The safety profile of one-anastomosis gastric bypass compared to Roux-en-Y gastric bypass: a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program analysis.

BACKGROUND: One anastomosis gastric bypass (OAGB) is an American Society for Metabolic and Bariatric Surgery (ASMBS)-endorsed bariatric surgery. As utilization of OAGB increases, it is important that the safety profile of OAGB be rigorously assessed. OBJECTIVES: We studied the 30-day safety of OAGB compared to a similar gastro-jejunal anastomotic procedure, Roux-en-Y gastric bypass (RYGB). SETTING: Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) participating bariatric centers in the United States. METHODS: A matched case-control study was conducted of patients who underwent primary gastric bypass surgery 2021-2022, identified in the MBSAQIP database. Each patient who underwent OAGB was matched to 4 controls who underwent RYGB on age (±10), sex, race, body mass index (BMI) (±5 kg/m2), preoperative functional status, American Society of Anesthesiologists (ASA) classification, and 13 comorbidities. Univariate and multivariate regression analyses were performed. RESULTS: A total of 1569 patients who underwent OAGB were matched to 6276 controls. Matched baseline characteristics were similar between groups. Operative time, length of stay (LOS), and overall complication rate were lower in the OAGB cohort (P < .001) with higher 30-day BMI loss percentage (P = .048). Specifically, OAGB was associated with a significantly lower bowel obstruction rate, as compared to RYGB (.1% versus 1.0%, P < .001). On logistic regression adjusting for all variables used in matching, OAGB was associated with a 27% decrease in overall complication rate (odds ratio [OR] .73, 95% confidence interval [CI] .62-.87, P < .001). CONCLUSIONS: Although OAGB is minimally utilized, the 30-day safety profile appears favorable. As compared to RYGB, OAGB was associated with shorter operative time and LOS, and a lower complication rate, partially due to minimization of small bowel obstructions with a loop anatomy. Further evidence in the comparative long-term safety profile is still needed.

The length of the biliopancreatic limb in one anastomosis gastric bypass.

Introduction: The one-anastomosis gastric bypass (OAGB), first published by Dr Rutledge in 1997 is now a well-established procedure in the bariatric-metabolic armamentarium. This procedure based on a (single) loop gastro-jejunal anastomosis (the biliopancreatic limb or BPL) with a long narrow gastric pouch combines restriction with hypo-absorption. The biliopancreatic limb and in particular its length is held responsible for the degree of the hypo-absorptive effect but the most appropriate or "optimal" length of the BPL remains debatable. Methods: The following text is based on a comprehensive and meticulous selection of the most recent literature in Cochrane, Pubmed and Google Scholar using the search terms "biliopancreatic limb", "biliopancreatic limb in one anastomosis gastric bypass" in an attempt to define not only the most common used biliopancreatic limb length but also to find out If there is an "ideal" limb length not only to optimize the outcomes of the OAGB in terms of weight loss and resolution of obesity-related diseases but also to reduce the potential side-effects in particular nutritional deficiencies. Results: Until today there is no consensus about the "standard" or "ideal" length of the biliopancreatic limb in OAGB, a fixed length of 200 cm is still the most common used procedure although many reports and studies are in favour of shorter limb lengths adjusted to the BMI or the total small bowel length. Conclusion: The "ideal" or "optimal" biliopancreatic limb length in OAGB still needs to be defined. There are different options and all of them have their credits, the question remains if a consensus can be reached regarding the best strategy to obtain the best outcome.

30-day morbidity and mortality of revisional bariatric surgery - An international multi-centre collaborative (BROAD) study.

