Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up

Jan 24, 2015Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Long-term results and quality of life 5 years after single connection or mini-gastric bypass surgery

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Abstract

At 5 years, mean body mass index (BMI) was 31±6 kg/m² among patients who underwent laparoscopic mini-gastric bypass.

No deaths occurred during the study period.
Major complications developed in 10.3% of patients, including marginal ulcers in 4% and biliary reflux in 1.6%.
The mean percent excess BMI loss (%EBMIL) was 71.5%±26.5%.
Quality of life scores significantly improved postoperatively, with a Gastrointestinal Quality of Life Index (GIQLI) score of 110.3±17.4 compared to 92.5±15.9 in the control group.
Social, psychological, and physical functions showed significant increases after the procedure.
Long-term follow-up indicated improvements in all co-morbidities.

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BACKGROUND: Laparoscopic mini-gastric bypass (LMGB) is an alternative to the laparoscopic Roux-en-Y gastric bypass (LRYGB), which is considered to be the gold standard in the treatment of morbid obesity.

OBJECTIVES: Present 5-year results of 175 patients who had undergone a LMGB between October 2006 and October 2008.

SETTING: University public hospital, France.

METHODS: Complete follow-up was available in 126 of 175 patients (72%) who had LMGB. Mortality, morbidity, weight loss, co-morbidities, and quality of life were assessed. Weight loss was determined as a change in body mass index (BMI) and percent excess BMI loss (%EBMIL). Quality of life in the treatment group was analyzed using the Gastrointestinal Quality of Life Index (GIQLI) and was compared with a retrospectively case matched preoperative control group.

RESULTS: There were no deaths. Thirteen patients (10.3%) developed major complications. Marginal ulcers occurred in 4% of patients. Incapacitating biliary reflux developed in 2 (1.6%) who required conversion into RYGB. Gastric pouch dilation occurred in 4 patients (3.2%) and inadequate weight loss with severe malnutrition in 2 (1.6%). At 5 years, mean BMI was 31±6 kg/m(2) and mean %EBMIL was 71.5%±26.5%. Postoperative GIQLI score of the treatment group was significantly higher than preoperative score of the control group (110.3±17.4 versus 92.5±15.9, P<.001). Social, psychological, and physical functions were increased significantly. No significant differences were found in gastroesophageal reflux or diarrhea symptoms between the 2 groups. Long-term follow-up showed an improvement in all co-morbidities.

CONCLUSIONS: At 5 years, LMGB was safe, effective, and provided interesting quality of life results.

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Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up

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