Skip to main content

Advertisement

SpringerLink
Log in

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass: a 5-year follow-up prospective randomized trial

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

One anastomosis gastric bypass (OAGB) is a relatively novel technique with excellent outcomes, comparable to most accepted procedures. Our aim was to compare OAGB and Roux-en-Y gastric bypass (RYGB) in terms of percent of excess weight lost (%EWL) and resolution of comorbidities.

Methods

Thirty-three patients were randomly assigned (1:2) to two groups (OAGB = 9 and RYGB = 24). Patients were analyzed prospectively.

Results

The 5-year follow-up was 85% (28 patients). Both groups were comparable preoperatively in age, weight, body mass index (BMI), and excess weight. One intraoperative complication in OAGB group and no major postoperative complications for both groups were recorded. Progressive decrease in weight, BMI, and %EWL was observed at 1, 6, 12 months, and 5 years, with no differences between groups. Regarding comorbidities, we registered complete remission in type 2 diabetes mellitus (T2DM), insulin resistance, and dyslipidemia with OAGB. RYGB group reported complete remission in T2DM, insulin resistance, dyslipidemia, and gastroesophageal reflux disease (GERD). Mean operative time were 113.3 min ± 41.2 and 143.7 min ± 21.85 for OAGB and RYGB respectively. Mean number of reloads used was 5 for OAGB and 7 for RYGB, which demands further investigations. Postoperative pain was significantly higher in RYGB group. Hospital stay was 3 days for both groups.

Conclusion

At 5-year follow-up, patients of both techniques achieved similar outcomes in terms of %EWL and resolution of comorbidities, without early or mid-term major complications and no mortality. OAGB demonstrated less use of surgical stapling and unexplainably less postoperative pain compared to RYGB.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Schulz KF, Altman DG (2011) Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Int J Surg 9(8):672–677. https://doi.org/10.1016/j.ijsu.2011.09.004

    Article  PubMed  Google Scholar 

  2. Garcia-Caballero M, Carbajo M (2004) One anastomosis gastric bypass: a simple, safe and efficient surgical procedure for treating morbid obesity. Nutr Hosp 19(6):372–375

    CAS  PubMed  Google Scholar 

  3. Cardoso RA, Galväo NM, Carlo A (2004) Simplified gastric bypass. 522 initial cases. Rev Mex Cir Endosc 5(1):36

    Google Scholar 

  4. Brethauer SA, Kim J, el Chaar M et al (2015) Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg 25:587–606. https://doi.org/10.1007/s11695-015-1645-3

    Article  PubMed  Google Scholar 

  5. Magouliotis DE, Tasiopoulou VS, Tzovaras G (2018) One anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: a meta-analysis. Clin Obes 8(3):159–169. https://doi.org/10.1111/cob.12246

    Article  CAS  PubMed  Google Scholar 

  6. Parmar CD, Mahawar KK (2018) One anastomosis (Mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 Patients. Obes Surg 28(9):2956–2967. https://doi.org/10.1007/s11695-018-3382-x

    Article  PubMed  Google Scholar 

  7. Carbajo MA, de Ortiz SJ, García-Lanza C, Pérez MM, Fonseca OG, Castro MJ (2008) Bypass gástrico laparoscópico de una sola anastomosis (BAGUA) asistido con brazo robótico: Técnica y resultados en 1,126 pacientes. Rev Mex Cir Endoscop 9(1):6–13

    Google Scholar 

  8. Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Huang MT (2005) Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg 242(1):20–28

    Article  Google Scholar 

  9. Rutledge R, Walsh TR (2005) Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg 15(9):1304–1308. https://doi.org/10.1381/096089205774512663

    Article  PubMed  Google Scholar 

  10. Boza C, Salgado N, Jones A, Funke R, Crovari F, Raddatz A et al (2011) Análisis de las complicaciones después de 2550 bypass gástricos laparoscópicos. IV Congreso IFSO LAC, Cartagena de Indias, Colombia, Marzo 2011. BMI-J 1(2):43–44

    Google Scholar 

  11. Romero-Ibargüengoitia ME, Lerman-Garber I, Herrera-Hernández MF, Pantoja JP, Sierra-Salazar M, López-Rosales F (2009) Bypass gástrico laparoscópico en Y de Roux y obesidad mórbida. Rev Investig Clin 61(3):186–193

    Google Scholar 

  12. Chiappetta S, Weiner R (2018) Was macht den Mini-/One-anastomosis-gastric-Bypass zueinem Standardverfahren? – Evidenz zur Einschlingenrekonstruktion [Evidence of the Mini-/One-anastomosis-gastric-Bypass for being a standard procedure in obesity and metabolic surgery]. Chirurg 89(8):589–596. German. https://doi.org/10.1007/s00104-018-0663-9

    Article  CAS  PubMed  Google Scholar 

  13. Mahawar KK, Himpens J, Shikora SA, Chevallier JM, Lakdawala M, de Luca M, Weiner R, Khammas A, Kular KS, Musella M, Prager G, Mirza MK, Carbajo M, Kow L, Lee WJ, Small PK (2018) The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified Delphi approach. Obes Surg 28(2):303–312

