Clinical outcomes after one anastomosis gastric bypass versus sleeve gastrectomy in super-super-obese patients

S.M.T. Schmitz*, P.H. Alizai, A. Kroh, S. Schipper, J.F. Brozat, A. Plamper, U.P. Neumann, K. Rheinwalt, T.F. Ulmer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background Bariatric surgery in super-super-obese (SSO) patients remains a continuous challenge due to intraabdominal fat masses, higher liver volume and existing comorbidities. A convenient procedure in SSO patients is one anastomosis gastric bypass (OAGB). The aim of this study was to compare the outcome of SSO patients undergoing OAGB in comparison to laparoscopic sleeve gastrectomy (LSG). Methods We retrospectively reviewed data from SSO patients who underwent OAGB and LSG in our institution between 2008 and 2020. Primary endpoints included percentage total body weight loss and percentage BMI loss at 12, 24, and 36 months after the operation. Secondary endpoints were perioperative complications, procedure length, length of hospital stay and outcome of comorbidities. Results 243 patients were included in this study. 93 patients underwent LSG and 150 underwent OAGB. At any of the time points evaluated, weight loss in patients after OAGB was greater than in LSG patients, while procedure length was significantly shorter for OAGB than LSG (81.4 vs. 92.1 min, p-value < 0.001). Additionally, mean length of hospital stay was shorter in the OAGB group (3.4 vs. 4.5 days, p-value < 0.001). There were more severe complications (Clavien-Dindo >= 3a) in the LSG group (11.8% vs 2.7%, p-value = 0.005). Conclusion In this retrospective analysis, OAGB was superior to LSG in terms of weight loss in SSO patients. Procedure length and hospital stay were shorter after OAGB in comparison to LSG and there were fewer severe complications. OAGB can therefore be regarded a safe and effective treatment modality for SSO patients.
Original languageEnglish
Pages (from-to)4401-4407
Number of pages7
JournalSurgical endoscopy and other interventional techniques
Volume36
Issue number6
Early online date26 Oct 2021
DOIs
Publication statusPublished - Jun 2022

Keywords

  • BARIATRIC SURGERY
  • Bariatric surgery
  • COMPLICATIONS
  • EXPERIENCE
  • MANAGEMENT
  • MORBID-OBESITY
  • OAGB
  • One anastomosis gastric bypass
  • ROUX-EN-Y
  • SSO
  • Super-super-obese
  • WEIGHT
  • COHORT

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