Comparison of Short-term Safety of One Anastomosis Gastric Bypass to Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in the United States: 341 cases from MBSAQIP-accredited Centers

Dec 13, 2021Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Short-term safety of one-anastomosis gastric bypass compared to Roux-en-Y gastric bypass and sleeve gastrectomy in the United States

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Abstract

A total of 341 patients underwent primary anastomosis gastric bypass (OAGB), which demonstrated a lower overall complication rate than Roux-en-Y gastric bypass (RYGB).

The overall complication rate for OAGB was 6.7%, compared to 12.3% for RYGB.
OAGB showed a similar overall complication rate to sleeve gastrectomy (SG) at 5.0%.
The surgical complication rate for OAGB was 5.0%, while RYGB had a rate of 8.5% and SG had a lower rate of 1.2%.
Patients undergoing OAGB had a shorter median hospitalization of 1 day compared to 2 days for RYGB.
Hospitalization length for OAGB was similar to that of SG, which ranged from 1 to 2 days.

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BACKGROUND: One anastomosis gastric bypass (OAGB) is the third most common (4%) primary bariatric procedure worldwide but is seldom performed in the United States and is currently under consideration for endorsement by the American Society for Metabolic and Bariatric Surgery. Evidence from the United States on safety of OAGB compared to Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) is limited.

OBJECTIVE: To compare the short-term safety outcomes of the three primary bariatric procedures.

SETTING: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)-accredited hospitals in the United States and Canada.

METHODS: Using the 2015-2019 MBSAQIP database, we compared the safety outcomes of adult patients who underwent primary laparoscopic OAGB, RYGB, and SG. Exclusion criteria included age over 80 years, emergency operation, conversion, and incomplete follow-up. The primary outcome was 30-day overall complication. Secondary outcomes were 30-day surgical and medical complications and hospitalization length.

RESULTS: A total of 341 patients underwent primary OAGB. Using propensity scores, we matched the OAGB cohort 1:1 with two cohorts of similar baseline characteristics who underwent RYGB and SG, respectively. The OAGB cohort had a lower overall complication rate than the RYGB cohort (6.7% versus12.3%, P = .02) and a similar rate to the SG cohort (5.0%, P = .43). The OAGB cohort had a similar rate of surgical complication to the RYGB cohort (5.0% versus 8.5%, P = .1) and a higher rate than the SG group (1.2%, P = .009). The OAGB cohort had a shorter median hospitalization than the RYGB cohort (1 d [interquartile range (IQR) 1-2 d] versus 2 d [IQR 1-2 d], P < .001) and a similar hospitalization length to the SG cohort ([1-2 d], P = .46).

CONCLUSION: Using the largest and the most current U.S. data, this study demonstrated that the short-term safety profile of primary OAGB is acceptable, but future studies should determine the long-term safety.

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Comparison of Short-term Safety of One Anastomosis Gastric Bypass to Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in the United States: 341 cases from MBSAQIP-accredited Centers

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