Five-year outcomes of one anastomosis gastric bypass as conversional surgery following sleeve gastrectomy for weight loss failure

Abstract

The most accepted procedures as conversion for poor weight changes after sleeve gastrectomy (SG), are malabsorptive surgeries. This study was designed to evaluate the 5-year outcomes of One Anastomosis Gastric Bypass (OAGB) following SG due to weight loss failure and weight regain. From September 2014 to January 2017, totally 23 patients with a history of SG conversion to OAGB in terms of weight loss failure or weight regain who had completed their 5-year follow-ups were studied. Some obesity related co-morbidities containing type-2 diabetes (DM), hypertension (HTN), dyslipidemia, obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) were also investigated at 1, 2, 3 and 5 years after conversional surgery. All cases had remission/improvement in DM, DLP, HTN and OSA 1 year after conversional OAGB. Analysis showed statistically significant (P < 0.001) change in trend of BMI. Mean BMI before conversional surgery, at 1, 2, 3and 5 years were 46.3 ± 10.4, 34.5 ± 8.5, 34.1 ± 8.6, 35.7 ± 8.7 and 37.5 ± 11.6, respectively. Mean percent excess weight loss (%EWL) at 1, 2, 3 and 5 years was 51.6 ± 11.0, 52.9 ± 13.1, 45.5 ± 16.4 and 41.0 ± 18.0, respectively. Mean percent total weight loss (%TWL) at 1, 2, 3 and 5 years was 26.6 ± 5.9, 27.4 ± 7.2, 23.9 ± 9.2 and 20.9 ± 9.3, respectively. OAGB is an effective conversional procedure for insufficient weight loss and weight regain following failed SG and lead to satisfactory changes in obesity associated medical problems. The optimal weight loss results are obtained at 2-year follow-ups and these effects are then reduced.

ReSleeve or revisional one anastomosis gastric bypass for failed primary sleeve gastrectomy with dilated gastric tube: a retrospective study

“…Recently published systematic reviews and meta-analyses showed that RLOAGB is a valuable choice after failed restriction and that SG conversion to OAGB was technically easier [ 37 , 49 – 54 ]; this would be particularly useful in handling revisional surgery and could be helpful in higher BMI patients. These studies demonstrated better WL and acceptable incidences of the main complications with RLOAGB compared to those of RYGB.…”

“…After RLOAGB, two cases (8%) noticed increased/newly developed GERD symptoms, while five cases noticed improvement/disappearance of symptoms. Kermansaravi et al [ 49 ] study showed three new-onset GERD symptoms (13%). In Debs et al [ 55 ] study, seven pts (9%) developed de-novo GERD.…”

Association between the Preoperative Dietary Antioxidant Index and Postoperative Quality of Life in Patients with Esophageal Squamous Cell Carcinoma: A Prospective Study Based on the TTD Model

“…Patients who underwent esophagectomy often have a variety of long-term persistent symptoms, such as reflux and eating problems. Minimally invasive surgical methods can reduce reflux problems [ 33 ], but symptoms related to reflux are difficult to treat and difficult to improve through surgical changes, which is crucial to find other improvement methods. Zhang et al found a negative correlation between dietary antioxidant vitamin intake and esophageal reflux [ 34 ].…”

Best practice approach for redo-surgeries after sleeve gastrectomy, an expert's modified Delphi consensus

“…Conversion to RYGB in symptomatic GERD and inadequate weight loss and weight regain was, for this group, the only acceptable surgical option with a consensus of 97.7%. Even though OAGB provides further weight loss after failed primary restrictive surgery [26,27], it seems that OAGB comparing to RYGB is less optimal in reflux control [28] and that particularly in the long-term bile reflux might be a critical issue [29]. Finally, in a recent expert consensus on patient selection for OAGB, there was no consensus reached on OAGB as conversional surgery in patients with GERD after restrictive procedures [8].…”