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Shang M, Li Z, Du D, Xu G, Lian D, Liao Z, Wang D, Amin B, Wang Z, Chen W, Zhang N, Wang L. Comparative Study for Safety and Efficacy of OAGB and SADJB-SG: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:3499-3508. [PMID: 39319304 PMCID: PMC11420895 DOI: 10.2147/dmso.s484616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
Purpose Obesity and related complications are managed by One Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Jejunal Bypass with Sleeve Gastrectomy (SADJB-SG), both of which are adapted from traditional gastric bypass procedures. However, there are no current comparative studies on the safety and efficacy of these two surgical procedures. Patients and Methods Preoperative baseline data of patients who had undergone OAGB and SADJB-SG surgeries from June 2019 to June 2021 were retrospectively analyzed at our bariatric facility. Postoperative data, including weight changes, improvement in type 2 diabetes (T2DM), and complication rates were collected over 2 years. This was followed by a comprehensive evaluation of the safety and efficacy of the two surgical procedures. Results A total of 63 patients completed the follow-up in this study. At the 24-month follow-up, excess weight loss percentage (EWL%) for the OAGB and SADJB-SG was 73.970±5.005 and 75.652±7.953, respectively (P-value = 0.310); total weight loss percentage (TWL%) was 24.006±8.231 and 23.171±6.600, respectively (P-value = 0.665). The diabetes remission rates for the two groups were 71.429% and 69.048%, respectively (P-value = 0.846). The cost for OAGB was 55088.208±1508.220 yuan, which was significantly lower than the 57538.195±1374.994 yuan for SADJB-SG (P-value< 0.001). Conclusion The two surgical procedures are reliable in terms of safety and efficacy, and each has distinct advantages. While OAGB has reduced operational expenses, SADJB-SG offers a broader range of applicability.
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Affiliation(s)
- Mingyue Shang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Zhehong Li
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Dexiao Du
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Guangzhong Xu
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Dongbo Lian
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Zhaohui Liao
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Dezhong Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Buhe Amin
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Zheng Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Weijian Chen
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Nengwei Zhang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
| | - Liang Wang
- Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, People's Republic of China
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Onzi TR, Salgado Júnior W, Bastos ELDS, Dantas ACB, Silva LB, Oliveira Neto AAD, Tristão LS, Santos CLD, Bernardo WM, Chavez MP. EFFICACY AND SAFETY OF ONE ANASTOMOSIS GASTRIC BYPASS IN SURGICAL TREATMENT OF OBESITY: SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2024; 37:e1814. [PMID: 39230117 PMCID: PMC11363908 DOI: 10.1590/0102-6720202400021e1814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/17/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND One anastomosis gastric bypass (OAGB) has gained prominence in the search for better results in bariatric surgery. However, its efficacy and safety compared to Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) remain ill-defined. AIMS To compare the efficacy and safety of OAGB relative to RYGB and SG in the treatment of obesity. METHODS We systematically searched PubMed, EMBASE, Cochrane Library, Lilacs, and Google Scholar databases for randomized controlled trials comparing OAGB with RYGB or SG in the surgical approach to obesity. We pooled outcomes for body mass index, percentage of excess weight loss, type-2 diabetes mellitus remission, complications, and gastroesophageal reflux disease. Statistical analyses were performed with R software (version 4.2.3). RESULTS Data on 854 patients were extracted from 11 randomized controlled trials, of which 422 (49.4%) were submitted to OAGB with mean follow-up ranging from six months to five years. The meta-analysis revealed a significantly higher percentage of excess weight loss at 1-year follow-up and a significantly lower body mass index at 5-year follow-up in OAGB patients. Conversely, rates of type-2 diabetes mellitus remission, complications, and gastroesophageal reflux disease were not significantly different between groups. The overall quality of evidence was considered very low. CONCLUSIONS Our results corroborate the comparable efficacy of OAGB in relation to RYGB and SG in the treatment of obesity, maintaining no significant differences in type-2 diabetes mellitus remission, complications, and gastroesophageal reflux disease rates.