    Article  Google Scholar 

  14. Ramos AC, Chevallier J-M, Mahawar K, Brown W, Kow L, White KP, Shikora S, IFSO Consensus Conference Contributors (2020) IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a modified Delphi study. Obes Surg 30(5):1625–1634. https://doi.org/10.1007/s11695-020-04519-y

    Article  PubMed  Google Scholar 

  15. Poghosyan T, Caille C, Moszkowicz D, Hanachi M, Carette C, Bouillot JL (2017) Roux-en-Y gastric bypass for the treatment of severe complications after omega-loop gastric bypass. Surg Obes Relat Dis 13(6):988–994. https://doi.org/10.1016/j.soard.2016.12.003

    Article  PubMed  Google Scholar 

  16. Robert M, Espalieu P, Pelascini E, Caiazzo R, Sterkers A, Khamphommala L, Poghosyan T, Chevallier JM, Malherbe V, Chouillard E, Reche F, Torcivia A, Maucort-Boulch D, Bin-Dorel S, Langlois-Jacques C, Delaunay D, Pattou F, Disse E (2019) 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. 393(10178):1299–1309. https://doi.org/10.1016/S0140-6736(19)30475-1

    Article  PubMed  Google Scholar 

  17. Jia D, Tan H, Faramand A, Fang F (2020) One anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity: a systematic review and meta-analysis of randomized clinical trials. Obes Surg 30(4):1211–1218. https://doi.org/10.1007/s11695-019-04288-3

    Article  PubMed  Google Scholar 

  18. Navarrete S, Leyba JL, Ll SN, Borjas G, Tapia JL, Alcázar R (2018) Results of the comparative study of 200 cases: one anastomosis gastric bypass vs Roux-en-Y gastric bypass. Obes Surg 28(9):2597–2602. https://doi.org/10.1007/s11695-018-3224-x

    Article  PubMed  Google Scholar 

  19. Lee WJ, Wang W, Lee YC, Huang MT, Ser KH, Chen JC (2008) Effect of laparoscopic mini- gastric bypass for type 2 diabetes mellitus: comparison of BMI >35 and < 35 kg/m2. J Gastrointest Surg 12(5):945–952

    Article  Google Scholar 

  20. Costa AC, Furtado MC, Godoy EP, Pontes ER, Tognini JR, Ivo ML (2013) [Insufficient loss of weight and/or absence of DM2 remission after Roux-en-Y gastric bypass: factors that may influence the unsatisfactory results]. [Article in Portuguese]. Arq Bras Cir Dig 26(2):112–116

    Article  Google Scholar 

  21. Jiang HP, Lin LL, Jiang X, Qiao HQ (2016) Meta-analysis of hand-sewn versus mechanical gastrojejunal anastomosis during laparoscopic Roux-en-Y gastric bypass for morbid obesity. Int J Surg 32:150–157. https://doi.org/10.1016/j.ijsu.2016.04.024

    Article  PubMed  Google Scholar 

  22. Rutledge R (2007) Hospitalization before and after mini-gastric bypass surgery. Int J Surg 5(1):35–40

    Article  Google Scholar 

  23. Huang ZP, Guo Y, Liu CQ, Qi L, Zou DJ, Zhou WP (2018) The effect of metabolic surgery on nonobese patients (BMI < 30 kg/m2) with type 2 diabetes: a systematic review. Surg Obes Relat Dis 14(6):810–820. https://doi.org/10.1016/j.soard.2018.02.013

    Article  PubMed  Google Scholar 

  24. Magouliotis DE, Tasiopoulou VS, Tzovaras G (2019) One anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: an updated meta-analysis. Obes Surg 29(9):2721–2730. https://doi.org/10.1007/s11695-019-04005-0

    Article  PubMed  Google Scholar 

  25. Kassir R, Petrucciani N, Debs T, Juglard G, Martini F, Liagre A (2020) 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 30(6):2093–2098. https://doi.org/10.1007/s11695-020-04460-0

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Universidad Central de Venezuela, Hospital Dr. Miguel Pérez Carreño, General Surgery Service I, Caracas, Venezuela

    Luis Level

  2. Hospital Dr. Miguel Pérez Carreño, General Surgery Service I, Caracas, Venezuela

    Alejandro Rojas, Silvia Piñango & Yubisay Avariano

Authors
  1. Luis Level
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alejandro Rojas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Silvia Piñango
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yubisay Avariano
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design: Dr. Level, Dr. Piñango, and Dr. Avariano; Acquisition of data: Dr. Rojas; Analysis and interpretation of data: Dr. Level and Dr. Rojas; Drafting of manuscript: Dr. Level; Critical revision of manuscript: Dr. Level, Dr. Piñango, and Dr. Avariano

Corresponding author

Correspondence to Luis Level.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Approval from the local ethics committee and informed consent from all patients were obtained. 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. The Bioethics Committee of Dr. Miguel Perez Carreño Hospital approved the study.

Consent to participate

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

Consent to publish

Not applicable

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Level, L., Rojas, A., Piñango, S. et al. One anastomosis gastric bypass vs. Roux-en-Y gastric bypass: a 5-year follow-up prospective randomized trial. Langenbecks Arch Surg 406, 171–179 (2021). https://doi.org/10.1007/s00423-020-01949-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-020-01949-1

Keywords

Search

Navigation