes in Super Obese Patients Undergoing One Anastomosis Gastric Bypass or Laparoscopic Sleeve Gastrectomy

Authors: Vitish Singla, Sandeep Aggarwal, Bhanu Singh, Gattu Tharun, Varidh Katiyar, Amit Bhambri

Published in: Obesity Surgery | Issue 4/2019

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Abstract

Introduction

The data on the role of OAGB in super obese patients and its direct comparison with LSG in super obese patients is scarce.

Objectives

To compare weight loss, impact on comorbidities and nutritional parameters between LSG and OAGB in super obese patients.

Methods

Prospectively collected data of 75 matched patients with BMI > 50, who underwent either laparoscopic sleeve gastrectomy (LSG) or one anastomosis gastric bypass (OAGB), was analyzed retrospectively. Percentage excess weight loss at 1 year and impact on comorbidities were compared in both the groups.

Results

Both the groups were comparable for age, sex, BMI, and presence or absence of diabetes mellitus. Mean TWL% ± 2SD at 1 year was 30.09% ± 19.76 in patients undergoing LSG, while it was 39.9% ± 12.78 in patients undergoing OAGB (p < 0.001). In the LSG group, 85.7% and 66.67% of patients had remission of diabetes mellitus and hypertension, respectively, as compared to 77.77% and 78.5%, respectively, in the OAGB group. All the patients with OSA had a resolution of their symptoms in both the groups. Patients in the OAGB group became more folate deficient despite regular supplementation.