INTRODUCTION: Revisional bariatric surgery (RBS) for insufficient weight loss/weight regain or metabolic relapse is increasing worldwide. There is currently no large multinational, prospective data on 30-day morbidity and mortality of RBS. In this study, we aimed to evaluate the 30-day morbidity and mortality of RBS at participating centres. METHODS: An international steering group was formed to oversee the study. The steering group members invited bariatric surgeons worldwide to participate in this study. Ethical approval was obtained at the lead centre. Data were collected prospectively on all consecutive RBS patients operated between 15th May 2021 to 31st December 2021. Revisions for complications were excluded. RESULTS: A total of 65 global centres submitted data on 750 patients. Sleeve gastrectomy (n = 369, 49.2 %) was the most common primary surgery for which revision was performed. Revisional procedures performed included Roux-en-Y gastric bypass (RYGB) in 41.1 % (n = 308) patients, One anastomosis gastric bypass (OAGB) in 19.3 % (n = 145), Sleeve Gastrectomy (SG) in 16.7 % (n = 125) and other procedures in 22.9 % (n = 172) patients. Indications for revision included weight regain in 615(81.8 %) patients, inadequate weight loss in 127(16.9 %), inadequate diabetes control in 47(6.3 %) and diabetes relapse in 27(3.6 %). 30-day complications were seen in 80(10.7 %) patients. Forty-nine (6.5 %) complications were Clavien Dindo grade 3 or higher. Two patients (0.3 %) died within 30 days of RBS. CONCLUSION: RBS for insufficient weight loss/weight regain or metabolic relapse is associated with 10.7 % morbidity and 0.3 % mortality. Sleeve gastrectomy is the most common primary procedure to undergo revisional bariatric surgery, while Roux-en-Y gastric bypass is the most commonly performed revision.

Safety and Efficacy of Barbed Sutures Compared to Non-barbed Sutures in Bariatric Surgery: An Updated Systematic Review and Meta-analysis.

PURPOSE: Mastering intracorporeal suturing is challenging in the evolution from conventional to laparoscopic bariatric surgery. Among various techniques competing for superiority in overcoming this hurdle, we focus on exploring the potential of barbed sutures through a meta-analysis that compares outcomes to those of conventional non-barbed sutures in bariatric surgery. MATERIALS AND METHODS: We conducted a comprehensive search on PubMed, Scopus, and Embase to identify studies comparing barbed sutures with non-barbed sutures in bariatric surgeries, focusing on outcomes such as operative time, suturing time, postoperative complications, and hospital stay. The statistical analysis was carried out using RStudio version 4.3.2. Heterogeneity was assessed using the Cochrane Q test and I2 statistics. RESULTS: Incorporating data from 11 studies involving a total of 27,442 patients, including 3,516 in the barbed suture group across various bariatric surgeries, our analysis demonstrates a significant reduction in suturing time (mean difference -4.87; 95% CI -8.43 to -1.30; p < 0.01; I2 = 99%) associated with the use of barbed sutures. Specifically, in Roux-en-Y gastric bypass, we observed a significant decrease in operative time (mean difference -12.11; 95% CI -19.27 to -4.95; p < 0.01; I2 = 93%). Subgroup analyses and leave-one-out analyses consistently supported these findings. Furthermore, we found that the mean body mass index did not significantly predict the mean difference in operative time outcome. No significant differences emerged in hospital stay or postoperative complications, including leak, bleeding, stenosis, and bowel obstruction (p > 0.05). CONCLUSION: Our study findings address barbed sutures as a potential alternative for laparoscopic intracorporeal suturing in bariatric surgery.

Long Narrow Pouch Roux-en-Y Gastric Bypass (LN-RYGB) for Recurrent Weight Gain After Sleeve Gastrectomy.

PURPOSE: Sleeve gastrectomy (SG) is the most performed metabolic and bariatric surgery (MBS). However, with the increase of SG in different regions, recurrent weight gain after SG is challenging for bariatric surgeons. We introduce a modified operation with a long, narrow pouch in RYGB (LN-RYGB) for weight regain after SG which enhanced the restrictive function in RYGB. METHODS AND RESULTS: The LN-RYGB has a longer and narrow gastric pouch for 10 cm. The length of small Roux and biliopancreatic are the same as RYGB. As a revisional surgery, the post-1 year excess weight loss percentage (%EWL) was 63.1% and total weight loss percentage (%TWL) was 29.1% in 5 cases. CONCLUSION: LN-RYGB is an optional treatment for recurrent weight gain after SG; a randomized control trial is needed to verify the long-term effect of LN-RYGB.

The predictive relationship between early and long-term weight loss outcomes after one anastomosis gastric bypass.

