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. 2022 Jun;36(6):4401-4407.
doi: 10.1007/s00464-021-08790-7. Epub 2021 Oct 26.

Clinical outcomes after one anastomosis gastric bypass versus sleeve gastrectomy in super-super-obese patients

Sophia M-T Schmitz  1 , Patrick H Alizai  2 , Andreas Kroh  2 , Sandra Schipper  2 , Jonathan F Brozat  3 , Andreas Plamper  4 , Ulf P Neumann  2   5 , Karl Rheinwalt #  4 , Tom F Ulmer #  2   5
Affiliations

Clinical outcomes after one anastomosis gastric bypass versus sleeve gastrectomy in super-super-obese patients

Sophia M-T Schmitz et al. Surg Endosc. 2022 Jun.

Abstract

Background: Bariatric surgery in super-super-obese (SSO) patients remains a continuous challenge due to intraabdominal fat masses, higher liver volume and existing comorbidities. A convenient procedure in SSO patients is one anastomosis gastric bypass (OAGB). The aim of this study was to compare the outcome of SSO patients undergoing OAGB in comparison to laparoscopic sleeve gastrectomy (LSG).

Methods: We retrospectively reviewed data from SSO patients who underwent OAGB and LSG in our institution between 2008 and 2020. Primary endpoints included percentage total body weight loss and percentage BMI loss at 12, 24, and 36 months after the operation. Secondary endpoints were perioperative complications, procedure length, length of hospital stay and outcome of comorbidities.

Results: 243 patients were included in this study. 93 patients underwent LSG and 150 underwent OAGB. At any of the time points evaluated, weight loss in patients after OAGB was greater than in LSG patients, while procedure length was significantly shorter for OAGB than LSG (81.4 vs. 92.1 min, p-value < 0.001). Additionally, mean length of hospital stay was shorter in the OAGB group (3.4 vs. 4.5 days, p-value < 0.001). There were more severe complications (Clavien-Dindo ≥ 3a) in the LSG group (11.8% vs 2.7%, p-value = 0.005).

Conclusion: In this retrospective analysis, OAGB was superior to LSG in terms of weight loss in SSO patients. Procedure length and hospital stay were shorter after OAGB in comparison to LSG and there were fewer severe complications. OAGB can therefore be regarded a safe and effective treatment modality for SSO patients.

Keywords: Bariatric surgery; OAGB; One anastomosis gastric bypass; SSO; Super-super-obese.

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Conflict of interest statement

Sophia M.-T. Schmitz, Patrick H. Alizai, Andreas Kroh, Sandra Schipper, Jonathan F. Brozat, Andreas Plamper, Ulf P. Neumann, Karl Rheinwalt and Tom F. Ulmer have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Weight loss outcomes in patients undergoing OAGB and LSG; LSG laparoscopic sleeve gastrectomy, OAGB one anastomosis gastric bypass, TBWL total body weight loss; there was a significant difference in TBWL at all time points
Fig. 2
Fig. 2
Weight loss outcomes in patients undergoing OAGB and LSG; LSG laparoscopic sleeve gastrectomy, OAGB one anastomosis gastric bypass, %BMIL percent BMI Loss
Fig. 3
Fig. 3
Comorbidity outcomes after 12 months of patients undergoing OAGB and LSG; LSG laparoscopic sleeve gastrectomy, OAGB one anastomosis gastric bypass, SEM standard error of the mean, T2DM type 2 diabetes mellitus; χ2-Test revealed a significant difference for remission of Hypertension between OAGB and LSG (p-value 0.048), for other comorbidities differences were not significant
See this image and copyright information in PMC

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