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Comparison of Efficacy and Safety Between Roux-en-Y Gastric Bypass (RYGB) vs One Anastomosis Gastric Bypass (OAGB) vs Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S): a Systematic Review of Bariatric and Metabolic Surgery

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Abstract

In recent years, combined restrictive and hypo-absorptive procedures have gained widespread acceptance. The rationale of this systematic review is to compare the safety and efficacy between Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). Eighteen eligible studies were finalized for this review. Weight loss outcomes were greater with SADI-S (5 years) and OAGB (10 years). SADI-S offered better resolution of diabetes whereas hypertension and dyslipidaemia resolution were better with OAGB. Although early complications and mortality were higher with SADI-S, late complications were more frequent with RYGB. Both SADI-S and OAGB are as effective as RYGB for weight loss, but OAGB offers lesser complications. However, more data is imperative to determine the next gold standard procedure.

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Data Availability

The data is maintained in a local database, and details are available at request from the corresponding author.

References

  1. Health topics. https://www.who.int/health-topics/.

  2. Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4:353–7.

    Article  CAS  PubMed  Google Scholar 

  3. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.

    Article  PubMed  Google Scholar 

  4. Sánchez-Pernaute A, et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17:1614–8.

    Article  PubMed  Google Scholar 

  5. Robert M, et al. Prospective multicentre randomised trial comparing the efficacy and safety of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) versus Roux-en-Y gastric bypass (RYGB): SADISLEEVE study protocol. BMJ Open. 10:(2020).

  6. Robert M, 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;393:1299–309.

    Article  PubMed  Google Scholar 

  7. Verhoeff K, et al. Patient selection and 30-day outcomes of SADI-S compared to RYGB: a retrospective cohort study of 47,375 patients. Obes Surg. 2022;32:1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Page MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 372:(2021).

  9. Brethauer SA, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11:489–506.

    Article  PubMed  Google Scholar 

  10. Markopoulos G, Skroubis G, Kalfarentzos F, Kehagias I. Comparison of one anastomosis gastric bypass versus standard Roux-en-Y gastric bypass versus a variant of biliopancreatic diversion, in a case-matched, non-superobese population: 6 years of follow-up. Gastroenterol Review/Przegląd Gastroenterologiczny. 2021;17:152–61.

    Google Scholar 

  11. Ibrahim MY, et al. One anastomosis gastric bypass versus long biliopancreatic limb Roux-en-Y gastric bypass. Obes Surg. 2022;32:779–85.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Zarshenas N, Tapsell LC, Batterham M, Neale EP, Talbot ML. Changes in anthropometric measures, nutritional indices and gastrointestinal symptoms following one anastomosis gastric bypass (OAGB) compared with Roux-en-Y gastric bypass (RYGB). Obes Surg. 2021;31:2619–31.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Singhal R, et al. 30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data. Int J Obes. 2021;4(46):750–7.

    Google Scholar 

  14. Docimo S, Yang J, Zhang X, Pryor A, Spaniolas K. One anastomosis gastric bypass versus Roux-en-Y gastric bypass: a 30-day follow-up review. Surg Endoscopy. 2021;1(36):498–503.

    Google Scholar 

  15. Goel R, et al. Complications after bariatric surgery: a multicentric study of 11,568 patients from Indian bariatric surgery outcomes reporting group. J Minim Access Surg. 2021;17:213–20.

    Article  PubMed  Google Scholar 

  16. Surve A, Cottam D, Richards C, Medlin W, Belnap L. A matched cohort comparison of long-term outcomes of Roux-en-Y gastric bypass (RYGB) versus single-anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S). Obes Surg. 2020;4(31):1438–48.

    Google Scholar 

  17. Mustafa A, Rizkallah NNH, Samuel N, Balupuri S. Laparoscopic Roux-en-Y gastric bypass versus one anastomosis (loop) gastric bypass for obesity: a prospective comparative study of weight loss and complications. Annals Med Surg. 2020;55:143–7.

    Article  Google Scholar 

  18. Comparative study between single anastmosis duodeno-ileal bypass and one anastomosis-gastric bypass as regard remission of type-2 DM after application of DIAREM scoring system. https://www.discoveryjournals.org/medicalscience/current_issue/v24/n106/A35.htm.

  19. Level L, Rojas A, Piñango S Avariano, Y. One anastomosis gastric bypass vs Roux-en-Y gastric bypass: a 5-year follow-up prospective randomized trial. Langenbeck’s Archives Surg. 2020;1(406):171–9.

    Google Scholar 

  20. Bhandari M, Nautiyal HK, Kosta S, Mathur W, Fobi M. Comparison of one-anastomosis gastric bypass and Roux-en-Y gastric bypass for treatment of obesity: a 5-year study. Surg Obes Relat Dis. 2019;15:2038–44.