BACKGROUND: Weight loss failure after bariatric surgery imposes great stress on patients and surgeons and great costs on healthcare systems. The literature review shows that weight loss failure is the most common cause of redo bariatric surgery. Therefore, identifying the predictors of weight loss failure in patients in the early stages can help bariatric surgeons. The present study aims to determine the association between primary weight loss and long-term weight loss outcomes. METHODS: This retrospective cohort study was conducted on 329 patients undergoing OAGB who were followed for 60 months. For the prediction of short-term (24 months) and long-term (60 months) successful weight loss and weight regain, we used %TWL and BMI at any regular follow-ups. RESULTS: In preoperative indices, age, sex, DLP, hypothyroidism, and HTN were not significant to predict successful short-term and long-term weight loss but %TWL at 12 months is a significant predictor of successful weight loss in short-term and long-term follow up. In the prediction of weight regain, preoperative indices (except BMI) were not significant but 12-month %TWL was a significant predictor. CONCLUSIONS: This index can help surgeons find these patients early and provide helpful instructions to manage their issues more promptly to reach better weight loss outcomes.

Comparison of revisional surgeries after OAGB versus RYGB: Results from the multicenter Polish Revision Obesity Surgery Study (PROSS).

<br><b>Introduction:</b> Roux-en-Y gastric bypass (RYGB) is a leading bariatric surgery globally. One-anastomosis gastric bypass (OAGB), a modification of RYGB, ranks as the third most common bariatric procedure in Poland. While clinical trials show that OAGB outcomes are comparable to those of RYGB regarding weight loss, remission of comorbidities, and hormonal impact, there is limited data on long-term outcomes and complications.</br><br><b>Aim:</b> The aim of the study was to compare the outcomes of revisional surgeries conducted after OAGB <i>versus</i> RYGB.</br> <br><b>Material and methods:</b> This retrospective study analyzed patients undergoing revisional bariatric surgeries from January 2010 to January 2020 across 12 Polish centers. The inclusion criteria were an age of at least 18 years and prior OAGB or RYGB surgery. Those with incomplete primary surgery data and follow-up post-revision were excluded. Data were collected regarding parameters for anthropometrics, comorbidities, and perioperative details. The patients were categorized based on their initial surgery: OAGB or RYGB. The primary endpoints were the reasons for and types of revisional surgery and weight changes; the secondary endpoints were postoperative complications and length of hospital stay (LOS).</br> <br><b>Results:</b> In total, 27 patients participated, with a mean age of 38.18 7 years. Differences between the OAGB (13 patients) and RYGB (14 patients) groups included median initial body weight (100 kg <i>vs.</i> 126 kg, p<0.016), number of postoperative complications (9 <i>vs.</i> 3, p = 0.021), and median LOS (3 <i>vs.</i> 4.5 days, p = 0.03). GERD was the primary reason for OAGB revisions (69.2%), whereas insufficient weight loss led to the most RYGB revisions (42.9%).</br><br><b>Conclusions:</b> The RYGB patients commonly needed revisions due to weight issues, whereas reoperations in the OAGB patients were conducted due to postoperative complications. The postoperative complications and LOS were similar between the groups.</br> <br><b>The importance of research for the development of the field:</b> The results may influence clinical surgeons' choice of surgical technique.</br>.

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass-An Experts' Modified Delphi Consensus.

PURPOSE: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method. METHODS: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus. RESULTS: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300-400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB. CONCLUSION: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues.

Similar Rates of Symptomatic Marginal Ulcers After One-Anastomosis-Gastric Bypass Compared to Roux-en-Y Gastric Bypass.

PURPOSE: One-anastomosis-gastric-bypass (OAGB) has become a common bariatric procedure worldwide. Marginal ulcers (MU) are a significant non-immediate complication of gastric bypass surgeries. There seems to be concern among surgeons that MU are more common after OAGB compared with Roux-en-Y gastric bypass (RYGB) due to the constant and extensive exposure of the anastomosis to bile. The aim of this study was to compare the incidence, presentation, and management of MU between the two surgeries. MATERIALS AND METHODS: A retrospective study of prospectively collected data was performed to include all consecutive patients between 2010 and 2020, who underwent elective OAGB or RYGB at our institution. Patients diagnosed with symptomatic MU were identified. Factors associated with this complication were assessed and compared between the two surgeries. RESULTS: Symptomatic MU were identified in 23/372 OAGB patients (6.2%) and 35/491 RYGB patients (7.1%) (p = 0.58). Time to ulcer diagnosis was shorter in OAGB patients (12 ± 11 vs. 22 ± 17 months, p < 0.01). Epigastric pain was the common symptom (78% OAGB vs. 88.5% RYGB, p = 0.7) and approximately 15% of ulcers presented with perforation upon admission (17% vs.11.4%, p = 0.7). Re-operation was required in 5/23 OAGB (21.7%) and 6/36 RYGB (17%) patients (p = 0.11) while the rest of the patients were managed non-operatively. CONCLUSIONS: The risk of developing a marginal ulcer is similar between patients who underwent OAGB and RYGB. Patients diagnosed with MU following OAGB tend to present earlier; however, the clinical presentation is similar to RYGB patients. The management of this serious complication seems to be associated with acceptable outcomes with comparable operative and non-operative approaches.

