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Erschienen in: Obesity Surgery 8/2021

07.06.2021 | Original Contributions

Long-Term Results of One Anastomosis Gastric Bypass: a Single Center Experience with a Minimum Follow-Up of 10 Years

verfasst von: Sergio Carandina, Antoine Soprani, Viola Zulian, Jean Cady

Erschienen in: Obesity Surgery | Ausgabe 8/2021

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Abstract

Purpose

The purpose of this study was to evaluate the efficacy and safety of the OAGB at least 10 years after surgery.

Material and Methods

We retrospectively reviewed our prospectively collected data on consecutive morbid patients with obesity receiving OAGB from January 2005 to December 2007.

Results

A total of 385 patients met the inclusion criteria. The mean follow-up was 149 months. Of all patients, 52% underwent OAGB as a primary procedure and 48% as a revisional procedure. At the 10-year follow-up, the mean body mass index (BMI) was 30.7 ± 11.8, the mean %TWL was 33.4 ± 10.6, and the mean %EWL was 64.1 ± 24.6. We did not find a significant statistical difference in terms of weight loss between primary OAGB and secondary OAGB. In total, 43% of patients achieved a %EWL greater than 75%, while 29% of the patients had an EWL% that was below 50%. All of the comorbidities related to obesity showed a high improvement or fully resolved. Early complications occurred in 9 patients (2.3%), while the overall rate of late complications was 17.1%. Nineteen patients (4.9%) developed an ulcer at the gastrojejunal anastomosis level, nine patients (2.3%) were re-hospitalized for major malnutrition, thirty-eight patients (9.8%) showed a postoperative biliary reflux, and five patients (2.7%) experienced severe anemia, which required several hospitalizations for iron I.V. supplementation.

Conclusion

According to results of the present study, we believe that OAGB has shown to be a technique with a reasonable balance between long-term efficacy and undesirable sequelae.

