Commentary: Cancer after the OAGB-MGB

Rutledge, Robert; Deitel, Mervyn; Carbajo, Miguel Ángel Martín; Luque-de-León, Enrique; Chiappetta, Sonja; Inam, Aatif; Rheinwalt, Karl Peter; Prasad, Arun; Hargroder, David E.; Samoylov, V. S.; Özmen, Mehmet Mahir; Parmar, Chetan; Albuquerque, Antonio Cavalcanti de; Jammu, Gurvinder S.; Ustun, Murat; Sakran, Nasser; Aktimur, Recep; Khan, Amir; Hamza, Yasser; Rotundo, Adriana; Focquet, Marc; Bossche, Michael van den; Tantia, Om; Greco, Francesco; Sneineh, Midhat Abu; Rodriguez, Francisco Barrera; Musella, Mario; Ilić, Miroslav; Abbas, Imran

doi:10.1007/s11695-019-04313-5

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Whilst the rates of malnutrition reported in large multinational cohorts are low [ 67 ], a recent IFSO survey on OAGB recognised the potential serious risks of malnutrition, liver failure and bile reflux that may require surgical correction after OAGB [ 68 ]. Specifically relating to biliary reflux, there are case reports of biliary reflux associated cancers in the context of OAGB [ 69 ]. Whilst the overall risk of this complication is unclear, this should merit further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Both RYGB and OAGB are associated with a long-term risk of the development of internal hernias and chronic abdominal pain. SG is associated with a long-term risk of GERD [ 78 ], and there are reports of long-term gastro-oesophageal and bile reflux following OAGB [ 64 , 69 ]. By comparison with other NMAs, this current study assessed fewer procedural types, and therefore the confidence interval estimates are wider as fewer patients overall are included.…”

Section: Discussionmentioning

confidence: 99%

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Network Meta-Analysis of Metabolic Surgery Procedures for the Treatment of Obesity and Diabetes

et al. 2021

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Background Metabolic surgery is part of a well-established treatment intensification strategy for obesity and its related comorbidities including type 2 diabetes (T2DM). Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) are the most commonly performed metabolic surgeries worldwide, but comparative efficacy is uncertain. This study employed network meta-analysis to compare weight loss, T2DM remission and perioperative complications in adults between RYGB, SG and OAGB. Methods MEDLINE, EMBASE, trial registries were searched for randomised trials comparing RYGB, SG and OAGB. Study outcomes were excess weight loss (at 1, 2 and 3–5 years), trial-defined T2DM remission at any time point and perioperative complications. Results Twenty randomised controlled trials were included involving 1803 patients investigating the three metabolic surgical interventions. RYGB was the index for comparison. The excess weight loss (EWL) demonstrated minor differences at 1 and 2 years, but no differences between interventions at 3–5 years. T2DM remission was more likely to occur with either RYGB or OAGB when compared to SG. Perioperative complications were higher with RYGB when compared to either SG or OAGB. Two-way analysis of EWL and T2DM remission against the risk of perioperative complications demonstrated OAGB was the most positive on this assessment at all time points. Conclusion OAGB offers comparable metabolic control through weight loss and T2DM remission to RYGB and SG whilst minimising perioperative complications. Registration number: CRD42020199779 (https:// www.crd.york.ac.uk/PROSPERO ) Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Network Meta-Analysis of Metabolic Surgery Procedures for the Treatment of Obesity and Diabetes

et al. 2021

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“…Technical aspects in the creation of the gastric pouch have a prominent role in the possible development of duodeno-gastro-oesophageal reflux. Rutledge et al emphasize the need for creating a long pouch and avoiding a twisted or stenotic gastric tube, which are often sufficient to prevent persistent reflux [35].…”

Section: Discussionmentioning

confidence: 99%

GORD and Barrett’s oesophagus after bariatric procedures: multicentre prospective study

