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One Anastomosis Gastric Bypass (OAGB) vs Roux en Y Gastric Bypass (RYGB) for Remission of T2DM in Patients with Morbid Obesity: a Randomized Controlled Trial

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Abstract

Introduction

Majority of the studies comparing Roux en Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) are non-randomized. Moreover, few randomized studies have focussed on weight loss as the primary outcome rather than the impact on type 2 diabetes mellitus (T2DM). This randomized trial compared OABG over RYGB with the hypothesis that OAGB is not inferior to RYGB in terms of remission of T2DM.

Methods

This was an open-labelled, randomized trial in which patients having a BMI greater than 30 kg/m2 with T2DM were included. The primary outcome was the remission of T2DM.

Results

In the study, 25 and 24 patients were recruited in OAGB and RYGB groups respectively. The remission rates of T2DM were similar at all timelines. The highest rate was achieved at 1 year (86.36% vs 85.71%) for both the groups and a 4-year remission rate of (72.22% vs 71.43%), for OAGB vs RYGB respectively. The % EWL was also comparable with the highest rate achieved again at 1 year (69.23% vs 66.67%) and a 4-year rate of (58.33% vs 53.33%), for OAGB vs RYGB respectively. Remission of other co-morbidities, major and minor complication rate, re-admission rate, and nutritional issues were similar in both groups.

Conclusion

OAGB is non-inferior to RYGB in terms of remission of type 2 diabetes mellitus, weight loss, and early and late complications with a shorter operating time.

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Data Availability

All data generated or analysed during this study are included in this published article.

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Authors and Affiliations

  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

    Bhanu Singh, Yellamraju Saikaustubh, Vitish Singla, Arun Kumar & Sandeep Aggarwal

  2. Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India

    Vineet Ahuja

  3. Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India

    Yashdeep Gupta

  4. Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India

    Lokesh Kashyap

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  1. Bhanu Singh
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  2. Yellamraju Saikaustubh
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  4. Arun Kumar
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Correspondence to Sandeep Aggarwal.

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Ethics Approval

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.

Consent to Participate

A formal informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key Points

• OAGB is a technically easier procedure with a shorter operative time.

• OAGB is not inferior to RYGB in terms of remission of T2DM.

• OAGB may be a preferred option over RYGB in patients with morbid obesity and T2DM.

Supplementary Information

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Singh, B., Saikaustubh, Y., Singla, V. et al. One Anastomosis Gastric Bypass (OAGB) vs Roux en Y Gastric Bypass (RYGB) for Remission of T2DM in Patients with Morbid Obesity: a Randomized Controlled Trial. OBES SURG 33, 1218–1227 (2023). https://doi.org/10.1007/s11695-023-06515-4

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  • DOI: https://doi.org/10.1007/s11695-023-06515-4

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