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Obesity Surgery
Published in: Obesity Surgery 10/2021

01-10-2021 | Obesity | Original Contributions

Network Meta-Analysis of Metabolic Surgery Procedures for the Treatment of Obesity and Diabetes

Authors: Andrew C. Currie, Alan Askari, Ana Fangueiro, Kamal Mahawar

Published in: Obesity Surgery | Issue 10/2021

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Abstract

Background

Metabolic surgery is part of a well-established treatment intensification strategy for obesity and its related comorbidities including type 2 diabetes (T2DM). Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) are the most commonly performed metabolic surgeries worldwide, but comparative efficacy is uncertain. This study employed network meta-analysis to compare weight loss, T2DM remission and perioperative complications in adults between RYGB, SG and OAGB.

Methods

MEDLINE, EMBASE, trial registries were searched for randomised trials comparing RYGB, SG and OAGB. Study outcomes were excess weight loss (at 1, 2 and 3–5 years), trial-defined T2DM remission at any time point and perioperative complications.

Results

Twenty randomised controlled trials were included involving 1803 patients investigating the three metabolic surgical interventions. RYGB was the index for comparison. The excess weight loss (EWL) demonstrated minor differences at 1 and 2 years, but no differences between interventions at 3–5 years. T2DM remission was more likely to occur with either RYGB or OAGB when compared to SG. Perioperative complications were higher with RYGB when compared to either SG or OAGB. Two-way analysis of EWL and T2DM remission against the risk of perioperative complications demonstrated OAGB was the most positive on this assessment at all time points.

Conclusion

OAGB offers comparable metabolic control through weight loss and T2DM remission to RYGB and SG whilst minimising perioperative complications.
Registration number: CRD42020199779 (https:// www.​crd.​york.​ac.​uk/​PROSPERO)

Graphical abstract

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Metadata
Title
Network Meta-Analysis of Metabolic Surgery Procedures for the Treatment of Obesity and Diabetes
Authors
Andrew C. Currie
Alan Askari
Ana Fangueiro
Kamal Mahawar
Publication date
01-10-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05643-z

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