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Postoperative Outcomes and Advantages of Hand-Sewn Laparoscopic One-Anastomosis Gastric Bypass: Experience on 805 Patients

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Abstract

Purpose

One-anastomosis gastric bypass (OAGB) is a novel laparoscopic approach. The anastomosis of OAGB can be sewn either with a stapler or manually. The aim of this study is to determine the outcome of hand-sewn OAGB.

Materials and Methods

A total of 805 consecutive patients were retrospectively enrolled in this study. Data collection included change in weight, body mass index (BMI), symptoms, and complications before surgery and continued during annual follow-up visits up to 5 years. Inclusion criteria were patients with a BMI of higher than 40 kg/m2 or higher than 35 kg/m2 with one severe comorbidity. Patients with BMI > 50 kg/m2 were referred to dieticians.

Results

The follow-up rate ranged from 93 to 50% at the 1-year and 5-year visits after surgery, respectively. Mean weight and BMI of patients before surgery were 121.93 kg (± 22.92) and 44.79 kg/m2 (± 6.07), respectively. Mean of annual BMI in 5 years of follow-up were 27.83, 27.26, 28.90, 29.45, and 29.56 kg/m2. Excess weight loss (EWL) in 5 years of follow-up were 85.7%, 89.5%, 78.9%, 77.7%, and 76.0%. Reflux was present in 202 patients (25.1%) before surgery and resolved in 153 cases (75.7%) 1 year after surgery. Procedure-specific early complication was an anastomosis leak in one patient, which led to death. Two cases of malnutrition necessitating reversal and two severe reflux disorders leading to Roux-en-Y bypass surgery were remarkable late complications.

Conclusion

Hand-sewn anastomosis could represent an efficient and safe technique in the management of patients undergoing OAGB surgery with acceptable outcomes and rare adverse complications.

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References

  1. 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(5):1153–67. Available from:. https://doi.org/10.1007/s11695-016-2428-1.

    Article  PubMed  Google Scholar 

  2. Deitel M, Rutledge R. Mini-gastric bypass: prevention and management of complications in performance and follow–up. Int J Surg. 2019;71(September):119–23. Available from:. https://doi.org/10.1016/j.ijsu.2019.09.003.

    Article  PubMed  Google Scholar 

  3. Khrucharoen U, Juo YY, Chen Y, et al. Indications, operative techniques, and outcomes for revisional operation following mini-gastric bypass-one anastomosis gastric bypass: a systematic review. Obes Surg. 2020;30(4):1564–73.

    Article  PubMed  Google Scholar 

  4. 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 multicentre, randomised, open-label, non-inferiority trial. Lancet. 2019;393(10178):1299–309.

    Article  PubMed  Google Scholar 

  5. Musella M, Susa A, Greco F, et al. Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg. 2017;27(11):2956–67. Available from:. https://doi.org/10.1007/s11695-017-2726-2.

    Article  PubMed  Google Scholar 

  6. Rutledge R, Deitel M, Carbajo MA, et al. Commentary: cancer after the OAGB-MGB. Obes Surg. 2020;30(2):755–8.

    Article  PubMed  Google Scholar 

  7. 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(3):875–81.

    Article  PubMed  Google Scholar 

  8. Jiang H-P, Lin L-L, Jiang X, et al. Meta-analysis of hand-sewn versus mechanical gastrojejunal anastomosis during laparoscopic Roux-en-Y gastric bypass for morbid obesity. Int J Surg. 2016;32:150–7.

    Article  PubMed  Google Scholar 

  9. Abellán I, López V, Lujan J, et al. Stapling versus hand suture for Gastroenteric anastomosis in Roux-en-Y gastric bypass: a randomized clinical trial. Obes Surg. 2015;25(10):1796–801.

    Article  PubMed  Google Scholar 

  10. Kassir R, Petrucciani N, Debs T, et al. Conversion of one anastomosis gastric bypass (OAGB) to Roux-en-Y gastric bypass (RYGB) for biliary reflux resistant to medical treatment: lessons learned from a retrospective series of 2780 consecutive patients undergoing OAGB. Obes Surg. 2020;30:2093–8.