Genco

Castagneto-Gissey

Gualtieri

et al. 2021

British Journal of Surgery

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Introduction Gastro-oesophageal reflux disease (GORD) after bariatric surgery is a debated topic. This study investigated the prevalence of GORD and associated oesophageal complications following bariatric procedures—namely, adjustable gastric banding (AGB), sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB). Methods This was a prospective multicentre study designed to evaluate the long-term effects of bariatric surgery on GORD. Patients were studied at baseline, at >10 years following AGB, SG, and RYGB, and at >3 years following OAGB (due to the more recent recognition of OAGB as a standard bariatric procedure). Patients were assessed by endoscopy and GORD symptom evaluation. Results A total of 241 patients were enrolled. A minimum follow-up of 10 years was completed by 193 patients following AGB (57 patients), SG (95 patients), and RYGB (41 patients), and of >3 years by 48 subjects following OAGB. GORD symptoms increased following AGB and SG (from 14 to 31.6 per cent and from 26.3 to 58.9 per cent, respectively; P < 0.0001), improved following RYGB (from 36.6 to 14.6 per cent; P < 0.0001), and were unchanged following OAGB. The overall prevalence of erosive oesophagitis was greater in the SG group (74.7 per cent) than in the AGB (42.1 per cent), RYGB (22 per cent), and OAGB (22.9 per cent) groups (P < 0.0001). Barrett’s oesophagus was found only in patients who had SG (16.8 per cent). Biliary-like gastric stagnation was found in a greater proportion of SG and OAGB patients (79.7 and 69.4 per cent, respectively) than in other treatment groups (P < 0.0001). The prevalence of biliary-type reflux into the oesophagus was higher in patients who underwent SG (74.7 per cent), compared with other treatment groups. Conclusion Bariatric surgery leads to gastro-oesophageal complications of variable severity, particularly SG, which can result in a large proportion of patients developing Barrett’s oesophagus.

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“… 40 , 41 Considering that OAGB has been systematically performed at least since 1997, no surge in the diagnosis of this type of cancer has been observed over recent years, as it would have been expected in case this operation really carried such risk. 42 , 43 Nevertheless, continuous long-term endoscopic surveillance is warranted.…”

Section: Discussionmentioning

confidence: 99%

Effects of bariatric surgery on renal function: a retrospective cohort study comparing one-year outcomes between one-anastomosis gastric bypass and Roux-en-Y gastric bypass

Ivano,

Hatto,

Teramoto

et al. 2024

Sao Paulo Med. J.

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BACKGROUND: Evidence on the effect of one-anastomosis gastric bypass (OAGB) on renal function is limited. OBJECTIVE: To compare the evolution of estimated renal function observed 1 year after OAGB and Rouxen-Y gastric bypass (RYGB) in individuals with obesity. DESIGN AND SETTING: Observational, analytical, and retrospective cohort study. Tertiary-level university hospital. METHODS: This study used a prospectively collected database of individuals who consecutively underwent bariatric surgery. Renal function was assessed by calculating the estimated glomerular filtration rate (eGFR), according to the Chronic Kidney Disease Epidemiology Collaboration. The one-year variation in the eGFR was compared between the procedures. RESULTS: No significant differences in age, sex, obesity-associated conditions, or body mass index were observed among individuals who underwent either OAGB or RYGB. OAGB led to a significantly higher percentage of total (P = 0.007) and excess weight loss (P = 0.026). Both OAGB and RYGB led to significantly higher values of eGFR (103.9 ± 22 versus 116.1 ± 13.3; P = 0.007, and 102.4 ± 19 versus 113.2 ± 13.3; P < 0.001, respectively). The one-year variation in eGFR was 11 ± 16.2% after OAGB and 16.7 ± 26.3% after RYGB (P = 0.3). Younger age and lower baseline eGFR were independently associated with greater postoperative improvement in renal function (P < 0.001). CONCLUSION: Compared with RYGB, OAGB led to an equivalent improvement in renal function 1 year after the procedure, along with greater weight loss.

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Commentary: Cancer after the OAGB-MGB

Cited by 6 publications

References 10 publications

Network Meta-Analysis of Metabolic Surgery Procedures for the Treatment of Obesity and Diabetes

Network Meta-Analysis of Metabolic Surgery Procedures for the Treatment of Obesity and Diabetes

GORD and Barrett’s oesophagus after bariatric procedures: multicentre prospective study

Effects of bariatric surgery on renal function: a retrospective cohort study comparing one-year outcomes between one-anastomosis gastric bypass and Roux-en-Y gastric bypass

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