One Anastomosis Gastric Bypass Compared with Sleeve Gastrectomy in Elderly Patients: Safety and Long-term Outcomes

Dec 22, 2022Obesity surgery

Safety and Long-term Results of One Anastomosis Gastric Bypass versus Sleeve Gastrectomy in Older Adults

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Abstract

Among 124 elderly patients, 80.6% of those undergoing one anastomosis gastric bypass (OAGB) achieved excess weight loss greater than 50%.

OAGB led to a mean excess weight loss of 67.2% compared to 45.8% with sleeve gastrectomy (SG).
Patients who underwent OAGB experienced a greater reduction in body mass index (BMI) from 41.8 to 28.6, while SG patients reduced from 43.3 to 33.2.
Resolution rates for type 2 diabetes were significantly higher in OAGB patients (86.6%) than in those with SG (29.7%).
Hypertension resolution rates were also better in OAGB patients (73.3%) compared to SG patients (36.3%).
Major early complication rates were similar in both OAGB and SG groups.

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BACKGROUND: As life expectancy increases, more elderly patients are being considered for metabolic bariatric surgery. We aimed to assess the safety and long-term effectiveness of one anastomosis gastric bypass (OAGB) compared to sleeve gastrectomy (SG).

METHODS: Single-center retrospective comparative study of OAGB and SG (2012-2019) in patients aged ≥ 65 years.

RESULTS: In all, 124 patients underwent OAGB (n = 41) and SG (n = 83). Mean age was 67.6 ± 2.8 and 67.6 ± 2.6 years (p = 0.89), respectively. Baseline characteristics were comparable, except lower rates of hypertension (HTN) and non-alcoholic fatty liver disease in OAGB than SG patients (43.9% vs. 74.6%; p < 0.001, and 39.0% vs. 89.1%; p < 0.001, respectively). Body mass index (BMI) of OAGB and SG patients decreased from 41.8 ± 7.8 and 43.3 ± 5.9 kg/m(p = 0.25) to 28.6 ± 4.7 and 33.2 ± 5.3 (p < 0.001), at long-term follow-up, respectively. Excess weight loss (EWL) > 50% was achieved in 80.6% and 43.2% of OAGB and SG patients, with a mean EWL of 67.2% ± 22.3 and 45.8% ± 18.0 (p < 0.001) and a mean total weight loss (TWL) of 30.7% ± 10.4 and 21.9% ± 8.1 (p < 0.001), respectively. Resolution rates of obesity-associated medical problems were similar, except type 2 diabetes (T2D) and HTN, which were 86.6% and 73.3% in OAGB, compared with 29.7% and 36.3% in SG patients (p < 0.001 and p = 0.001), respectively. Major early complication rates were comparable (2.4% vs. 3.6%; p = 0.73, respectively). Revision for late complications was required in two OAGB patients. 2

CONCLUSIONS: OAGB in the elderly is safe and results in better long-term weight reduction and resolution of T2D and HTN than SG.

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One Anastomosis Gastric Bypass Compared with Sleeve Gastrectomy in Elderly Patients: Safety and Long-term Outcomes

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