One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study.

PURPOSE: Sleeve Gastrectomy (SG) is the most performed bariatric surgery, but a considerable number of patients may require revisional procedures for suboptimal clinical response/recurrence of weight (SCR/RoW). Conversion options include One-Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal Bypass (SADI). The study aims to compare SADI vs. OAGB as revisional procedures in terms of early and mid-term complications, operative time, postoperative hospital stay and clinical outcomes. METHODS: All patients who underwent OAGB or SADI as revisional procedures following SG for SCR/RoW at three high-volume bariatric centers between January 2014 and April 2021 were included. Propensity score matching (PSM) analysis was performed. Demographic, operative, and postoperative outcomes of the two groups were compared. RESULTS: One hundred and sixty-eight patients were identified. After PSM, the two groups included 42 OAGB and 42 SADI patients. Early (≤ 30 days) postoperative complications rate did not differ significantly between OAGB and SADI groups (3 bleedings vs. 0, p = 0.241). Mid-term (within 2 years) complications rate was significantly higher in the OAGB group (21.4% vs. 2.4%, p = 0.007), mainly anastomotic complications and reflux disease (12% of OAGBs). Seven OAGB patients required conversion to another procedure (Roux-en-Y Gastric Bypass-RYGB) vs. none among the SADI patients (p = 0.006). CONCLUSIONS: SADI and OAGB are both effective as revisional procedures for SCR/RoW after SG. OAGB is associated with a significantly higher rate of mid-term complications and a not negligible rate of conversion (RYGB). Larger studies are necessary to draw definitive conclusions.

LSG vs OAGB: 7-Year Follow-up Data of a Randomised Control Trial and Comparative Outcome Based on BAROS Score.

BACKGROUND: This study aims to evaluate and compare long-term results of laparoscopic sleeve gastrectomy (LSG) and one anastomosis gastric bypass (OAGB) based on bariatric analysis reporting and outcome system (BAROS) score. MATERIALS AND METHODS: Patients operated for morbid obesity between 2013 and 2015 were randomised to LSG and OAGB groups. Based on inclusion and exclusion criteria, 201 patients (100 LSG and 101 OAGB) were analysed for changes in total body weight (TBW), body mass index (BMI), percent excess weight loss (%EWL), percent total weight loss (%TWL), QoL (quality of life) scores, comorbidity resolution and outcome based on BAROS at 7 years. RESULTS: Sixty-six LSG and 64 OAGB patients were followed up at 7 years. Mean pre-operative TBW and BMI were 119 ± 28.2 and 44.87 ± 7.71 for LSG group and 113.25 ± 23.74 and 44.71 ± 8.75 for OAGB group respectively. At 7 years after surgery, there was significant drop in mean TBW and BMI in both groups. Mean %EWL for LSG and OAGB patients was 50.78 ± 28.48 and 59.99 ± 23.32 and mean %TWL for LSG and OAGB patients was 23.22 ± 12.66 and 27.71 ± 12.27 respectively. Mean QoL scores at 7 years were significantly higher than the pre-operative scores and most of the patients in both groups had remission or improvement in their comorbidities. 68.76% OAGB patients had very good or excellent outcome on BAROS score while only 36.37% LSG patients had similar outcome. CONCLUSIONS: LSG and OAGB are successful bariatric procedures over the long term. OAGB outperforms LSG and has significantly higher %EWL and %TWL over the long term.

American Society for Metabolic and Bariatric Surgery position statement on one-anastomosis gastric bypass.

The following position statement is issued by the American Society for Metabolic and Bariatric Surgery in response to inquiries made to the society by patients, physicians, society members, hospitals, health insurance payors, and others regarding one-anastomosis gastric bypass as a treatment for obesity and metabolic disease. This statement is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence available at this time. The statement may be revised in the future as more information becomes available.

