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One Anastomosis Transit Bipartition (OATB): Rational and Mid-term Outcomes

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Abstract

Background

The “One-anastomosis transit bipartition” (OATB) is a promising emerging technique in the metabolic syndrome treatment.

Objective

To demonstrate the results achieved with OATB in the first 5 years after surgery.

Method

Cross-sectional, retrospective study, with individuals undergoing primary OATB. Individuals included in the study were: ≥ 18 years, BMI ≥ 35 kg/m2; and excluded smoking habits, drug dependence, inflammatory bowel diseases. The data analyzed demographic, anthropometric, surgical, clinical, and nutritional.

Results

Sixty eight participants, 75% women, average age 45.5 years and BMI 41 kg/m2. Associated diseases: osteoarthritis (52.9%), hypertension (48.5%) and type 2 diabetes mellitus—T2DM (39.7%). All underwent laparoscopy, without conversions. Average operative time is 122.6 ± 31.7 min, and hospital stay is 2.2 ± 0.8 days. The common channel length 27 and 41 patients with 250 cm and 300 cm respectively. We registered no intraoperative complications, 2 (2.9%) early complications, and 14 (20.6%) late complications. In the first 6 months, 94.7% (250 cm) and 88.9% (300 cm) of the patients no longer used medication for T2DM, with no statistical difference between the two groups. The incidence of nutritional disorders at any time during follow-up: hypovitaminosis D (14.7%), folate hypovitaminosis (14.7%), elevated PTH (7.4%), hypoproteinemia (5.9%) and anemia (5.9%). We found no statistically significant difference between 250 and 300 cm common channel groups.

Conclusion

We conclude that OATB is a safe and effective technique, demonstrating good control of T2DM and metabolic syndrome. There is a requirement to treat previous nutritional deficits. We need more long-term evidence and comparison to other surgical techniques.

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Data Availability

We declare that the data are available for future studies.

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Acknowledgements

To Ana Maria Taranu, for developing the art we present about the surgical technique—OATB.

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Authors and Affiliations

  1. Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas, 2724-002, Amadora, Portugal

    Rui Ribeiro, Octávio Viveiros, Viorel Taranu & Carina Rossoni

  2. General Surgery Department, Hospital Lusíadas, Amadora, Portugal

    Rui Ribeiro, Octávio Viveiros & Viorel Taranu

  3. Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas, Lisbon, Portugal

    Rui Ribeiro & Octávio Viveiros

  4. School of Sciences and Health Technologies, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal

    Carina Rossoni

  5. Institute of Environmental Health (ISAMB) - Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal

    Carina Rossoni

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  1. Rui Ribeiro
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  2. Octávio Viveiros
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  3. Viorel Taranu
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  4. Carina Rossoni
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Correspondence to Carina Rossoni.

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Key Findings

• OATB is an effective and safe metabolic bariatric procedure, and 250 or 300 cm of CC seems to offer the same weight loss and metabolic effect 5 years after the operation.

• The percentage of total weight reduction was 31.1%, and the remission of type 2 diabetes mellitus was 91.8% at the end of 5 years.

• The percentage of patients with previous reflux who stopped taking medication was 90.5%.

• The main deficits found over 5 years were folic acid and vitamin D. Both anemia and hypoproteinemia rates were low (5.9%).

The results of this study were presented in oral communication at the XXVI IFSO World Congress of Bariatric and Metabolic Surgery. Naples 2023. 30th August–1st September 2023, at the Mostra d’ Oltremare.

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Ribeiro, R., Viveiros, O., Taranu, V. et al. One Anastomosis Transit Bipartition (OATB): Rational and Mid-term Outcomes. OBES SURG 34, 371–381 (2024). https://doi.org/10.1007/s11695-023-06988-3

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