Full text is available at the source.
Obesity surgery···
Comparing Two Types of Stomach Bypass Surgery for Patients Needing Revision After Sleeve Gastrectomy Didn’t Work Well
Updated
Abstract
OAGB showed a statistically significant advantage in total weight loss percentage compared to RYGB.
- Total weight loss percentage was greater with OAGB than with RYGB.
- No significant difference in BMI reduction was found between the two procedures.
- Both OAGB and RYGB had similar remission rates for hypertension, GERD, and type 2 diabetes.
- Postoperative complications were comparable for both surgical techniques.
- Operative time was significantly shorter for OAGB by an average of 30.10 minutes.
Simplified
BACKGROUND: Sleeve gastrectomy (SG) is the most performed bariatric procedure worldwide. Although effective in the short term, it has a high insufficient clinical response rate, leading to weight regain and gastroesophageal reflux disease (GERD), necessitating revisional surgery. The two primary options for conversion procedures are the Roux-en-Y gastric bypass (RYGB), considered the gold standard, and the one-anastomosis gastric bypass (OAGB), recognized for its simplicity and metabolic benefits.
OBJECTIVE: To compare the effectiveness and safety of RYGB and OAGB as revisional procedures after insufficient clinical response to SG in terms of weight loss, metabolic improvements, surgical complications, and operative time.
METHODS: This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search was conducted across six databases (PubMed, Scopus, Web of Science, Cochrane, Ovid/Medline, and Embase). Out of 236 identified studies, five met the inclusion criteria. Data were analyzed using relative risk (RR) for categorical variables and mean difference (MD) for continuous outcomes, applying a random-effects model.
RESULTS: OAGB showed a statistically significant advantage in total weight loss percentage (TWL%) compared to RYGB (MD, - 1.24; 95% CI, - 1.94, - 0.53; p = 0.0006). However, no significant difference was observed in BMI reduction (MD, 0.00; 95% CI, - 1.24, 1.24; p = 1.00). Both techniques demonstrated similar remission rates for hypertension (RR, 0.85; 95% CI, 0.60-1.22; p = 0.38), GERD (RR, 1.00; 95% CI, 0.86-1.17; p = 0.97), and type 2 diabetes (RR, 0.97; 95% CI, 0.79-1.21; p = 0.81). Postoperative complications were comparable between groups (RR, 0.89; 95% CI, 0.67-1.18; p = 0.42). However, operative time was significantly shorter in OAGB (MD, 30.10 min; 95% CI, 27.89, 32.32; p < 0.00001).
CONCLUSION: OAGB demonstrated greater total weight loss and a shorter operative time compared to RYGB, with a comparable safety profile. Both techniques were equally effective in managing hypertension and GERD, though OAGB showed a non-significant trend favoring type 2 diabetes remission. RYGB may be preferable for patients with severe GERD. Further high-quality, long-term studies are needed to establish the optimal revisional procedure for SG.
Related papers
Nov '23
Comparing two stomach bypass surgeries used after failed sleeve gastrectomy
top 30% journal
cited by 20 papers
systematic review
Jul '24
Comparing two types of follow-up weight loss surgeries after sleeve gastrectomy: Roux-en-Y vs one-anastomosis gastric bypass
top 50% journal
cited by 11 papers
systematic review
May '23
Revisional One Anastomosis vs Roux-en-Y Gastric Bypass after Sleeve Surgery: Impact on Acid Reflux Symptoms and Quality of Life
top 20% journal
cited by 13 papers
journal article
Jan '22
Results of Sleeve Gastrectomy Changed to Roux-en-Y or One-Anastomosis Gastric Bypass
top 20% journal
cited by 53 papers
journal article
Sep '22
Comparing two types of stomach surgery after failed weight-loss sleeve: Roux-en-Y versus one-anastomosis gastric bypass
top 20% journal
cited by 43 papers
randomized controlled trial
Dec '18
Comparing Two Types of Gastric Bypass Surgery as a Second Step After Sleeve Gastrectomy
top 20% journal
cited by 76 papers
journal article
Oct '22
Comparing Two Types of Weight-Loss Surgery After Sleeve Gastrectomy: One-Anastomosis vs Roux-en-Y Gastric Bypass
top 20% journal
cited by 13 papers
systematic review
Jul '25
Long-Term Results of Sleeve Gastrectomy Compared to Roux-en-Y Gastric Bypass Surgery
top 20% journal
cited by 20 papers
systematic review
May '23
Short-Term Safety of One Anastomosis Gastric Bypass Used to Redo Weight Loss Surgery
top 20% journal
cited by 3 papers
journal article
Jun '18
Long-term weight loss and health improvements after three types of stomach surgery: sleeve gastrectomy, Roux-en-Y, and one-anastomosis gastric bypass
top 20% journal
cited by 114 papers
randomized controlled trial