Conclusion

Weight loss following OAGB was found to be better than LSG in the super obese patients in our study. There was a similar resolution of comorbidities and a lesser rate of major complications in the OAGB group.
Literature
1.
go back to reference Parikh MS, Shen R, Weiner M, et al. Laparoscopic bariatric surgery in super-obese patients (BMI>50) is safe and effective: a review of 332 patients. Obes Surg. 2005;15:858–63.CrossRefPubMed Parikh MS, Shen R, Weiner M, et al. Laparoscopic bariatric surgery in super-obese patients (BMI>50) is safe and effective: a review of 332 patients. Obes Surg. 2005;15:858–63.CrossRefPubMed
2.
go back to reference Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2009;5:469–75.CrossRef Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2009;5:469–75.CrossRef
3.
go back to reference Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2010;6:1–5. Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2010;6:1–5.
4.
go back to reference Noel P, Nedelcu M, Eddbali I, et al. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2017;13:1110–5.CrossRef Noel P, Nedelcu M, Eddbali I, et al. What are the long-term results 8 years after sleeve gastrectomy? Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2017;13:1110–5.CrossRef
5.
go back to reference Gadiot RPM, Biter LU, van Mil S, et al. Long-term results of laparoscopic sleeve gastrectomy for morbid obesity: 5 to 8-year results. Obes Surg. 2017;27:59–63.CrossRefPubMed Gadiot RPM, Biter LU, van Mil S, et al. Long-term results of laparoscopic sleeve gastrectomy for morbid obesity: 5 to 8-year results. Obes Surg. 2017;27:59–63.CrossRefPubMed
6.
go back to reference Mahawar KK, Kumar P, Carr WR, et al. Current status of mini-gastric bypass. J Minimal Access Surg. 2016;12:305–10.CrossRef Mahawar KK, Kumar P, Carr WR, et al. Current status of mini-gastric bypass. J Minimal Access Surg. 2016;12:305–10.CrossRef
7.
go back to reference Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22:697–703.CrossRefPubMed Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22:697–703.CrossRefPubMed
8.
go back to reference Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.CrossRefPubMed Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.CrossRefPubMed
9.
go back to reference Peraglie C. Laparoscopic mini-gastric bypass (LMGB) in the super-super obese: outcomes in 16 patients. Obes Surg. 2008;18:1126–9.CrossRefPubMed Peraglie C. Laparoscopic mini-gastric bypass (LMGB) in the super-super obese: outcomes in 16 patients. Obes Surg. 2008;18:1126–9.CrossRefPubMed
10.
go back to reference Villamere J, Gebhart A, Vu S, et al. Body mass index is predictive of higher in-hospital mortality in patients undergoing laparoscopic gastric bypass but not laparoscopic sleeve gastrectomy or gastric banding. Am Surg. 2014;80:1039–43.PubMed Villamere J, Gebhart A, Vu S, et al. Body mass index is predictive of higher in-hospital mortality in patients undergoing laparoscopic gastric bypass but not laparoscopic sleeve gastrectomy or gastric banding. Am Surg. 2014;80:1039–43.PubMed
11.
go back to reference Parmar C, Abdelhalim MA, Mahawar KK, et al. Management of super-super obese patients: comparison between one anastomosis (mini) gastric bypass and roux-en-Y gastric bypass. Surg Endosc. 2017;31:3504–9.CrossRefPubMed Parmar C, Abdelhalim MA, Mahawar KK, et al. Management of super-super obese patients: comparison between one anastomosis (mini) gastric bypass and roux-en-Y gastric bypass. Surg Endosc. 2017;31:3504–9.CrossRefPubMed
12.
go back to reference Plamper A, Lingohr P, Nadal J, et al. Comparison of mini-gastric bypass with sleeve gastrectomy in a mainly super-obese patient group: first results. Surg Endosc. 2017;31:1156–62.CrossRefPubMed Plamper A, Lingohr P, Nadal J, et al. Comparison of mini-gastric bypass with sleeve gastrectomy in a mainly super-obese patient group: first results. Surg Endosc. 2017;31:1156–62.CrossRefPubMed
13.
go back to reference Madhok B, Mahawar KK, Boyle M, et al. Management of Super-super Obese Patients: comparison between mini (one anastomosis) gastric bypass and sleeve gastrectomy. Obes Surg. 2016;26:1646–9.CrossRefPubMed Madhok B, Mahawar KK, Boyle M, et al. Management of Super-super Obese Patients: comparison between mini (one anastomosis) gastric bypass and sleeve gastrectomy. Obes Surg. 2016;26:1646–9.CrossRefPubMed
14.
go back to reference Kuczmarski RJ, Flegal KM. Criteria for definition of overweight in transition: background and recommendations for the United States. Am J Clin Nutr. 2000;72:1074–81.CrossRefPubMed Kuczmarski RJ, Flegal KM. Criteria for definition of overweight in transition: background and recommendations for the United States. Am J Clin Nutr. 2000;72:1074–81.CrossRefPubMed
15.
go back to reference Corcelles R, Boules M, Froylich D, et al. Total weight loss as the outcome measure of choice after roux-en-Y gastric bypass. Obes Surg. 2016;26:1794–8.CrossRefPubMed Corcelles R, Boules M, Froylich D, et al. Total weight loss as the outcome measure of choice after roux-en-Y gastric bypass. Obes Surg. 2016;26:1794–8.CrossRefPubMed
16.
go back to reference Epstein LJ, Kristo D, Strollo PJ, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2009;5:263–76. Epstein LJ, Kristo D, Strollo PJ, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2009;5:263–76.
17.
