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One Anastomosis Gastric Bypass after Sleeve Gastrectomy Failure: Does a Single Procedure Fit for all?

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Abstract

Introduction

Considering the multitude of bariatric procedures performed all over the world, the necessity of revisional surgery increased accordingly. Several authors argued that with the great diffusion of sleeve gastrectomy (SG), the number of patients who experienced a weight regain at long follow-up was congruous and physiologic, even if not negligible. Recent studies showed that one anastomosis gastric bypass (OAGB) was an effective and safe option also as redo surgery. The aim of the study was to evaluate effectiveness of OAGB as redo surgery after SG in term of anthropometric features and remission of comorbidities.

Methods

Bariatric patients experiencing weight regain and insufficient weight loss after SG and undergoing OAGB as redo surgery were retrospectively analyzed. During post-OAGB outpatient visit weight, %EWL, BMI, comorbidities, and vitamin deficiencies were evaluated. A further visit was scheduled for the evaluation of postoperative esophagitis/gastritis at upper endoscopy.

Results

Fifty-nine (Reviewer #3–1) patients underwent OAGB as redo-surgery consequently to the worsening of the bariatric outcomes at 29.42 ± 7.29 months from SG (mean weight, BMI and %EWL were 120.89 ± 16.79 kg, 43 ± 4.39 and 19.84 ± 30.29, respectively). Conversely, at a mean follow-up of 34.32 ± 1.71 months (Reviewer #3–3) after OAGB, no weight regain or insufficient weight loss cases were recorded (mean weight 71.25 ± 10.22 kg, mean BMI 24.46 ± 2.06 kg/m2, mean %EWL 69.49 ± 14.4, p < 0.0001) (Reviewer #3–2).

Conclusion

OAGB is a safe and effective bariatric procedure in terms of morbidity, mortality, and %EWL also as revision surgery after SG. Further larger studies are needed to address this issue.

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Authors and Affiliations

  1. Department of Surgery, Hospital “A. Rizzoli”, Lacco Ameno, Naples, Italy

    Francesco Pizza & Dario D’Antonio

  2. Biomedical Research Institute (INCLIVA). Bioinformatics and Biostatistics Unit, Valencia, Spain

    Juan Antonio Carbonell Asíns

  3. Division of General, Mininvasive and Bariatric Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy

    Francesco Saverio Lucido, Salvatore Tolone, Ludovico Docimo & Claudio Gambardella

  4. Department of Infectious Diseases - Hepatologic Address, AORN “dei Colli” Monaldi-Cotugno_CTO, Naples, Italy

    Chiara Dell’Isola

Authors
  1. Francesco Pizza
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  2. Dario D’Antonio
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  3. Juan Antonio Carbonell Asíns
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  4. Francesco Saverio Lucido
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  5. Salvatore Tolone
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  6. Ludovico Docimo
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  7. Chiara Dell’Isola
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  8. Claudio Gambardella
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Contributions

Francesco Pizza: Conceptualization, Methodology, Software, Data curation, Writing-Original draft preparation. Dario D’antonio: Visualization, Investigation. Salvatore Tolone: Supervision, Francesco Saverio Lucido: Software, Validation., Chiara Dell’Isola e Cludio Gambardella: Reviewing, Editing, Carbonell-Asíns Juan Antonio: Statistical analisis.

Corresponding author

Correspondence to Francesco Pizza.

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Conflict of Interest

The authors, Francesco Pizza PhD Md, Dario D’antonio Md, Salvatore Tolone PhD Md, Francesco Saverio Lucido Md, Claudio Gambardella Md, Carbonell-Asíns Juan Antonio, Chiara dell’Isola Md AND Ludovico Docimo MD, declare that they have no competing interests.

Informed Consent Statement

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

Ethical Approval Statement

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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Publisher’s Note

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

Study dataset is available on ClinicalTrials.gov ID NCT04450082

The paper is not based on a previous communication to a society or meeting.

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Pizza, F., D’Antonio, D., Carbonell Asíns, J.A. et al. One Anastomosis Gastric Bypass after Sleeve Gastrectomy Failure: Does a Single Procedure Fit for all?. OBES SURG 31, 1722–1732 (2021). https://doi.org/10.1007/s11695-020-05191-y

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  • DOI: https://doi.org/10.1007/s11695-020-05191-y

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