Graphical abstract

Literatur
1.
Zurück zum Zitat Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21:1458–68.CrossRef Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg. 2011;21:1458–68.CrossRef
2.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.CrossRef Angrisani L, Santonicola A, Iovino P, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.CrossRef
3.
Zurück zum Zitat Magouliotis DE, VS T, Tzovaras G. One anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: an updated metaanalysis. Obes Surg. 2019;29:2721–30.CrossRef Magouliotis DE, VS T, Tzovaras G. One anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: an updated metaanalysis. Obes Surg. 2019;29:2721–30.CrossRef
4.
Zurück zum Zitat Parmar CD, Bryant C, Luque-de-Leon E, et al. One anastomosis gastric bypass in morbidly obese patients with BMI ≥50 kg/m2: a systematic review comparing it with Roux-En-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2019;29:3039–46.CrossRef Parmar CD, Bryant C, Luque-de-Leon E, et al. One anastomosis gastric bypass in morbidly obese patients with BMI ≥50 kg/m2: a systematic review comparing it with Roux-En-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2019;29:3039–46.CrossRef
5.
Zurück zum Zitat Ramos AC, Chevallier JM, Mahawar K, et al. IFSO (International Federation of Obesity and Metabolic Disorders) consensus conference statement on oneanastomosis gastric bypass (OAGB-MGB): results of a modified Delphi study. Obes Surg. 2020;30:1625–34.CrossRef Ramos AC, Chevallier JM, Mahawar K, et al. IFSO (International Federation of Obesity and Metabolic Disorders) consensus conference statement on oneanastomosis gastric bypass (OAGB-MGB): results of a modified Delphi study. Obes Surg. 2020;30:1625–34.CrossRef
6.
Zurück zum Zitat O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-years outcomes after adjustable gastric banding. Obes Surg. 2019;29:3–14.CrossRef O’Brien PE, Hindle A, Brennan L, et al. Long-term outcomes after bariatric surgery: a systematic review and meta-analysis of weight loss at 10 or more years for all bariatric procedures and a single-centre review of 20-years outcomes after adjustable gastric banding. Obes Surg. 2019;29:3–14.CrossRef
7.
Zurück zum Zitat Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155:385–94.PubMed Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155:385–94.PubMed
8.
Zurück zum Zitat Roslin MS, Gagner M, Goriparthi RG, et al. The rationale for a duodenal switch as the primary surgical treatment of advanced type 2 diabetes mellitus and metabolic disease. Surg Obes Relat Dis. 2015;11:704–10.CrossRef Roslin MS, Gagner M, Goriparthi RG, et al. The rationale for a duodenal switch as the primary surgical treatment of advanced type 2 diabetes mellitus and metabolic disease. Surg Obes Relat Dis. 2015;11:704–10.CrossRef
9.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRef
10.
Zurück zum Zitat Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11(2):321–6.CrossRef Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11(2):321–6.CrossRef
11.
Zurück zum Zitat Parmar CD, Mahawar KK. One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 patients. Obes Surg. 2018;28:2956–67.CrossRef Parmar CD, Mahawar KK. One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 patients. Obes Surg. 2018;28:2956–67.CrossRef
12.
Zurück zum Zitat Boyle M, Mahawar K. One anastomosis gastric bypass performed with 150-cm biliopancreatic limb delivers weight loss outcomes similar to those with a 200-cm biliopancreatic limb at 18-24 months. Obes Surg. 2020;30:1258–64.CrossRef Boyle M, Mahawar K. One anastomosis gastric bypass performed with 150-cm biliopancreatic limb delivers weight loss outcomes similar to those with a 200-cm biliopancreatic limb at 18-24 months. Obes Surg. 2020;30:1258–64.CrossRef
13.
Zurück zum Zitat Robert M, Espalieu P, Pelascini E, et al. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicenter, randomized, open-label, non-inferiority trial. Lancet. 2019;393:1299–309.CrossRef Robert M, Espalieu P, Pelascini E, et al. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicenter, randomized, open-label, non-inferiority trial. Lancet. 2019;393:1299–309.CrossRef
14.
Zurück zum Zitat Komaei I, Sarra F, Lazzara C, et al. One anastomosis gastric bypass-mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019;29:3062–70.CrossRef Komaei I, Sarra F, Lazzara C, et al. One anastomosis gastric bypass-mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019;29:3062–70.CrossRef
15.
Zurück zum Zitat Liagre A, Debs T, Kassir R, et al. One anastomosis gastric bypass with a biliopancreatic limb of 150 cm: weight loss, nutritional outcomes, endoscopic results, and quality of life at 8-year follow-up. Obes Surg. 2020;30:4206–17.CrossRef Liagre A, Debs T, Kassir R, et al. One anastomosis gastric bypass with a biliopancreatic limb of 150 cm: weight loss, nutritional outcomes, endoscopic results, and quality of life at 8-year follow-up. Obes Surg. 2020;30:4206–17.CrossRef
16.
Zurück zum Zitat Neuberg M, Blanchet MC, Gignoux B, et al. Long-term outcomes after one-anastomosis gastric bypass (OAGB) in morbidly obese patients. Obes Surg. 2020;30:1379–84.CrossRef Neuberg M, Blanchet MC, Gignoux B, et al. Long-term outcomes after one-anastomosis gastric bypass (OAGB) in morbidly obese patients. Obes Surg. 2020;30:1379–84.CrossRef
17.