    Article  PubMed  Google Scholar 

  21. Enochs P, et al. Comparative analysis of the single-anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) to established bariatric procedures: an assessment of 2-year postoperative data illustrating weight loss, type 2 diabetes, and nutritional status in a single US center. Surg Obes Relat Dis. 2020;16:24–33.

    Article  PubMed  Google Scholar 

  22. Rheinwalt KP, et al. One anastomosis gastric bypass–mini-gastric bypass (OAGB-MGB) versus Roux-en-Y gastric bypass (RYGB)—a mid-term cohort study with 612 patients. Obes Surg. 2020;30:1230–40.

    Article  PubMed  Google Scholar 

  23. Navarrete S. Results of the comparative study of 200 cases: one anastomosis gastric bypass vs Roux-en-Y gastric bypass. Obes Surg. 2018;9(28):2597–602.

    Article  Google Scholar 

  24. Alkhalifah N, et al. 15-year experience of laparoscopic single anastomosis (mini-)gastric bypass: comparison with other bariatric procedures. Surgical Endoscopy. 2018;7(32):3024–31.

    Article  Google Scholar 

  25. Torres A, Rubio MA, Ramos-Leví AM, Sánchez-Pernaute A. Cardiovascular risk factors after single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S): a new effective therapeutic approach? Curr Atherosclerosis Rep. 2017;12(19):1–8.

    Google Scholar 

  26. Jia D, Tan H, Faramand A, Fang F. One anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity: a systematic review and meta-analysis of randomized clinical trials. Obes Surg. 2020;30:1211–8.

    Article  PubMed  Google Scholar 

  27. Spinos D, Skarentzos K, Esagian SM, Seymour KA, Economopoulos KP. The effectiveness of single-anastomosis duodenoileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS): an updated systematic review. Obes Surg. 2021;31:1790–800.

    Article  PubMed  Google Scholar 

  28. O’Brien PE, 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-year outcomes after adjustable gastric banding. Obes Surg. 2019;29:3–14.

    Article  PubMed  Google Scholar 

  29. Wang FG, Yan WM, Yan M, Song MM. Outcomes of mini vs Roux-en-Y gastric bypass: a meta-analysis and systematic review. Int J Surg. 2018;56:7–14.

    Article  PubMed  Google Scholar 

  30. Parmar CD, 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.

    Article  PubMed  Google Scholar 

  31. Uhe I, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials. Obesity (Silver Spring). 2022;30:614–27.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

It is with great gratitude that I acknowledge my mentors Prof. Ajay H Bhandarwar, Prof. Girish Bakhshi and Dr. Amol Wagh for their constant support and Dr. Khadeija Hussain, who is always being there to help me out.

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Authors and Affiliations

  1. Department of General Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India, 400008

    G. Balamurugan

  2. Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, WF1 4DG, UK

    Sagaya Joel Leo

  3. Apollo Hospitals, Perungudi, Chennai, India, 600096

    Subbiah Tirunelveli Sivagnanam

  4. Millenia Hospital, Triplicane, Chennai, India

    S. Balaji Prasad

  5. Stonebench Research, Chennai, India

    Chetna Ravindra

  6. Dr. Mehta’s Hospitals, Chennai, India

    Vinayak Rengan

  7. Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India

    Eham Arora

  8. Max Super Speciality Hospital, Vaishali, India, 201012

    Vivek Bindal

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  1. G. Balamurugan
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  2. Sagaya Joel Leo
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Contributions

1. Balamurugan G—conceptualization, data curation, formal analysis, methodology, writing original draft

2. Sagaya Joel Loe—data curation, formal analysis

3. Subbiah Tirunelveli Sivagnanam—formal analysis, supervision

4. Balaji Prasad S—review and editing

5. Chetna Ravindra—supervision, formal analysis, review and editing

6. Vinayak Rengan–review and editing

7. Eham Arora—supervision, review and editing

8. Vivek Bindal—review and editing

Corresponding author

Correspondence to G. Balamurugan.

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Key Points

• Both SADI-S and OAGB are comparable to RYGB, while OAGB offers fewer complications.

• OAGB surpasses RYGB in weight loss outcomes, comorbidity resolution and fewer complications.

• More data is needed to ascertain the next gold standard procedure.

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Balamurugan, G., Leo, S.J., Sivagnanam, S.T. et al. Comparison of Efficacy and Safety Between Roux-en-Y Gastric Bypass (RYGB) vs One Anastomosis Gastric Bypass (OAGB) vs Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S): a Systematic Review of Bariatric and Metabolic Surgery. OBES SURG 33, 2194–2209 (2023). https://doi.org/10.1007/s11695-023-06602-6

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