One Anastomosis/Mini-Gastric Bypass (OAGB/MGB) as Revisional Surgery Following Primary Restrictive Bariatric Procedures: a Systematic Review and Meta-Analysis

Kermansaravi, Mohammad; Shahabi, Shahab; DavarpanahJazi, Amir Hossein; Valizadeh, Rohollah; Berardi, Giovanna; Vitiello, Antonio; Musella, Mario; Carbajo, Miguel Ángel Martín

doi:10.1007/s11695-020-05079-x

Cited by 54 publications

(36 citation statements)

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“…Effectiveness of OAGB/MGB, both in terms of weight loss and obesity-related comorbidities, has been largely demonstrated [13][14][15]. Due to these good outcomes, it has rapidly become one of the most performed primary and revisional procedures worldwide [16,17]. Despite these good results, recalled in a recent consensus conference [4], three major issues raise doubts regarding the safety of OAGB/MGB: risk of biliary reflux, fear of gastro-oesophageal carcinogenesis due to alkaline reflux and rate of post-operative malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Revisional Surgery After One Anastomosis/Minigastric Bypass: an Italian Multi-institutional Survey

et al. 2022

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Background Efficacy and safety of OAGB/MGB (one anastomosis/mini gastric bypass) have been well documented both as primary and as revisional procedures. However, even after OAGB/MGB, revisional surgery is unavoidable in patients with surgical complications or insufficient weight loss. Methods A questionnaire asking for the total number and demographics of primary and revisional OAGB/MGBs performed between January 2006 and July 2020 was e-mailed to all S.I.C. OB centres of excellence (annual caseload > 100; 5-year follow-up > 50%). Each bariatric centre was asked to provide gender, age, preoperative body mass index (BMI) and obesity-related comorbidities, previous history of abdominal or bariatric surgery, indication for surgical revision of OAGB/MGB, type of revisional procedure, pre- and post-revisional BMI, peri- and post-operative complications, last follow-up (FU). Results Twenty-three bariatric centres (54.8%) responded to our survey reporting a total number of 8676 primary OAGB/MGBS and a follow-up of 62.42 ± 52.22 months. A total of 181 (2.08%) patients underwent revisional surgery: 82 (0.94%) were suffering from intractable DGER (duodeno-gastric-esophageal reflux), 42 (0.48%) were reoperated for weight regain, 16 (0.18%) had excessive weight loss and malnutrition, 12 (0.13%) had a marginal ulcer perforation, 10 (0.11%) had a gastro-gastric fistula, 20 (0.23%) had other causes of revision. Roux-en-Y gastric bypass (RYGB) was the most performed revisional procedure (109; 54%), followed by bilio-pancreatic limb elongation (19; 9.4%) and normal anatomy restoration (19; 9.4%). Conclusions Our findings demonstrate that there is acceptable revisional rate after OAGB/MGB and conversion to RYGB represents the most frequent choice. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Revisional Surgery After One Anastomosis/Minigastric Bypass: an Italian Multi-institutional Survey

et al. 2022

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“…A multicenter study showed an EWL of 77% in a 5-year follow-up after OAGB 20 . Two recently-published systematic reviews showed that OAGB is a valuable choice as a conversion bariatric surgery following a failed restrictive bariatric procedure 21 , 22 . Our study showed mean BMI, EWL% and %TWL of 34.5 ± 8.5 kg/m 2 , %51.6 ± 11.0 and %26.6 ± 5.9 at 1-year follow-up after conversional OAGB respectively.…”

Section: Discussionmentioning

confidence: 99%

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

Kermansaravi

Karami

Valizadeh

et al. 2022

Sci Rep

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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.

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“…OAGB is also a therapeutic option ensuring safety and a good effect after insufficient AGB surgery [ 25 ]. OAGB is recognized as a revision after primary restrictive surgery – the Kermansaravi meta-analysis included a total of 1771 revised patients, indicating high efficacy in both weight loss after secondary surgery and satisfactory remission of T2D with follow-up up to 5 years [ 26 ]. It should be remembered that OAGB may be a factor conducive to GERD remission and the development of GERD de novo symptoms.…”

Section: Discussionmentioning

confidence: 99%

Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS)

Major¹,

Zarzycki²,

Rymarowicz³

et al. 2022

wiitm

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Introduction Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. Aim The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. Material and methods This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. Results The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) – 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) – 289 (36.17%) patients and sleeve gastrectomy (SG) – 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common – 117 (14.64%) patients. Conclusions RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.

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One Anastomosis/Mini-Gastric Bypass (OAGB/MGB) as Revisional Surgery Following Primary Restrictive Bariatric Procedures: a Systematic Review and Meta-Analysis

Cited by 54 publications

References 54 publications

Revisional Surgery After One Anastomosis/Minigastric Bypass: an Italian Multi-institutional Survey

Revisional Surgery After One Anastomosis/Minigastric Bypass: an Italian Multi-institutional Survey

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

Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS)

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