Outcomes of One-Anastomosis Gastric Bypass Conversion to Roux-en-Y Gastric Bypass for Severe Obesity: A Systematic Review and Meta-analysis.

One-anastomosis gastric bypass (OAGB) is an effective procedure to treat severe obesity. However, conversion to Roux-en-Y gastric bypass (RYGB) is increasing. We therefore conducted a systematic review to determine the safety and efficacy associated with OAGB-RYGB conversion. A systematic search was conducted by three independent reviewers using Medline, Embase, and the Cochrane library following PRISMA guidelines. Six studies including 134 patients were selected who were undergoing OAGB-RYGB conversion. The most common indications were reflux (47.8%), malnutrition (31.3%), and inadequate weight loss (8.2%). Study outcomes demonstrated 100% resolution of bile reflux. Overall, there was medium-term weight gain of 0.61 BMI. OAGB to RYGB conversion leads to resolution of reflux symptoms. However, it is associated with weight regain, albeit this may be acceptable to patients to treat biliary reflux.

Effect of Primary Versus Revisional One Anastomosis Gastric Bypass (OAGB) on Fatty Acid Profile.

INTRODUCTION: One anastomosis gastric bypass (OAGB) is one option of a revisional procedure for failed sleeve gastrectomy. Moreover, it can be used as a primary bariatric procedure, and is an effective surgery resulting in significant weight loss and the resolution or improvement of obesity-associated medical problems, accompanied by low perioperative complications. However, as with any therapy, OAGB has its limitations, including micronutrient deficiency or malnutrition. In our study, we compared the fatty acid (FA) profile in serum of patients after both primary OAGB (pOAGB) and revisional OAGB (rOAGB) to identify potential postsurgical FA alterations. METHODS: This is a retrospective study on patients with obesity who underwent OAGB procedures (pOAGB n=68; rOAGB n=17), conducted from 2016 to 2018. In blood, we analyzed a series of biochemical parameters, and in the serum, the FA profile was determined using gas chromatography-mass spectrometry. RESULTS: The percentage of excess BMI loss (% EBMIL) after pOAGB was 73.5 ± 2.47% in comparison to 45.9 ± 4.15% in the rOAGB group (p<0.001). In contrast to the lack of effect of rOAGB on most polyunsaturated FAs, in the pOAGB group, there was a decrease in eicosapentaenoic acid, and eicosatetraenoic and docosahexaenoic acid levels (p<0.001). We also found a decrease in very long-chain FAs (VLCFAs) and an increase in branched-chain FAs (BCFAs) after both types of OAGB procedure. CONCLUSIONS: Both OAGB procedures improved the profile of most FAs, leading to a decrease in VLCFAs, which are considered harmful, and an improvement in BCFAs, which are considered to be beneficial. There is a need to further investigate the possibility of n-3 polyunsaturated FA supplementation after pOAGB, due to the large decrease in these FAs after pOAGB.

Laparoscopic repair of internal hernia in one anastomosis gastric bypass (OAGB): a case report.

One anastomosis gastric bypass (OAGB), considered an alternative to Roux-en-Y gastric bypass, is becoming an increasingly common procedure. It shows excellent results in terms of weight reduction and remission of metabolic disease. Among the advantages of OAGB is the lack of internal hernia due to the absence of jejuno-jejunal anastomosis. However, internal herniation in OAGB is not impossible, and multiple cases have been mentioned in the literature. We describe a laparoscopic revisional surgery of internal hernia in a patient with a 2-month history of OAGB.

Malnutrition Following One-Anastomosis Gastric Bypass: a Systematic Review.

Severe malnutrition following one-anastomosis gastric bypass (OAGB) remains a concern. Fifty studies involving 49,991 patients were included in this review. In-hospital treatment for severe malnutrition was needed for 0.9% (n = 446) of patients. Biliopancreatic limb (BPL) length was 150 cm in five (1.1%) patients, > 150 cm in 151 (33.9%), and not reported in 290 (65%) patients. OAGB was revised to normal anatomy in 126 (28.2%), sleeve gastrectomy in 46 (10.3%), Roux-en-Y gastric bypass in 41 (9.2%), and shortening of BPL length in 17 (3.8%) patients. One hundred fifty-one (33.8%) patients responded to treatment; ten (2.2%) did not respond and was not reported in 285 (63.9%) patients. Eight (0.02%) deaths were reported. Standardisation of the OAGB technique along with robust prospective data collection is required to understand this serious problem.

