Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 3/2021

01-03-2021 | Bariatric Surgery | Original Contributions

Revisional One-Anastomosis Gastric Bypass After Restrictive Index Surgery—a Metaanalysis and Comparison with Revisional Roux-en-Y Gastric Bypass

Authors: Charleen Yeo, Glen Ho, Nicholas Syn, Malcolm Mak, Saleem Ahmed, Aung Myint Oo, Aaryan Koura, Sanghvi Kaushal, Danson Yeo

Published in: Obesity Surgery | Issue 3/2021

Login to get access

Abstract

Background

One-anastomosis gastric bypass (OAGB) was established as a recognized bariatric procedure in the 2018 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) position statement. This study evaluates the outcomes of revisional OAGB (rOAGB) after a restrictive index procedure, and to compare it to revisional RYGB (rRYGB).

Methods

A literature search was performed according to the PRISMA guidelines on papers published from inception till February 2020. Original studies involving patients who underwent rOAGB after a primary failed restrictive procedure were included. The primary outcome measured was postrOAGB weight loss. Secondary outcome measures include comorbidity resolution, operative duration, length of stay, morbidity, and mortality.

Results

A total of 21 studies with 1377 patients were included. Five studies compared rOAGB versus rRYGB. Majority of the patients (76%) were female, with mean age of 43.5 years old. Mean body mass index (BMI) before revisional surgery was 41.6 kg/m2. The most common biliopancreatic limb length was 200 cm. Percentage of excess weight loss after rOAGB increases to a maximum of 76.0% at 48 months postsurgery. rOAGB resulted in a pooled prevalence of diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea resolution of 74.9%, 48.4%, 63.2%, and 75.7% respectively. When compared to rRYGB, rOAGB demonstrated greater weight loss, comparable metabolic syndrome resolution, but with a shorter operating time. Morbidity and mortality rates were low across all studies.

