Weight loss one year after laparoscopic roux-en-Y gastric bypass is not dependent on the type of gastrojejunal anastomosis

Munoz-Flores, Fernando; Rodríguez-Quintero, Jorge Humberto; Pechman, David; Creange, Collin; Zenilman, Ariela; Choi, Jenny; Moran-Atkin, Erin; Lima, Diego Laurentino; Camacho, Diego

doi:10.1007/s00464-021-08288-2

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…All cases were done laparoscopically with a 50-75cm biliopancreatic limb and a 120-150cm alimentary limb. The gastro jejunal anastomosis was performed in an antecolic, ante gastric configuration using 3 different surgical techniques (handsewn, circular and linear stapler) which have been demonstrated to have similar %EWL at 1 year 19 .…”

Section: Methodsmentioning

confidence: 99%

Safety and efficacy of roux-en-y gastric bypass in older aged patients

Rodríguez-Quintero

Grosser

Romero-Vélez

et al. 2022

Rev. Col. Bras. Cir.

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Introduction: laparoscopic Roux-en-Y Gastric Bypass (LRYGB) has been a revolutionary intervention for weight loss with reduction of up to 60-70% of excess body weight. However, these outcomes are not as well validated at the extremes of age, where the safety of the intervention still has some caveats. The aim of this study is to assess the efficacy and safety of primary LRYGB among different age groups. Methods: the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried for patients who underwent primary LRYGB from January 2014 to December 2017 at a single institution. Four groups were created and compared by dividing our sample by age quartiles. The primary outcome was percent excess weight loss (%EWL) at 1 year. Additional operative outcomes and complications were also compared across groups. Results: a total of 1013 patients underwent non-revisional LRYGB during the study period. Mean %EWL at one year was 55%. When compared between quartiles, there was a statistically significant difference in %EWL: 1st 62%, 2nd 57%, 3rd 54% and 4th 47% (p=0.010). The differences in the secondary outcomes between age groups did not demonstrate statistical significance. Conclusions: though patients in the fourth age quartile (range) did not demonstrate a statistically significant increase in adverse outcomes, they did lose less weight compared to other cohorts. The %EWL at one year after RYGB varied by age in our cohort. Goals after bariatric surgery should be individualized as weight loss is less robust with aging.

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Section: Methodsmentioning

confidence: 99%

Safety and efficacy of roux-en-y gastric bypass in older aged patients

Rodríguez-Quintero

Grosser

Romero-Vélez

et al. 2022

Rev. Col. Bras. Cir.

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“…A nivel mundial para el año 2011, se habían realizado 340.768 procedimientos bariátricos, siendo los más frecuentes: Roux-en-Y bypass gástrico (BPGYR) (46.6%), gastrectomía en manga (27.8%), banda gástrica ajustable (17.8%) y la derivación biliopancreatica (2.2%) (Buchwald & Oien, 2013). Para la presente investigación se consideró el Bypass gástrico en Y de Roux, desarrollado por Mason en la década de 1970, y considerado el procedimiento gold standard para perder peso (Wolfe, Kvach & Eckel, 2016;Munoz-Flores et al, 2022). En esta cirugía se modela la bolsa gástrica con un volumen de 25 cm, se realiza la anastomosis gastroyeyunal con 100-150 cm del asa alimentaria y la anastomosis yeyuno-yeyunal con 75 cm del asa biliopancreática (Deledda et al, 2021).…”

Section: Introductionunclassified

Pérdida de peso corporal y control metabólico en obesos diabéticos sometidos a bypass gástrico

