Comparative outcomes of one-anastomosis gastric bypass and sleeve gastrectomy: a retrospective analysis of weight loss and micronutrient deficiencies in super-obese patients in 12 months

Abstract

Purpose: This study aimed to compare the efficacy of one-anastomosis gastric bypass (OAGB) and laparoscopic sleeve gastrectomy (LSG) in achieving weight loss and evaluating postoperative micronutrient disturbances in patients with super-obesity.

Methods: A single-center retrospective cohort study was conducted using medical records of patients with a body mass index (BMI) of ≥50 kg/m² who underwent either OAGB or LSG.

Results: A total of 92 patients were included in the analysis (53 in the LSG group and 39 in the OAGB). The OAGB group was significantly older than the LSG group (median: 41 vs 33 years, respectively; P =.001). Baseline weight, height, BMI, electrolyte levels, and most biochemical markers were comparable between groups. The LSG group had a significantly shorter operative time than the OAGB group (median: 30 vs 53 min, respectively; P <.0001). Comorbidities were more prevalent in the OAGB group than in the LSG group, with higher rates of diabetes mellitus and hypertension (35.9% vs 3.8%, respectively; P <.0001) and ischemic heart disease (12.8% vs 0.0%, respectively; P =.012). Postoperative hospital stay and overall complication rates were similar (3.8% in the LSG group vs 7.8% in the OAGB group; P =.349). At 12 months, the OAGB group achieved significantly greater %excess body weight loss than the LSG group (86.6% vs 78.2%, respectively; P <.0001). Although early postoperative weight loss was comparable, the OAGB group had a lower median weight at 12 months than the LSG group (78.5 vs 89.0 kg, respectively; P =.003). Postoperative albumin, hemoglobin, ferritin, and zinc levels were significantly lower in the OAGB group than in the LSG group (P ≤.03).

Conclusion: OAGB achieved more significant long-term weight loss than LSG in patients with super-obesity. However, OAGB was associated with a higher risk of micronutrient deficiencies, particularly in iron, vitamin B12, and zinc, than LSG. LSG may be preferable for patients at higher risk of nutritional deficiencies.

Keywords: Bariatric surgery; Laparoscopic sleeve gastrectomy; Nutritional deficiencies; One-anastomosis gastric bypass; Super-obese.