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15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures

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Abstract

Background

Laparoscopic single anastomosis (mini-)gastric bypass (LSAGB) has been validated as a safe and effective treatment for morbid obesity. However, data of the long-term outcome remain lacking.

Methods

Between October 2001 and December 2015, 1731 morbidly obese patients who received LSAGB as primary bariatric procedure at the Min-Sheng General Hospital were recruited. Surgical outcome, weight loss, resolution of comorbidities, and late complications were followed, then compared with groups of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). All data derived from a prospective bariatric database and a retrospective analysis were conducted.

Results

The average patient age was 33.8 ± 10.4 years with a mean body mass index (BMI) of 40.4 ± 7.7 kg/m2. Of them, 70.0% were female while 30.0% were male. Mean operating time, intraoperative blood, and hospital stay of LSAGB were 124.6 ± 38.8 min, 39.5 ± 38.7 ml, and 5.0 ± 4.1 days, respectively. The 30-day post-operative major complication occurred in 30 (1.7%) of LSAGB patients, 16 (2.0%) of LRYGB, and 15 (1.4%) of LSG patients. The follow-up rates at 1, 5, and 10 years were 89.3, 52.1, and 43.6%, respectively. At postoperative 1, 5, and 10 years, the mean percentage of weight loss (%WL) of LSAGB patients were 32.7, 32.2, and 29.1%, and mean BMI became 27, 26.9, and 27 kg/m2, respectively. The LSAGB had a higher weight loss than LRYGB and LSG at 2–6 years after surgery. LSG had a lower remission rate in dyslipidemia comparing to LSAGB and LRYGB. The overall revision rate of LSAGB is 4.0% (70/1731) which was lower than the 5.1% in LRYGB and 5.2% in the LSG.

Conclusion

LSAGB is an effective procedure for treating morbid obesity and metabolic disorders, which results in sustained weight loss and a high resolution of comorbidities.

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Authors and Affiliations

  1. Department of Surgery, Min-Sheng General Hospital, No. 168, Chin Kuo Road, Tauoyan, Taiwan, ROC

    Nawaf Alkhalifah, Wei-Jei Lee, Tan Chun Hai, Kong-Han Ser, Jung-Chien Chen & Chun-Chi Wu

  2. Department of Surgery, Al-Adan General Hospital, Kuwait City, Kuwait

    Nawaf Alkhalifah

  3. Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore

    Tan Chun Hai

Authors
  1. Nawaf Alkhalifah
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  2. Wei-Jei Lee
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Correspondence to Wei-Jei Lee.

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Disclosures

Dr. Narwaf Alkhalifah, Dr. Wei-Jei Lee, Dr. Tan Chun Hai, Dr. Kong-Han Ser, Dr. Jung-Chieh Chen, Dr. Chun-Chi Wu have no conflicts of interest or financial ties to disclose.

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Alkhalifah, N., Lee, WJ., Hai, T.C. et al. 15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures. Surg Endosc 32, 3024–3031 (2018). https://doi.org/10.1007/s00464-017-6011-1

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  • DOI: https://doi.org/10.1007/s00464-017-6011-1

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