Conventional Versus Distal Laparoscopic One-Anastomosis Gastric Bypass: a Randomized Controlled Trial with 1-Year Follow-up

Nabil, Tamer Mohamed; Khalil, Ahmed; Mikhail, Sameh; Soliman, Salah S; Aziz, M.M. Abdel; Antoine, Halepian

doi:10.1007/s11695-019-03991-5

Cited by 25 publications

(6 citation statements)

References 16 publications

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“…OAGB is still a controversial method with limited literature on long-term effectiveness [75][76][77][78]. The main modifications of this technique include a different length of the biliopancreatic limb [60]. The analysis of pooled data in the review showed that variation with the longer biliopancreatic limb in OAGB is associated with worse HRQoL in comparison to standard OAGB.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life After Bariatric Surgery—a Systematic Review with Bayesian Network Meta-analysis

et al. 2021

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Objective Comprehensive analysis and comparison of HRQoL following different bariatric interventions through systematic review with network meta-analysis. Background Different types of bariatric surgeries have been developed throughout the years. Apart from weight loss and comorbidities remission, improvement of health-related quality of life (HRQoL) is an important outcome of metabolic surgery. Methods MEDLINE, EMBASE, and Scopus databases have been searched up to April 2020. Inclusion criteria to the analysis were (1) study with at least 2 arms comparing bariatric surgeries; (2) reporting of HRQoL with a validated tool; (3) follow-up period of 1, 2, 3, or 5 years. Network meta-analysis was conducted using Bayesian statistics. The primary outcome was HRQoL. Results Forty-seven studies were included in the analysis involving 26,629 patients and 11 different surgeries such as sleeve gastrectomy (LSG), gastric bypass (LRYGB), one anastomosis gastric bypass (OAGB), and other. At 1 year, there was significant difference in HRQoL in favor of LSG, LRYGB, and OAG compared with lifestyle intervention (SMD: 0.44; 95% CrI 0.2 to 0.68 for LSG, SMD: 0.56; 95% CrI 0.31 to 0.8 for LRYGB; and SMD: 0.43; 95% CrI 0.06 to 0.8 for OAGB). At 5 years, LSG, LRYGB, and OAGB showed better HRQoL compared to control (SMD: 0.92; 95% CrI 0.58 to 1.26, SMD: 1.27; 95% CrI 0.94 to 1.61, and SMD: 1.01; 95% CrI 0.63 to 1.4, respectively). Conclusions LSG and LRYGB may lead to better HRQoL across most follow-up time points. Long-term analysis shows that bariatric intervention results in better HRQoL than non-surgical interventions. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Quality of Life After Bariatric Surgery—a Systematic Review with Bayesian Network Meta-analysis

et al. 2021

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“…A recently published RCT by Nabil T. et al, for example, compared two groups of OAGB: group 1: BPL: 200 cm; group 2: CL: 400 cm (with a mean BPL of 301 cm). No significant differences in terms of weight loss were found, however, group 2 showed greater albumin, iron and hemoglobin deficiency rates [33]. Komaei I. et al also compared fixed 200 cm BPL in the first group to a BPL of 40% of the small bowel in the second group and found less deficiencies of vitamins A, D, B12, iron and albumin one year after OAGB in the tailored BPL group, despite the fact that some patients in the tailored BPL group had a CL length of only 250 cm [34].…”

Section: Single-anastomosis Duodeno-ileal Bypass With Sleeve Gastrectmentioning

confidence: 72%

Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

Felsenreich

Langer

Eichelter

et al. 2021

JCM

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The number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several different bypass procedures exist alongside each other today and each type of bypass is performed using a distinct technique. Furthermore, the length of the bypassed intestine may differ as well. One might add that the operations are performed differently in different parts of the world and have been changing and evolving over time. This review evaluates the most frequently performed bariatric bypass procedures (and their variations) worldwide: Roux-en-Y Gastric Bypass, One-Anastomosis Gastric Bypass, Single-Anastomosis Duodeno-Ileal Bypass + Sleeve Gastrectomy, Biliopancreatic Diversion + Duodenal Switch and operations due to weight regain. The evaluation of the procedures and different limb lengths focusses on weight loss, remission of comorbidities and the risk of malnutrition and deficiencies. This narrative review does not aim at synthesizing quantitative data. Rather, it provides a summary of carefully selected, high-quality studies to serve as examples and to draw tentative conclusions on the effects of the bypass procedures mentioned above. In conclusion, it is important to carefully choose the procedure and small bowel length excluded from the food passage suited best to each individual patient. A balance has to be achieved between sufficient weight loss and remission of comorbidities, as well as a low risk of deficiencies and malnutrition. In any case, at least 300 cm of small bowel should always remain in the food stream to prevent the development of deficiencies and malnutrition.

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“…Furthermore, in anastomotic leaks, the spillage of intestinal fluid and bile is frequently responsible for generalized peritonitis, due to the location of the anastomosis. The length of the common limb is another debated technical topic and is of maximal importance for its relationship with both the efficacy of weight loss and the rate of nutritional complications [34][35][36][37][44][45][46]. In the present series, three patients have been treated for severe malnutrition (two with medical treatment, one with surgical revision).…”

Section: Discussionmentioning

confidence: 96%

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

et al. 2021

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Background The need for revisional procedures after sleeve gastrectomy (SG) for insufficient weight loss or weight regain, gastroesophageal reflux, or other complications is reported to be 18–36% in studies with 10-year follow-up. Single-anastomosis duodeno-ileal bypass (SADI) may be performed as a revisional procedure after SG. This study aims to evaluate the short- and mid-term outcomes of SADI after SG in a referral center for bariatric surgery. Materials and Methods Data of patients who underwent SADI between March 2015 and March 2020 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 106 patients underwent SADI after a previous SG. The timeframe between SG and SADI was 50 ± 31.3 months. Postoperative mortality was observed in two cases (1.8%) and morbidity in 15.1% of patients. At 24 months, %total weight loss was 37.6 ± 12.3 and %excess weight loss 76.9 ± 25.2 (64 patients). Three patients were treated for malnutrition during follow-up, two with medical treatment and one with SADI reversal. Conclusion SADI after SG provides effective weight loss results in the short-term, even if in the present series the postoperative complication rate was non-negligible. Further trials are needed to establish the more advantageous revisional bariatric procedure after failed SG.

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Conventional Versus Distal Laparoscopic One-Anastomosis Gastric Bypass: a Randomized Controlled Trial with 1-Year Follow-up

Cited by 25 publications

References 16 publications

Quality of Life After Bariatric Surgery—a Systematic Review with Bayesian Network Meta-analysis

Quality of Life After Bariatric Surgery—a Systematic Review with Bayesian Network Meta-analysis

Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

Efficacy and Drawbacks of Single-Anastomosis Duodeno-Ileal Bypass After Sleeve Gastrectomy in a Tertiary Referral Bariatric Center

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