Conclusions

rOAGB has potential as an alternative revisional surgery, with weight loss profiles and rates of metabolic syndrome resolution that are comparable to rRYGB.
Literature
1.
Saber AA, Elgamal MH, McLeod MK. Bariatric surgery: the past, present, and future. Obes Surg. 2008;18(1):121–8.PubMed
2.
Yeo D, Yeo C, Low TY, et al. Outcomes after metabolic surgery in Asians-a meta-analysis. Obes Surg. 2019;29(1):114–26.PubMed
3.
Yeo C, Kaushal S, Lim B, et al. Impact of bariatric surgery on serum uric acid levels and the incidence of gout-A meta-analysis. Obes Rev Off J Int Assoc Study Obes. 2019;20(12):1759–70.
4.
Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12(10):1778–86.
5.
Braghetto I, Csendes A. Prevalence of Barrett’s esophagus in bariatric patients undergoing sleeve gastrectomy. Obes Surg. 2016;26(4):710–4.PubMed
6.
Felsenreich DM, Langer FB, Kefurt R, et al. Weight loss, weight regain, and conversions to roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12(9):1655–62.
7.
El Chaar M, Stoltzfus J, Claros L, et al. Indications for revisions following 630 consecutive laparoscopic sleeve gastrectomy cases: experience in a single accredited center. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2017;21(1):12–6.
8.
Weiner RA, Theodoridou S, Weiner S. Failure of laparoscopic sleeve gastrectomy--further procedure? Obes Facts. 2011;4(Suppl 1):42–6.PubMedPubMedCentral
9.
DeMaria EJ. Bariatric surgery for morbid obesity. N Engl J Med. 2007;356(21):2176–83.PubMed
10.
Doumouras AG, Saleh F, Anvari S, et al. Mastery in bariatric surgery: the long-term surgeon learning curve of roux-en-Y gastric bypass. Ann Surg. 2018;267(3):489–94.PubMed
11.
Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276–80.PubMed
12.
Hussain A, Van den Bossche M, Kerrigan DD, et al. Retrospective cohort study of 925 OAGB procedures. The UK MGB/OAGB collaborative group. Int J Surg (London, England). 2019;69:13–8.
13.
Jia D, Tan H, Faramand A, Fang F. One anastomosis gastric bypass versus roux-en-Y gastric bypass for obesity: a systematic review and meta-analysis of randomized clinical trials. Obes Surg. 2020;30(4):1211–18.
14.
Lee WJ, Almalki OM, Ser KH, et al. Randomized controlled trial of one anastomosis gastric bypass versus roux-en-Y gastric bypass for obesity: comparison of the YOMEGA and Taiwan studies. Obes Surg. 2019;29(9):3047–53.PubMed
15.
Magouliotis DE, Tasiopoulou VS, Tzovaras G. One anastomosis gastric bypass versus roux-en-Y gastric bypass for morbid obesity: an updated meta-analysis. Obes Surg. 2019;29(9):2721–30.PubMed
16.
Parmar CD, Mahawar KK. One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 patients. Obes Surg. 2018;28(9):2956–67.PubMed
17.
Robert M, Espalieu P, Pelascini E, et al. Efficacy and safety of one anastomosis gastric bypass versus roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. Lancet (London, England). 2019;393(10178):1299–309.
18.
De Luca M, Tie T, Ooi G, et al. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018;28(5):1188–206.PubMed
19.
Ramos AC, Chevallier J-M, Mahawar K, et al. IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) consensus conference statement on One-Anastomosis Gastric Bypass (OAGB-MGB): results of a nodified Delphi study. Obes Surg. 2020;30(5):1625–34.PubMed
20.
Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ: Br Med J. 2015;349:g7647.
21.
Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute: Ottawa; 2011.
22.
Murad MH, Sultan S, Haffar S, et al. Methodological quality and synthesis of case series and case reports. BMJ Evid-Based Med. 2018;23(2):60–3.PubMedPubMedCentral
23.
Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Publ Health. 2014;72(1):39.
24.
Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.PubMedPubMedCentral
25.
Furukawa TA, Barbui C, Cipriani A, et al. Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol. 2006;59(1):7–10.PubMed
26.
Díaz-Francés E, Rubio FJ. On the existence of a normal approximation to the distribution of the ratio of two independent normal random variables. Stat Pap. 2013;54(2):309–23.
27.
Pham-Gia T, Turkkan N, Marchand E. Density of the ratio of two normal random variables and applications. Commun Stat - Theory Methods. 2006;35(9):1569–91.
28.
Bhandari M, Humes T, Kosta S, et al. Revision operation to one anastomosis gastric bypass for failed sleeve gastrectomy. Surg Obes Relat Dis. 2019;15:2033–37.
29.
Chiappetta S, Stier C, Scheffel O, et al. 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. 2019;29(3):819–27.PubMed
30.
Almalki OM, Lee WJ, Chen JC, et al. Revisional gastric bypass for failed restrictive procedures: comparison of single-anastomosis (mini-) and roux-en-Y gastric bypass. Obes Surg. 2018;28(4):970–5.PubMed
31.
Poghosyan T, Alameh A, Bruzzi M, et al. Conversion of sleeve gastrectomy to one anastomosis gastric bypass for weight loss failure. Obes Surg. 2019;29(8):2436–41.PubMed
32.
Noun R, Slim R, Chakhtoura G, et al. Resectional one anastomosis gastric bypass/mini gastric bypass as a novel option for revision of restrictive procedures: preliminary results. J Obes. 2018;2018:4049136.PubMedPubMedCentral
33.
Pujol Rafols J, Al Abbas AI, Devriendt S, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one anastomosis gastric bypass as rescue therapy after failed adjustable gastric banding: a multicenter comparative study. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2018;14(11):1659–66.
34.
Chansaenroj P, Aung L, Lee WJ, et al. Revision procedures after failed adjustable gastric banding: comparison of efficacy and safety. Obes Surg. 2017;27(11):2861–7.PubMed
35.