Plua¹,

Vásquez²,

Jarrim³

2022

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La obesidad y la Diabetes Mellitus tipo 2 constituyen un grave problema de salud pública asociada a una mayor morbilidad y mortalidad a nivel mundial. El bypass Gástrico con Y de Roux se considera el procedimiento quirúrgico de referencia para el tratamiento de la obesidad y control metabólico de la Diabetes tipo 2. La presente investigación tuvo como objetivo determinar el efecto del bypass gástrico con Y de Roux sobre la pérdida de peso corporal y el control metabólico en 32 obesos diabéticos tipo 2 (11 hombres y 21 mujeres entre 24 y 64 años de edad, durante el período abril 2018 hasta abril 2019). Se realizó evaluación antropométrica (Peso, talla, IMC, %de IMC perdido (%IMCP), % de peso excedido perdido(%PEP) y evaluación bioquímica (glucemia, HbA1c, Colesterol total, triacilglicéridos). Se aplicó t de Student, Chi cuadrado y Wilcoxon. Entre los resultados Al inicio del estudio= obesidad grado II (50%), obesidad III (44%) y 6% superobesidad; A los 12 meses= IMC normal (20%), sobrepeso (47%), obesidad grado I (24%), obesidad grado II (8%) y 3% obesidad grado III (p=0,000). %IMCP=excelente (65%), con una mayor frecuencia de pérdida en las mujeres (53%). En cuanto a %PEP= pérdida excelente (3%), buena (21%); mientras que el 76% presentó una pérdida menor de 50% al año. Observándose al año un control metabólico adecuado. Se concluye que el BPGYR es una estrategia efectiva para la pérdida de peso y el control metabólico en estos pacientes.

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“…Indeed, the gastrojejunal anastomosis can be performed in 3 different ways: hand-sewn (HS), linear stapled (LSA) and circular stapled anastomosis (CSA). Even if weight loss is not influenced by the type of GJ,4 many authors have argued that the complication rate may depend on this surgical choice.…”

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confidence: 99%

Linear Versus Circular Laparoscopic Gastrojejunal Anastomosis of Roux-en-Y Gastric Bypass: Systematic Review and Meta-Analysis of 22 Comparative Studies

Vitiello

Berardi

Velotti

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Purpose: To compare the rate of complications of linear versus circular gastrojejunal anastomosis of laparoscopic Roux-en-Y gastric bypass. Methods: A systematic search of PubMed, Embase, and the Cochrane Library databases was carried out using the terms “laparoscopic,” “circular,” “linear,” “anastomosis,” “gastric bypass” in accordance to PRISMA guidelines. Only original articles in English language comparing linear versus circular anastomosis were included. No temporal interval was set. Outcome measures were wound infection, bleeding, marginal ulcer, leak, and stricture. Pooled odds ratio (OR) with a 95% confidence interval (CI) was calculated. Heterogeneity was assessed using the I 2 statistic. Funnel plots were used to detect publication bias. Results: Twenty-two articles (7 prospective and 15 retrospective) out of 184 retrieved papers were included in this study. The pooled analysis showed a reduced odd of wound infection and bleeding after linear anastomosis. Likelihood of marginal ulcer, leak, and stricture was similar after the 2 techniques. Wound infection was reported in 15 studies (OR, 0.17; 95% CI, 0.06-0.45; P=0.0003; I 2=91), bleeding in 9 (OR, 0.45; 95% CI, 0.34-0.59; P=0.00001; I 2=6) marginal ulcer in 11 (OR, 0.61; 95% CI, 0.26-1.41; P=0.25; I 2=65), leaks in 15 (OR, 0.61; 95% CI, 0.21-1.67; P=0.34; I 2=83) and stricture in 18 (OR, 0.48; 95% CI, 0.23-1.00; P=0.05; I 2=68). Conclusion: Laparoscopic RYGB can be safely performed both with circular and linear staplers. Rates of wound infection and bleeding were significantly lower after linear gastrojejunal anastomosis.

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Weight loss one year after laparoscopic roux-en-Y gastric bypass is not dependent on the type of gastrojejunal anastomosis

Cited by 7 publications

References 12 publications

Safety and efficacy of roux-en-y gastric bypass in older aged patients

Safety and efficacy of roux-en-y gastric bypass in older aged patients

Pérdida de peso corporal y control metabólico en obesos diabéticos sometidos a bypass gástrico

Linear Versus Circular Laparoscopic Gastrojejunal Anastomosis of Roux-en-Y Gastric Bypass: Systematic Review and Meta-Analysis of 22 Comparative Studies

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