go back to reference Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10:177–83.CrossRef Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10:177–83.CrossRef
18.
go back to reference Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.CrossRefPubMed Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.CrossRefPubMed
19.
go back to reference Lee W-J, Lin Y-H. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.CrossRefPubMed Lee W-J, Lin Y-H. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.CrossRefPubMed
20.
go back to reference Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRefPubMed Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRefPubMed
21.
go back to reference Musella M, Apers J, Rheinwalt K, et al. Efficacy of bariatric surgery in type 2 diabetes mellitus remission: the role of mini gastric bypass/one anastomosis gastric bypass and sleeve gastrectomy at 1 year of follow-up. A European survey. Obes Surg. 2016;26:933–40.CrossRefPubMed Musella M, Apers J, Rheinwalt K, et al. Efficacy of bariatric surgery in type 2 diabetes mellitus remission: the role of mini gastric bypass/one anastomosis gastric bypass and sleeve gastrectomy at 1 year of follow-up. A European survey. Obes Surg. 2016;26:933–40.CrossRefPubMed
22.
go back to reference Mahawar KK, Jennings N, Brown J, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23:1890–8.CrossRefPubMed Mahawar KK, Jennings N, Brown J, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23:1890–8.CrossRefPubMed
23.
go back to reference Kular KS, Manchanda N, Rutledge R. Analysis of the five-year outcomes of sleeve gastrectomy and mini gastric bypass: a report from the Indian sub-continent. Obes Surg. 2014;24:1724–8.CrossRefPubMed Kular KS, Manchanda N, Rutledge R. Analysis of the five-year outcomes of sleeve gastrectomy and mini gastric bypass: a report from the Indian sub-continent. Obes Surg. 2014;24:1724–8.CrossRefPubMed
24.
go back to reference Lee W-J, Pok E-H, Almulaifi A, et al. Medium-term results of laparoscopic sleeve gastrectomy: a matched comparison with gastric bypass. Obes Surg. 2015;25:1431–8.CrossRefPubMed Lee W-J, Pok E-H, Almulaifi A, et al. Medium-term results of laparoscopic sleeve gastrectomy: a matched comparison with gastric bypass. Obes Surg. 2015;25:1431–8.CrossRefPubMed
25.
go back to reference Benaiges D, Más-Lorenzo A, Goday A, et al. Laparoscopic sleeve gastrectomy: more than a restrictive bariatric surgery procedure? World J Gastroenterol. 2015;21:11804–14.CrossRefPubMedPubMedCentral Benaiges D, Más-Lorenzo A, Goday A, et al. Laparoscopic sleeve gastrectomy: more than a restrictive bariatric surgery procedure? World J Gastroenterol. 2015;21:11804–14.CrossRefPubMedPubMedCentral
26.
go back to reference Lee W-J, Chong K, Lin Y-H, et al. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24:1552–62.CrossRefPubMed Lee W-J, Chong K, Lin Y-H, et al. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24:1552–62.CrossRefPubMed
27.
go back to reference Lee W-J, Chong K, Ser K-H, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg Chic Ill 1960. 2011;146:143–8. Lee W-J, Chong K, Ser K-H, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg Chic Ill 1960. 2011;146:143–8.
28.
go back to reference Lee W-J, Hur KY, Lakadawala M, et al. Gastrointestinal metabolic surgery for the treatment of diabetic patients: a multi-institutional international study. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2012;16:45–51. discussion 51-52CrossRef Lee W-J, Hur KY, Lakadawala M, et al. Gastrointestinal metabolic surgery for the treatment of diabetic patients: a multi-institutional international study. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2012;16:45–51. discussion 51-52CrossRef
29.
go back to reference Kansou G, Lechaux D, Delarue J, et al. Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: One year outcomes. Int J Surg Lond Engl. 2016;33(Pt A):18–22.CrossRef Kansou G, Lechaux D, Delarue J, et al. Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: One year outcomes. Int J Surg Lond Engl. 2016;33(Pt A):18–22.CrossRef
30.
go back to reference Eisenberg D, Bellatorre A, Bellatorre N. Sleeve gastrectomy as a stand-alone bariatric operation for severe, morbid, and super obesity. JSLS. 2013;17:63–7.CrossRefPubMedPubMedCentral Eisenberg D, Bellatorre A, Bellatorre N. Sleeve gastrectomy as a stand-alone bariatric operation for severe, morbid, and super obesity. JSLS. 2013;17:63–7.CrossRefPubMedPubMedCentral
31.
go back to reference Madhok BM, Mahawar KK, Hadfield JN, et al. Haematological indices and haematinic levels after mini gastric bypass: a matched comparison with roux-en-Y gastric bypass. Clin Obes. 2018;8:43–9.CrossRefPubMed Madhok BM, Mahawar KK, Hadfield JN, et al. Haematological indices and haematinic levels after mini gastric bypass: a matched comparison with roux-en-Y gastric bypass. Clin Obes. 2018;8:43–9.CrossRefPubMed
32.
go back to reference Fujioka K. Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care. 2005;28:481–4.CrossRefPubMed Fujioka K. Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care. 2005;28:481–4.CrossRefPubMed
Metadata
Title
Outcomes in Super Obese Patients Undergoing One Anastomosis Gastric Bypass or Laparoscopic Sleeve Gastrectomy
Authors
Vitish Singla
Sandeep Aggarwal
Bhanu Singh
Gattu Tharun
Varidh Katiyar
Amit Bhambri
Publication date
01-04-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-03673-8

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