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- Title
Revisional One-Anastomosis Gastric Bypass After Restrictive Index Surgery—a Metaanalysis and Comparison with Revisional Roux-en-Y Gastric Bypass.
- Authors
Yeo, Charleen; Ho, Glen; Syn, Nicholas; Mak, Malcolm; Ahmed, Saleem; Oo, Aung Myint; Koura, Aaryan; Kaushal, Sanghvi; Yeo, Danson
- Abstract
Background: One-anastomosis gastric bypass (OAGB) was established as a recognized bariatric procedure in the 2018 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) position statement. This study evaluates the outcomes of revisional OAGB (rOAGB) after a restrictive index procedure, and to compare it to revisional RYGB (rRYGB). Methods: A literature search was performed according to the PRISMA guidelines on papers published from inception till February 2020. Original studies involving patients who underwent rOAGB after a primary failed restrictive procedure were included. The primary outcome measured was postrOAGB weight loss. Secondary outcome measures include comorbidity resolution, operative duration, length of stay, morbidity, and mortality. Results: A total of 21 studies with 1377 patients were included. Five studies compared rOAGB versus rRYGB. Majority of the patients (76%) were female, with mean age of 43.5 years old. Mean body mass index (BMI) before revisional surgery was 41.6 kg/m2. The most common biliopancreatic limb length was 200 cm. Percentage of excess weight loss after rOAGB increases to a maximum of 76.0% at 48 months postsurgery. rOAGB resulted in a pooled prevalence of diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea resolution of 74.9%, 48.4%, 63.2%, and 75.7% respectively. When compared to rRYGB, rOAGB demonstrated greater weight loss, comparable metabolic syndrome resolution, but with a shorter operating time. Morbidity and mortality rates were low across all studies. Conclusions: rOAGB has potential as an alternative revisional surgery, with weight loss profiles and rates of metabolic syndrome resolution that are comparable to rRYGB.
- Subjects
GASTRIC bypass; SLEEP apnea syndromes; BARIATRIC surgery; BODY mass index; METABOLIC syndrome; METABOLIC disorders
- Publication
Obesity Surgery, 2021, Vol 31, Issue 3, p949
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-020-05094-y