Emergent conversion from single-anastomosis gastric bypass to Roux-en-Y gastric bypass with subsequent obstruction of entero-enteric anastomosis by ascaris.

One anastomosis gastric bypass (OAGB), the third most commonly performed procedure worldwide, has shown excellent results in terms of weight loss and resolution of comorbidities compared with other bariatric surgeries. However, its use remains limited in various parts of the world due to postoperative complications. After the efficacy of this procedure was established, the focus of treatment shifted toward resolving postoperative complications. Protein-energy malnutrition after OAGB is one of the main issues that needs to be addressed. There are several operative options for patients who require revision surgery including reversal and conversion to Roux-en-Y gastric bypass (RYGB). The conversion from OAGB to RYGB is a feasible method that has shown excellent results when performed by experts in the field. Here, we present the case of a woman with symptoms of acute obstruction secondary to OAGB who underwent conversion to RYGB under emergent conditions.

Safety and Efficacy of One Anastomosis Gastric Bypass in Children and Adolescents: a 5-Year Cohort Study.

BACKGROUND: Childhood obesity is an important worldwide issue of serious medical and social concern. One anastomosis gastric bypass (OAGB) is an approved, effective, and long-lasting procedure for weight loss and the remission of obesity-associated medical problems in the adult patients, but its efficacy and safety in children and adolescents are still on debate. This study aimed to evaluate safety and efficacy of OAGB compare to SG and RYGB during a 5-year follow-up. METHODS: A retrospective cohort study on children and adolescents with severe obesity who underwent primary OAGB, sleeve gastrectomy (SG), and Roux-e-Y gastric bypass (RYGB) at an academic hospital, between March 2016 and December 2020. RESULTS: Two hundred twenty-eight patients with 24 to 60 months of follow-up including 107 SG, 37 RYGB, and 84 OAGB were included in the final analysis. The mean age, preoperative weight, and BMI were 15.71 ± 2.09 years (range, 9-18 years), 126.3 ± 22.0 kg (74.5-215 kg), and 45.1 ± 6.9 kg/ m2 (36.4-79.3 kg/m2), respectively. The mean of follow-up was 30.05 ± 19.98 months. The mean of ∆BMI was 30.2 ± 5.1, 30.0 ± 5.4, and 31.1 ± 6.8 at 12th, 36th, and 60th months postoperative. At the 60-month follow-up, there were statistically significant differences in ΔBMI between SG and OAGB and SG and RYGB. CONCLUSION: OAGB is a safe and effective procedure for the treatment of obesity in children and adolescents in 24 to 60 months follow-ups.

One Anastomosis Gastric Bypass Versus Sleeve Gastrectomy for Obesity: a Systemic Review and Meta-analysis.

BACKGROUND: A long-lasting and efficient method of managing obesity and therapeutic associated comorbidities is bariatric surgery. However, a debated comparison between one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy is still essential (SG). The goal of this study is to evaluate outcomes using RCT and NRCT from 2015 to 2022. METHODS: By contrasting the OAGB and SG for bariatric surgery from January 2015 to September 2022, an RCT and NRCT were prospectively gathered using the PubMed, Cochrane Library, and MEDLINE databases of published research. This meta-statistical analysis was carried out in RevMan 5.4, and the best effect model was selected based on heterogeneity. RESULTS: Twelve retrospective studies describing 6344 patients (3725 OAGB and 2619 SG) satisfied the inclusion criteria. A statistically significant result was in %EWL first year (MD = 8.03, 95% CI: 4.54-11.52, P < 0.05), second year (MD = 8.94, 95% CI: 2.95-14.94, P < 0.05), third year (MD = 8.93, 95% CI: 5.75-12.10, P < 0.05), fourth year (MD = 15.09, 95% CI:0.87-29.31, P < 0.05), and fifth year (MD = 14.25, 95% CI: 5.34, P < 0.05). OAGB was associated with a lower rate of remission in dyslipidemia, hypertension, diabetes mellitus, and hemorrhage. However, OAGB increased the incidence of GERD and leakage. CONCLUSIONS: In terms of weight loss and comorbidity remission, OAGB is more effective than SG, although postoperative consequences are rather comparable between the two methods.