    Article  PubMed  Google Scholar 

  11. Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63.

    Article  CAS  PubMed  Google Scholar 

  12. Bolckmans R, Arman G, Himpens J. Efficiency and risks of laparoscopic conversion of omega anastomosis gastric bypass to Roux-en-Y gastric bypass. Surg Endosc. 2019;33(8):2572–82. Available from:. https://doi.org/10.1007/s00464-018-6552-y.

    Article  PubMed  Google Scholar 

  13. Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8.

    Article  PubMed  Google Scholar 

  14. Gero D, Raptis DA, Vleeschouwers W, et al. Defining global benchmarks in bariatric surgery: a retrospective multicenter analysis of minimally invasive Roux-en-Y gastric bypass and sleeve gastrectomy. Ann Surg. 2019;270(5):859–67.

    Article  PubMed  Google Scholar 

  15. Solouki A, Kermansaravi M, Davarpanah Jazi AH, et al. One-anastomosis gastric bypass as an alternative procedure of choice in morbidly obese patients. J Res Med Sci. 2018;23:84. Available from: https://pubmed.ncbi.nlm.nih.gov/30294352. Accessed 11 Apr 2020.

  16. Mahawar KK, Reed AN, Graham YNH. Marginal ulcers after one anastomosis (mini) gastric bypass: a survey of surgeons. Clin Obes. 2017;7(3):151–6. Available from:. https://doi.org/10.1111/cob.12186.

    Article  CAS  PubMed  Google Scholar 

  17. Patel RA, Brolin RE, Gandhi A. Revisional operations for marginal ulcer after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009;5(3):317–22. Available from:. https://doi.org/10.1016/j.soard.2008.10.011.

    Article  PubMed  Google Scholar 

  18. Owen JG, Yazdi F, Reisin E. Bariatric surgery and hypertension. Am J Hypertens. 2017;31(1):11–7. Available from. https://doi.org/10.1093/ajh/hpx112.

    Article  PubMed  Google Scholar 

  19. Kular KS, Manchanda N, Cheema GK. Seven years of mini-gastric bypass in type II diabetes patients with a body mass index <35 kg/m2. Obes Surg. 2016;26(7):1457–62. Available from:. https://doi.org/10.1007/s11695-015-1941-y.

    Article  PubMed  Google Scholar 

  20. Jamal M, Wegner R, Heitshusen D, et al. Resolution of hyperlipidemia follows surgical weight loss in patients undergoing Roux-en-Y gastric bypass surgery: a 6-year analysis of data. Surg Obes Relat Dis. 2011;7(4):473–9. Available from:. https://doi.org/10.1016/j.soard.2010.08.009.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Laparoscopic Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Mehran Sohrabi Maralani, Sina Azadnajafabad, Fezzeh Elyasinia, Mohammadjavad Bagheri, Farhad Kor, Amir Ashrafi & Mohammad Talebpour

  2. Primary Prevention of Cardiovascular Diseases Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Maryam Abolhasani

Authors
  1. Mehran Sohrabi Maralani
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  2. Sina Azadnajafabad
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  3. Fezzeh Elyasinia
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  4. Maryam Abolhasani
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  5. Mohammadjavad Bagheri
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  6. Farhad Kor
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  7. Amir Ashrafi
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  8. Mohammad Talebpour
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Correspondence to Mohammad Talebpour.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sohrabi Maralani, M., Azadnajafabad, S., Elyasinia, F. et al. Postoperative Outcomes and Advantages of Hand-Sewn Laparoscopic One-Anastomosis Gastric Bypass: Experience on 805 Patients. OBES SURG 31, 627–633 (2021). https://doi.org/10.1007/s11695-020-04981-8

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  • DOI: https://doi.org/10.1007/s11695-020-04981-8

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