Is one-anastomosis gastric bypass a good revisional bariatric surgery? A single-center retrospective cohort study

Pol Przegl Chir. 2023 Oct 12;96(1):49-56. doi: 10.5604/01.3001.0053.9293.

Abstract

<b><br>Introduction:</b> The rate of revisional surgeries following sleeve gastrectomy (SG) has increased. One-anastomosis gastric bypass (OAGB) appears to have multiple advantages as a primary bariatric procedure. OAGB as revisional surgery is still being investigated.</br> <b><br>Aim:</b> Evaluation of the efficacy and safety of OAGB performed as a post-SG revisional surgery.</br> <b><br>Materials and methods:</b> A single-center, retrospective cohort study was conducted using a routinely collected database of adults undergoing revisional OAGB after SG. A survey of patients was conducted, obtaining information on changes in body weight and improvement in gastroesophageal reflux disease (GERD) and obesity-related diseases.</br> <b><br>Results:</b> The study group included 74 patients: 59 women (80%) and 15 men, mean age of 41.61 9.21 years. The most common indication for OAGB was weight regain. The follow-up was up to 7 years, the mean time was 3.58 1.21 years. The mean preoperative body mass index (BMI) was 40.38 6.15. All patients experienced significant weight loss, reaching a BMI of 33.61 (27.28- 37.13) at the last observation. After surgery, 35% of patients achieved successful weight loss and 48% of patients achieved remission or improvement of GERD.</br> <b><br>Conclusions:</b> Revisional OAGB seems to be a good alternative after a failed SG in terms of obesity-related disease recurrence, not of weight regain. Long-term follow-up revealed that only a third of patients achieved successful weight loss. When proposing revisional OAGB, the risk of complications - mainly anemia and the possibility of de novo GERD should be considered.</br&gt.

Keywords: gastroesophageal reflux disease; obesity; one-anastomosis gastric bypass; revisional surgery.

MeSH terms

  • Adult
  • Bariatric Surgery*
  • Female
  • Gastrectomy / methods
  • Gastric Bypass* / methods
  • Gastroesophageal Reflux* / surgery
  • Humans
  • Male
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome
  • Weight Gain
  • Weight Loss