Resectional One Anastomosis Gastric Bypass/Mini Gastric Bypass as a Novel Option for Revision of Restrictive Procedures: Preliminary Results

Abstract

Background Revisional surgery is becoming a common and challenging practice in bariatric centers. The aim of this study was to evaluate resectional one anastomosis gastric bypass/mini gastric bypass (R-OAGB/MGB) as a revisional procedure. Methods From January 2016 to February 2017, data on 21 consecutive patients undergoing R-OAGB/MGB for weight loss failure after primary restrictive procedures were prospectively collected and analysed. Results Mean age was 39 ± 12 years (18–65), and 11 (52.3%) were women. The mean operative time was 96.4 ± 20.9 min (range, 122–80), and the mean postoperative stay was 47.8 ± 7.4 hours (range, 36–73). There were no deaths and no procedure-related complications. The mean body mass index (BMI) decreased from 42.9 ± 6.5 at the time of R-OAGB/MGB to 28.5 ± 4 at the 12-month follow-up. At that time point, the mean percentage of BMI loss (%EBL) and the mean percentage of total body weight loss (%TWL) reached 81.6 ± 0.17% and 35 ± 0.01%, respectively. Conclusion R-OAGB/MGB was technically straightforward, effective, and safe in this at-surgical risk population. R-OAGB/MGB should be added to the armamentarium of revisional bariatric procedures considering its technical aspects and the potential advantage on weight loss.

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

“…3 Forest plot showing the effect of OAGB/MGB on BMI after 1-year follow-up [41]. This review of literature also showed that simultaneous gastric remnant resection, which was performed in some of the studies [21,23,25,26,29], has no significant effects on weight loss, but, in our opinion, it can only increase the risk for postoperative complications and hamper reversal surgery (Table 11).…”

One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure

“…Five patients (42%) underwent the revisional procedure due to weight regain, while seven patients (58%) underwent re‐OAGB for insufficient weight loss. After careful adhesiolysis of the anterior and posterior gastric wall, the gastric pouch was calibrated with a 40 French bougie and had a length extending to approximately 12 cm from the esophagogastric junction, 22 using purple or black Tri‐Staple EndoGIA™ 60 mm cartridges. The average length of the biliopancreatic limb created during re‐OAGB was 166 ± 31 cm.…”

SADI-S vs OAGB como cirugía revisional después de gastrectomía vertical. Revisión sistemática

“…Considerando lo anteriormente enunciado, existen estudios con seguimientos de 3 -5 años en donde se observan índices de conversión de GV hasta un 36% a 10 años. [1,3,7,10,[16][17][18]…”

“…Se definió curación de DM como una HbA1c <6.5%, HbA1c <6% en combinación con glucometrías en ayuno <126 mg/dl, <110 mg/dl y/o <100 mg/dl sin tratamiento farmacológico para dichas patologías, en algunos estudios cumpliendo un periodo mínimo de 1 año. [2,4,11,16,17,27,33] Se observa que los pacientes que se les realizó un OAGB presentan índices mayores de curación en todas las patologías estudiadas. Un punto a considerar es el hecho que se tomó como base los pacientes que aun después de la GV persistian con su patología, por lo que el porcentaje total de pacientes que se logró remisión de DM, HTA y DL son mayores.…”

“…A pesar de ello, se ha observado que la absorción de zinc se ve afectado particularmente en pacientes en los que se les practica un SADI-S, por lo que se recomienda vigilancia estrecha y administración de suplementos vitamínicos que lo compensen. [14][15][16][17]25,39]…”