Ghosh S, Bui TL, Skinner CE, et al. A 12-month review of revisional single anastomosis gastric bypass for complicated laparoscopic adjustable gastric banding for body mass index over 35. Obes Surg. 2017;27(11):3048–54.PubMed
36.
Bruzzi M, Voron T, Zinzindohoue F, et al. Revisional single-anastomosis gastric bypass for a failed restrictive procedure: 5-year results. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12(2):240–5.
37.
Salama TM, Sabry K. Redo surgery after failed open VBG: laparoscopic minigastric bypass versus laparoscopic roux en Y gastric bypass-which is better? Minim Invasive Surg. 2016;2016:8737519.PubMedPubMedCentral
38.
Piazza L, Di Stefano C, Ferrara F, et al. Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients. Updat Surg. 2015;67(4):433–7.
39.
Moszkowicz D, Rau C, Guenzi M, et al. Laparoscopic omega-loop gastric bypass for the conversion of failed sleeve gastrectomy: early experience. J Visceral Surg. 2013;150(6):373–8.
40.
AlSabah S, Al Haddad E, Al-Subaie S, et al. Short-term results of revisional single-anastomosis gastric bypass after sleeve Gastrectomy for weight regain. Obes Surg. 2018;28(8):2197–202.PubMed
41.
Debs T, Petrucciani N, Kassir R, et al. Laparoscopic conversion of sleeve gastrectomy to one anastomosis gastric bypass for weight loss failure: mid-term results. Obes Surg. 2020;30(6):2259–65.PubMed
42.
Heidari R, Talebpour M, Soleyman-Jahi S, et al. Outcomes of reoperation after laparoscopic gastric plication failure. Obes Surg. 2019;29(2):376–86.PubMed
43.
Jamal MH, Elabd R, AlMutairi R, et al. The safety and efficacy of one anastomosis gastric bypass as a revision for sleeve Gastrectomy. Obes Surg. 2020;30(6):2280–4.PubMed
44.
Lessing Y, Pencovich N, Khatib M, et al. One-anastomosis gastric bypass: first 407 patients in 1 year. Obes Surg. 2017;27(10):2583–9.PubMed
45.
Meydan C, Raziel A, Sakran N, et al. Single anastomosis gastric bypass-comparative short-term outcome study of conversional and primary procedures. Obes Surg. 2017;27(2):432–8.PubMed
46.
Musella M, Bruni V, Greco F, et al. Conversion from laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) to one anastomosis gastric bypass (OAGB): preliminary data from a multicenter retrospective study. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2019;15(8):1332–9.
47.
Noun R, Zeidan S, Riachi E, et al. Mini-gastric bypass for revision of failed primary restrictive procedures: a valuable option. Obes Surg. 2007;17(5):684–8.PubMed
48.
Wang W, Huang MT, Wei PL, et al. Laparoscopic mini-gastric bypass for failed vertical banded gastroplasty. Obes Surg. 2004;14(6):777–82.PubMed
49.
O'Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94.PubMed
50.
Aarts EO, Dogan K, Koehestanie P, et al. Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10(4):633–40.
51.
Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.PubMed
52.
Juodeikis Ž, Brimas G. Long-term results after sleeve gastrectomy: a systematic review. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2017;13(4):693–9.
53.
Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2017;13(4):568–74.
54.
Aarts E, Koehestanie P, Dogan K, et al. Revisional surgery after failed gastric banding: results of one-stage conversion to RYGB in 195 patients. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10(6):1077–83.
55.
Creange C, Jenkins M, Pergamo M, et al. Gastric band conversion to roux-en-Y gastric bypass shows greater weight loss than conversion to sleeve gastrectomy: 5-year outcomes. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2018;14(10):1531–6.
56.
Moon RC, Fuentes AS, Teixeira AF, et al. Conversions after sleeve gastrectomy for weight regain: to single and double anastomosis duodenal switch and gastric bypass at a single institution. Obes Surg. 2019;29(1):48–53.PubMed
57.
Wang FG, Yan WM, Yan M, et al. Outcomes of mini vs roux-en-Y gastric bypass: a meta-analysis and systematic review. Int J Surg (Lond, Engl). 2018;56:7–14.
58.
Nabil TM, Khalil AH, Mikhail S, et al. Conventional versus distal laparoscopic one-anastomosis gastric bypass: a randomized controlled trial with 1-year follow-up. Obes Surg. 2019;29(10):3103–10.PubMed
59.
Komaei I, Sarra F, Lazzara C, et al. One anastomosis gastric bypass-mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019;29(9):3062–70.PubMed
Metadata
Title
Revisional One-Anastomosis Gastric Bypass After Restrictive Index Surgery—a Metaanalysis and Comparison with Revisional Roux-en-Y Gastric Bypass
Authors
Charleen Yeo
Glen Ho
Nicholas Syn
Malcolm Mak
Saleem Ahmed
Aung Myint Oo
Aaryan Koura
Sanghvi Kaushal
Danson Yeo
Publication date
01-03-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-05094-y

Other articles of this Issue 3/2021

Obesity Surgery 3/2021 Go to the issue

Original Contributions

Long-Term Outcome of Proximal Versus Very-Very Long Limb Roux-en-Y Gastric Bypass: the Roux-Limb to Common Channel Ratio Determines the Long-Term Weight Loss

Original Contributions

The Effect of Laparoscopic Sleeve Gastrectomy on Gastroesophageal Reflux Disease

Multimedia Article

The Hardship of Recovering a Patient from Liver Failure after One Anastomosis Gastric Bypass

Letter to the Editor

Incidence of Marginal Ulcers After Gastric Bypass Seems to Be Inversely Related to the Duration of Prophylaxis with Proton Pump Inhibitors

Brief Communication

The Prevalence of Co-morbidities in Adult and Adolescent Bariatric Surgery Candidates

Letter to the Editor

Letter to the Editor Concerning: Bures C, Benzing C, Marchesini JC, Sobottka WH, Sadowski JA, Marchesini JB, Zorron R. The “Hug” Technique-Roux-en-Y gastric Bypass with Preservation of the Posterior Wrap in Patients with Nissen Fundoplication: a Simple Solution for a Complex Problem