Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis

Feb 19, 2021Updates in surgery

Comparing Two Types of Gastric Bypass Surgery to Fix Failed Weight-Loss Surgeries: A Review and Analysis

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Abstract

OAGB-MGB demonstrates a lower rate of bleeding and improved outcomes compared to RYGB for patients undergoing revisional bariatric surgery.

Both OAGB-MGB and RYGB show similar rates of leaks as perioperative complications.
OAGB-MGB is associated with a lower rate of bleeding compared to RYGB.
Patients undergoing OAGB-MGB experience a better progression from pre- to post-revisional body mass index (BMI).
The operative time for OAGB-MGB is shorter than for RYGB.
OAGB-MGB achieves outcomes comparable to RYGB regarding perioperative complications.

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BACKGROUND: Although different procedures have been proposed as revisional surgery for patients who had previously undergone a failed primary restrictive procedure, the ideal revisional procedure is still a matter of debate.

METHODS: A systematic search was performed in all electronic databases to find studies comparing one anastomosis-mini gastric bypass (OAGB-MGB) or Roux-en-Y gastric bypass (RYGB) as revisional bariatric surgery for weight regain or intolerance/complications of a primary restrictive procedure. The data regarding sample size, patients' gender, age, primary surgery type, number of perioperative complications, operative time, pre- and post-revisional body mass index (BMI), and excess weight loss % (EWL%) at 1-year follow-up were extracted. Five studies were included in the analysis.

RESULTS: The primary bariatric procedures were represented by vertical banded gastroplasty (VBG), laparoscopic adjustable gastric band (LAGB) and laparoscopic sleeve gastrectomy (LSG). About perioperative complications, both RYGB and OAGB-MGB showed a similar rate of leaks but OAGB-MGB had a lower rate of bleedings; considering the progression from pre- to post-revisional BMI, OAGB-MGB reveals a better outcome as well as a shorter operative time.

CONCLUSIONS: Our meta-analysis has shown OAGB-MGB, used as revisional intervention after failed restrictive surgery, achieves outcomes comparable to RYGB in terms of perioperative complications providing a simpler and more effective technique.

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Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis

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