One Anastomosis Gastric Bypass (OAGB) vs Roux en Y Gastric Bypass (RYGB) for Remission of T2DM in Patients with Morbid Obesity: a Randomized Controlled Trial

Feb 22, 2023Obesity surgery

Comparing Two Stomach Bypass Surgeries for Type 2 Diabetes Improvement in Severely Obese Patients

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Abstract

In a randomized trial involving 49 patients, the remission rates of type 2 diabetes were similar for both one anastomosis gastric bypass (OAGB) and Roux en Y gastric bypass (RYGB) at 1 year (86.36% vs 85.71%) and 4 years (72.22% vs 71.43%).

OAGB achieved comparable weight loss to RYGB, with the highest percentage of excess weight loss at 1 year being 69.23% for OAGB and 66.67% for RYGB.
The 4-year excess weight loss rates were 58.33% for OAGB and 53.33% for RYGB, indicating similar long-term outcomes.
Remission rates for other co-morbidities and complication rates were also similar between the two groups.
OAGB was associated with a shorter operating time compared to RYGB.

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INTRODUCTION: Majority of the studies comparing Roux en Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) are non-randomized. Moreover, few randomized studies have focussed on weight loss as the primary outcome rather than the impact on type 2 diabetes mellitus (T2DM). This randomized trial compared OABG over RYGB with the hypothesis that OAGB is not inferior to RYGB in terms of remission of T2DM.

METHODS: This was an open-labelled, randomized trial in which patients having a BMI greater than 30 kg/mwith T2DM were included. The primary outcome was the remission of T2DM. 2

RESULTS: In the study, 25 and 24 patients were recruited in OAGB and RYGB groups respectively. The remission rates of T2DM were similar at all timelines. The highest rate was achieved at 1 year (86.36% vs 85.71%) for both the groups and a 4-year remission rate of (72.22% vs 71.43%), for OAGB vs RYGB respectively. The % EWL was also comparable with the highest rate achieved again at 1 year (69.23% vs 66.67%) and a 4-year rate of (58.33% vs 53.33%), for OAGB vs RYGB respectively. Remission of other co-morbidities, major and minor complication rate, re-admission rate, and nutritional issues were similar in both groups.

CONCLUSION: OAGB is non-inferior to RYGB in terms of remission of type 2 diabetes mellitus, weight loss, and early and late complications with a shorter operating time.

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One Anastomosis Gastric Bypass (OAGB) vs Roux en Y Gastric Bypass (RYGB) for Remission of T2DM in Patients with Morbid Obesity: a Randomized Controlled Trial

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