Laparoscopic Single Anastomosis Sleeve-Jejunal Bypass vs Laparoscopic Mini-Gastric Bypass in Morbid Obese Patients and Resolution of Diabetes Mellitus, A Single Centre Experience

Abstract

Background: The most effective therapy for morbid obese patients now available is bariatric surgery, which can help patients losing weight effectively and sustainably while also improving their quality of life and comorbidities associated with obesity. Worldwide, the one anastomosis gastric bypass (OAGB) technique is one of the most performed bariatric surgeries. Objective: The study's objective was to compare the outcomes of the OAGB, with those of the single anastomosis sleeve jejunal bypass (SASJ) as a new method in terms of weight reduction, operating time, postoperative complications, and impact on comorbidities three years following surgery. Patients and Methods: This prospective randomized study included a total of 200 morbidly obese patients undergoing OAGB or SASJ for the treatment of morbid obesity and comorbidities, attending at Department of the bariatric Surgery, tertiary care hospital, Ain Shams University Hospitals. The included subjects were divided into two equal groups: 100 each; SASJ and OAGB groups. Results: The operative time was prolonged in SASJ group (104.7 minutes) compared to OAGB group (76.4 minutes). OAGB group had significant lower Body mass index (BMI) mean as well as significant lower body weight mean at all time intervals through the 3 years follow up. OAGB group had 92% resolution of comorbidities while 68% of SASJ group had resolution. Post-operative HbA1c showed rapid improvement in both groups. Concerning the post-operative complications, no statistically significant differences. Conclusion: It could be concluded that OAGB and SASJ bypass are efficient bariatric surgeries for weight reduction and comorbidities resolution with favorable outcomes in OAGB group.

Single-Anastomosis Sleeve Jejunal Bypass as a Treatment for Morbid Obesity: A Systematic Review and Meta-Analysis

“…Three studies were non-randomized clinical trials [ 24 , 28 , 29 ], two studies were randomized clinical trials [ 25 , 26 ], three studies were retrospective cohorts [ 18 , 27 , 30 ], and one study was a prospective cohort [ 19 ]. The studies were conducted in Iran [ 24 , 27 , 30 ] and Egypt [ 18 , 19 , 25 , 26 , 28 , 29 ]. Patients were mostly females, with males representing only 14-34.9% of the sample size.…”

“…Moreover, most studies did not report whether the sample size was calculated before commencing the study. The two randomized controlled trials [ 25 , 26 ] showed high ROB regarding the deviations from intended interventions as no information was provided on whether carers were aware of the assigned interventions. Furthermore, ROB was high regarding missing outcome data as we could not ascertain whether data were provided for all randomized patients.…”

“… Sayadishahraki et al [ 24 ]; Sewefy and Saleh [ 19 ]; Helmy et al [ 26 ]; Hosseini et al [ 27 ]; Sewefy et al [ 18 ]; Rezaei et al [ 30 ]. …”

“…Five studies reported BMI at 12 months after SASJ [ 18 , 19 , 26 , 27 , 30 ] (Table 3 ). There was significant heterogeneity, so the random effects model was used to pool the results (Q = 519.313, p < 0.001, I² = 99.23%).…”

“… Sayadishahraki et al [ 24 ]; Helmy et al [ 26 ]; Hosseini et al [ 27 ]; Sewefy et al [ 18 ]; Elrefai et al [ 25 ]; Abdelzaher et al [ 28 ]; Rezaei et al [ 30 ]; Sewefy and Saleh [ 19 ]; Farrag et al [ 29 ]. …”