Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial

Robert, M.; Espalieu, P.; Pelascini, Élise; Caïazzo, Robert; Sterkers, Adrien; Khamphommala, Lita; Poghosyan, Tigran; Chevallier, Jean‐Marc; Malherbe, V.; Chouillard, Élie; Reche, Fabián; Torcivia, Adriana; Maucort‐Boulch, Delphine; Bin-Dorel, Sylvie; Langlois‐Jacques, Carole; Delaunay, Dominique; Pattou, François; Disse, Emmanuel

doi:10.1016/s0140-6736(19)30475-1

Cited by 330 publications

(247 citation statements)

References 33 publications

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“…Primary OAGB is effective in weight loss and remission of T2DM and superior to RYGB in this respect, while being associated with a shorter operating time and slightly less post-operative complications [35]. As a primary procedure when compared to RYGB, percentage excess weight loss (EWL) five years post-surgery of OAGB has been reported as 72.9% vs. 60.1% with a complication rate of 3.2% vs. 1.8% [36][37][38][39][40][41].…”

Section: Introductionmentioning

confidence: 99%

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

et al. 2020

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Background Failure occurs in up to 60% of the patients that were treated with primary restrictive bariatric operations such as Laparoscopic Adjustable Gastric Banding (LAGB), or restrictive/metabolic operations like Laparoscopic Sleeve Gastrectomy (LSG). Insufficient weight loss and weight regain are the most commonly reported reasons of failure. The aim of this retrospective multicenter study was to compare One Anastomosis Gastric Bypass (OAGB) to Roux-en-Y Gastric Bypass (RYGB) as a revisional procedure in terms of weight loss, procedure time, complication rate and morbidity. Methods 491 patients operated on between 2012 and 2017 for failed restrictive surgery were included in this study (OAGB (n=185) or RYGB (n=306)). Failure was defined as total weight loss (TWL) less than 25%, excess weight loss (EWL) less than 50% and/or a remaining body mass index (BMI) larger than 40 kg/m2 at two years of follow up. Primary outcome measures were %TWL and % excess BMI loss (EBMIL) at 12, 24 and 36 months of follow-up. Secondary outcomes were procedure time, reduction of comorbidity, early and late complication rate, and mortality. Results %TWL was significantly larger in the OAGB group at 12 months (mean 24.1±9.8 vs. 21.9±9.7, p = 0.023) and 24 months (mean 23.9±11.7 vs. 20.5±11.2, p = 0.023) of follow-up. %EBMIL was significantly larger in the OAGB group at 12 months (mean 69.0±44.6 vs. 60.0±30.1, p = 0.014) and 24 months (mean 68.6±51.6 vs. 56.4±35.4, p = 0.025) of follow-up. Intraabdominal complications (leakage, bleeding, intra-abdominal abscess and perforation) occurred less frequently after revisional OAGB (1.1% vs. 4.9%, p = 0.025). Surgical intervention for biliary reflux (5.4% vs. 0.3%, p < 0.001) was more prevalent in the OAGB group. Surgical intervention for internal herniation (0.0% vs. 4.9%, p = 0.002) was more prevalent in the RYGB group. Conclusions This study suggests that OAGB is superior to RYGB as a remedy for insufficient weight loss and weight regain after failed restrictive surgery with more weight loss and a lower early complication rate. To substantiate these findings, further research from prospective randomized controlled trials is needed.

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Section: Introductionmentioning

confidence: 99%

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

et al. 2020

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“…It should be also mentioned that in the study by Robert et al [57], at two year follow-up in patients after OAGB, among the serious events associated with surgery, 21% were nutritional complications, including vitamin and iron deficiency or malnutrition. This may affect the concentrations of amino acids in some patients.…”

Section: Discussionmentioning

confidence: 92%

One Anastomosis Gastric Bypass Reconstitutes the Appropriate Profile of Serum Amino Acids in Patients with Morbid Obesity

Haliński

Pakiet

Jabłońska

et al. 2019

JCM

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Bariatric surgery leads to metabolic benefits in patients with obesity, but their mechanisms are not well understood. The appropriate composition of serum amino acids (AA) is important for sufficient supply of these components into various tissues and organs. Obesity leads to alterations in serum AA concentrations. The aim of this study was to examine the effect of one anastomosis gastric bypass (OAGB), a promising type of bariatric surgery, on serum AA concentrations, which were assayed by LC-MS in serum of 46 bariatric patients prior to and 6–9 months after OAGB, as well as in 30 lean control subjects. The results were analyzed by principle components analysis and metabolic pathway analysis. PCA analysis showed that OAGB led to normalization of serum AA concentrations of patients with obesity to a pattern similar to the control subjects, and the concentrations of essential AA remained decreased after OAGB. Changes of individual AA and their associated metabolic pathways were also presented. OAGB caused normalization of the AA profile, which may contribute to improvement of glucose homeostasis and reduction of cardiovascular risk. Considering decreased essential AA concentrations after OAGB, increased intake of high protein food should be recommended to the patients after this type of bariatric surgery.

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“…An interim analysis at 3 years of the 5‐year randomized Swiss Multicentre Bypass Or Sleeve Study (SM‐BOSS) revealed equivalent excess BMI loss (71 ± 24% vs 74 ± 23%; P =0.316) after laparoscopic sleeve gastrectomy ( n= 107) compared to laparoscopic RYGB ( n= 110) and comparable remission rates of type 2 diabetes (60% vs 77%; P= 0.23) . In a randomized trial of one‐anastomosis gastric bypass vs standard RYGB (YOMEGA trial) in 117 morbidly obese patients there was equivalent mean BMI loss (88% vs 86%) and remission rates of type 2 diabetes at 2 years, but significantly higher rates of serious adverse events [36% vs 21%; P= 0.042) and nutritional complications (7.7% vs 0%; P= 0.0034) in the one‐anastomosis gastric bypass group . In a double‐blind randomized trial of laparoscopic banded RYGB ( n= 56 participants) vs sleeve gastrectomy ( n= 58 participants) from New Zealand in obese people with type 2 diabetes there was significantly greater weight loss with banded RYGB at 12 months (% excess weight loss 84 ± 26 vs 70 ± 19; P= 0.002), but the rates of remission of type 2 diabetes were comparable .…”

Section: Metabolic and Bariatric Surgerymentioning

confidence: 99%

Medical and surgical management of obesity and diabetes: what's new?

et al. 2020

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We conducted a narrative review of the medical and surgical management of people with obesity and diabetes. Results of this review showed that a 5-10% loss in body weight can be achieved with a change in lifestyle, diet and behaviour and with approved pharmacological therapies in people with obesity and diabetes. New targeted therapies are now available for patients with previously untreatable genetic causes of obesity. Compared to medical treatment, metabolic and bariatric surgery is associated with significantly higher rates of remission from type 2 diabetes and lower rates of incident macrovascular and microvascular complications and mortality. The National Institute for Health and Care Excellence and the American Diabetes Association endorse metabolic and bariatric surgery in obese adults with type 2 diabetes and there may also be a role for this in obese individuals with type 1 diabetes. The paediatric committee of the American Society for Metabolic and Bariatric Surgery have recommended metabolic and bariatric surgery in obese adolescents with type 2 diabetes. Earlier and more aggressive treatment with metabolic and bariatric surgery in obese or overweight people with diabetes can improve morbidity and mortality.

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Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial

Cited by 330 publications

References 33 publications

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

One Anastomosis Gastric Bypass Reconstitutes the Appropriate Profile of Serum Amino Acids in Patients with Morbid Obesity

Medical and surgical management of obesity and diabetes: what's new?

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