Zurück zum Zitat Rebecchi F, Allaix ME, Ugliono E, et al. Increased esophageal exposure to weakly acidic reflux 5 years after laparoscopic Roux-en-Y gastric bypass. Ann Surg. 2016;26:871–7.CrossRef Rebecchi F, Allaix ME, Ugliono E, et al. Increased esophageal exposure to weakly acidic reflux 5 years after laparoscopic Roux-en-Y gastric bypass. Ann Surg. 2016;26:871–7.CrossRef
18.
Zurück zum Zitat Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017;27:3092–101.CrossRef Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017;27:3092–101.CrossRef
19.
Zurück zum Zitat Musella M, Berardi G, Bocchetti A, et al. Esophagogastric neoplasms following bariatric surgery: an updated systematic review. Obes Surg. 2019;29:2660–9.CrossRef Musella M, Berardi G, Bocchetti A, et al. Esophagogastric neoplasms following bariatric surgery: an updated systematic review. Obes Surg. 2019;29:2660–9.CrossRef
20.
Zurück zum Zitat Runkel M, Pauthner M, Runkel N. The first case report of a carcinoma of the gastric cardia (AEGII) after OAGB-MGB. Obes Surg. 2020;30:753–4.CrossRef Runkel M, Pauthner M, Runkel N. The first case report of a carcinoma of the gastric cardia (AEGII) after OAGB-MGB. Obes Surg. 2020;30:753–4.CrossRef
21.
Zurück zum Zitat Saarinen T, Pietiläinen KH, Loimaala A, et al. Bile reflux is a common finding in the gastric pouch after one anastomosis gastric bypass. Obes Surg. 2020;30:875–81.CrossRef Saarinen T, Pietiläinen KH, Loimaala A, et al. Bile reflux is a common finding in the gastric pouch after one anastomosis gastric bypass. Obes Surg. 2020;30:875–81.CrossRef
22.
Zurück zum Zitat Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27:1153–67.CrossRef Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27:1153–67.CrossRef
23.
Zurück zum Zitat Carandina S, Soprani A, Montana L, et al. Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass in patients with gastroesophageal reflux disease: results of a multicenter study. Surg Obes Relat Dis. 2020;16:732–7.CrossRef Carandina S, Soprani A, Montana L, et al. Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass in patients with gastroesophageal reflux disease: results of a multicenter study. Surg Obes Relat Dis. 2020;16:732–7.CrossRef
24.
Zurück zum Zitat Pyke O, Yang J, Cohn T, et al. Marginal ulcer continues to be a major source of morbidity over time following gastric bypass. Surg Endosc. 2019;33:3451–6.CrossRef Pyke O, Yang J, Cohn T, et al. Marginal ulcer continues to be a major source of morbidity over time following gastric bypass. Surg Endosc. 2019;33:3451–6.CrossRef
25.
Zurück zum Zitat Dittrich L, Schwenninger MV, Dittrich K, et al. Marginal ulcers after laparoscopic Roux-en-Y gastric bypass: analysis of the amount of daily and lifetime smoking on postoperative risk. Surg Obes Relat Dis. 2020;16:389–96.CrossRef Dittrich L, Schwenninger MV, Dittrich K, et al. Marginal ulcers after laparoscopic Roux-en-Y gastric bypass: analysis of the amount of daily and lifetime smoking on postoperative risk. Surg Obes Relat Dis. 2020;16:389–96.CrossRef
26.
Zurück zum Zitat Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses - first study from the Indian subcontinent. Obes Surg. 2014;24:1430–5.CrossRef Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses - first study from the Indian subcontinent. Obes Surg. 2014;24:1430–5.CrossRef
27.
Zurück zum Zitat Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: A prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.CrossRef Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: A prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.CrossRef
28.
Zurück zum Zitat Mehaffey JH, LaPar DJ, Clement KC, et al. 10-year outcomes after Roux-en-Y gastric bypass. Ann Surg. 2016;264:121–6.CrossRef Mehaffey JH, LaPar DJ, Clement KC, et al. 10-year outcomes after Roux-en-Y gastric bypass. Ann Surg. 2016;264:121–6.CrossRef
29.
Zurück zum Zitat Maciejewski M, Arterburn DE, Van Scoyoc L, et al. Bariatric surgery and long-term durability of weight loss. JAMA Surg. 2016;151:1046–55.CrossRef Maciejewski M, Arterburn DE, Van Scoyoc L, et al. Bariatric surgery and long-term durability of weight loss. JAMA Surg. 2016;151:1046–55.CrossRef
30.
Zurück zum Zitat Bolckmans R, Himpens J. Long-term (>10 yrs) outcome of the laparoscopic biliopancreatic diversion with duodenal switch. Ann Surg. 2016;264:1029–37.CrossRef Bolckmans R, Himpens J. Long-term (>10 yrs) outcome of the laparoscopic biliopancreatic diversion with duodenal switch. Ann Surg. 2016;264:1029–37.CrossRef
31.
Zurück zum Zitat Kim MJ, Hur KY. Short-term outcomes of laparoscopic single anastomosis gastric bypass (LSAGB) for the treatment of type 2 diabetes in lower BMI (<30kg/m2) patients. Obes Surg. 2014;24:1044–51.CrossRef Kim MJ, Hur KY. Short-term outcomes of laparoscopic single anastomosis gastric bypass (LSAGB) for the treatment of type 2 diabetes in lower BMI (<30kg/m2) patients. Obes Surg. 2014;24:1044–51.CrossRef
32.
Zurück zum Zitat Guedes TP, Martins S, Costa M, et al. Detailed characterization of incretin cell distribution along the human small intestine. Surg Obes Relat Dis. 2015;11:1323–31.CrossRef Guedes TP, Martins S, Costa M, et al. Detailed characterization of incretin cell distribution along the human small intestine. Surg Obes Relat Dis. 2015;11:1323–31.CrossRef
Metadaten
Titel
Long-Term Results of One Anastomosis Gastric Bypass: a Single Center Experience with a Minimum Follow-Up of 10 Years
verfasst von
Sergio Carandina
Antoine Soprani
Viola Zulian
Jean Cady
Publikationsdatum
07.06.2021
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2021
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05455-1

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