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Tailored One Anastomosis Gastric Bypass: 3-Year Outcomes of 94 Patients

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Abstract

Background

One anastomosis gastric bypass (OAGB) claims its place among bariatric operations, proving itself a safe and effective procedure.

Methods

This is a retrospective analysis of prospectively collected data regarding 94 patients who underwent surgery in a single surgical unit. Tailoring of the biliopancreatic limb length decided upon preoperative BMI was applied. Patients’ excess weight loss and resolution of comorbidities were evaluated. Data on patients’ nutritional status is also presented.

Results

Mean BMI reduction at 36 months postoperatively was 21.7 ± 6.3 kg/m2. Mean excess weight loss (%EWL) was 83.6%, 91.8%, and 92.5% at 12, 24, and 36 months postoperatively, respectively. When controlling for preoperative BMI, a 36-month %EWL of 89.1% for the 2-m subgroup, a 95.3% for the 2.5-m subgroup, and a 104.7% for the 3-m subgroup were found. Operation’s success, defined as %EWL greater than 50%, was 97.9% 36 months postoperatively. All patients suffering from hypertension, diabetes, and dyslipidemia achieved full remission. Furthermore, the percentage of patients with obstructive sleep apnea and gastroesophageal reflux disease, achieving full remission was 91.7% and 86.7%, respectively. An incidence of 5.3% new onset regurgitation was noted. Iron deficiency presented in 26 (27.7%) patients postoperatively, vitamin B12 deficiency in 13 (13.8%), folic acid deficiency in 18 (19.1%), and mild hypoalbuminemia in 7 (7.4%). Major early postoperative complications (Clavien-Dindo grade ≥ 3) were reported in 1.7% of our patients. One (1.1%) patient developed marginal ulcer and two (2.2) patients had late dumping.

Conclusions

OAGB is a safe and efficient technique; however, careful selection of patients and postoperative surveillance with respect to weight regain and nutritional deficiencies are mandatory for optimal results.

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Authors and Affiliations

  1. First Propaedeutic Surgical Clinic, Hippocratio Athens General Hospital, Athens Medical School, National and Kapodistrian University of Athens, 114 Vassilissis Sophias Avenue, 115 27, Athens, Greece

    Theodoropoulos Charalampos, Natoudi Maria, Vrakopoulou Gavriella Zoi Vrakopoulou, Triantafyllou Tania, Zografos George, Leandros Emmanouil & Albanopoulos Konstantinos

  2. Department of General Surgery, Hellenic Air Force 251 General Hospital, 3 Panagioti Kanellopoulou Avenue, 115 25, Athens, Greece

    Dimitrios Raptis

Authors
  1. Theodoropoulos Charalampos
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  2. Natoudi Maria
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  3. Vrakopoulou Gavriella Zoi Vrakopoulou
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  4. Triantafyllou Tania
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  8. Albanopoulos Konstantinos
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Corresponding author

Correspondence to Vrakopoulou Gavriella Zoi Vrakopoulou.

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All authors declare no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Charalampos, T., Maria, N., Vrakopoulou, V.G.Z. et al. Tailored One Anastomosis Gastric Bypass: 3-Year Outcomes of 94 Patients. OBES SURG 29, 542–551 (2019). https://doi.org/10.1007/s11695-018-3572-6

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  • DOI: https://doi.org/10.1007/s11695-018-3572-6

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