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Affiliation(s)
- Tiago Rafael Onzi
- Universidade Federal de Santa Catarina, General and Digestive Surgery Service - Florianópolis (SC), Brazil
| | - Wilson Salgado Júnior
- Universidade de São Paulo, Department of Surgery and Anatomy - Ribeirão Preto (SP), Brazil
| | | | | | - Lyz Bezerra Silva
- University College London Hospital NHS Foundation Trust, Department of Bariatric and Metabolic Surgery, London - United Kingdom
| | | | - Luca Schiliró Tristão
- Lusíada Centro Universitário, Department of Evidence Based Medicine - Santos (SP), Brazil
| | | | - Wanderley Marques Bernardo
- Universidade de São Paulo, Faculty of Medicine, Department of Evidence Based Medicine - São Paulo (SP), Brazil
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Oliveira CR, Santos-Sousa H, Costa MP, Amorim-Cruz F, Bouça-Machado R, Nogueiro J, Resende F, Costa-Pinho A, Preto J, Lima-da-Costa E, Carneiro S, Sousa-Pinto B. Efficiency and safety of single anastomosis sleeve ileal (SASI) bypass in the treatment of obesity and associated comorbidities: a systematic review and meta-analysis. Langenbecks Arch Surg 2024; 409:221. [PMID: 39023536 PMCID: PMC11258063 DOI: 10.1007/s00423-024-03413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION The Single Anastomosis Sleeve Ileal (SASI) bypass is a new bariatric surgery corresponding to an adaptation of the Santoro approach, consisting of a sleeve gastrectomy (SG) followed by loop gastroileostomy. Therefore, we aimed to systematically assess all the current literature on SASI bypass in terms of safety, weight loss, improvement in associated comorbidities, and complications. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) recommendations, we conducted a systematic review and meta-analysis by searching three databases (PubMed, Scopus, and Web of Science). We performed a meta-analysis of risk ratios and mean differences to compare surgical approaches for excessive weight loss, improvement/remission in type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DL), obstructive sleep apnea (OSA), and complications. Heterogeneity was assessed using the I2 statistic. RESULTS Eighteen studies were included in the qualitative analysis and four in the quantitative analysis, comparing SASI bypass with SG and One-Anastomosis Gastric Bypass (OAGB). A comparison between Roux-en-Y Gastric Bypass (RYGB) and SASI bypass could not be performed. Compared to SG, the SASI bypass was associated with improved weight loss (MD = 11.32; 95% confidence interval (95%CI) [7.89;14.76]; p < 0.0001), and improvement or remission in T2DM (RR = 1.35; 95%CI [1.07;1.69]; p = 0.011), DL (RR = 1.41; 95%CI [1.00;1.99]; p = 0.048) and OSA (RR = 1.50; 95%CI [1.01;2.22]; p = 0.042). No statistically significant differences in any of the assessed outcomes were observed when compared with OAGB. When compared to both SG and OAGB, the complication rate of SASI was similar. CONCLUSION Although studies with longer follow-up periods are needed, this systematic review and meta-analysis showed that SASI bypass has a significant effect on weight loss and metabolic variables. Variations in outcomes between studies reinforce the need for standardization.
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Affiliation(s)
| | - Hugo Santos-Sousa
- Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal.
- Obesity Integrated Responsibility Unit (CRI-O), São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200- 319, Portugal.
| | - Maria Pinho Costa
- Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Filipe Amorim-Cruz
- São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Raquel Bouça-Machado
- Instituto de Medicina Molecular João Lobo Antunes, Edifício Egas Moniz, Avenida Professor Egas Moniz, Lisbon, Lisboa, 1649-028, Portugal
| | - Jorge Nogueiro
- Surgery Department, São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Fernando Resende
- Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal
- Obesity Integrated Responsibility Unit (CRI-O), São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200- 319, Portugal
| | - André Costa-Pinho
- Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal
- Obesity Integrated Responsibility Unit (CRI-O), São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200- 319, Portugal
| | - John Preto
- Obesity Integrated Responsibility Unit (CRI-O), São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200- 319, Portugal
| | - Eduardo Lima-da-Costa
- Obesity Integrated Responsibility Unit (CRI-O), São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200- 319, Portugal
| | - Silvestre Carneiro
- Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal
- Surgery Department, São João University Medical Center, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
| | - Bernardo Sousa-Pinto
- Faculty of Medicine, University of Porto - Alameda Prof.Hernâni Monteiro, Porto, 4200-319, Portugal
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, Rua Dr. Plácido da Costa, Porto, 4200-450, Portugal
- CINTESIS - Center for Health Technologies and Services Research, University of Porto, Rua Dr. Plácido da Costa, Porto, 4200-450, Portugal
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Si Y, Lin S, Guan W, Shen J, Liang H. Comparison of Sleeve Gastrectomy with Loop Duodenojejunal Bypass Versus One Anastomosis Gastric Bypass for Type 2 Diabetes: The Role of Pylorus Preservation. Obes Surg 2024; 34:2391-2398. [PMID: 38780835 DOI: 10.1007/s11695-024-07294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND One anastomosis gastric bypass (OAGB) is recognized as a standard procedure in metabolic surgery. However, concerns about postoperative bile reflux and nutritional risks are prevalent. Comparatively, sleeve gastrectomy with loop duodenojejunal bypass (SG + LoopDJB) bypasses an equivalent length of the foregut as OAGB while maintaining pyloric function. The role of pylorus function remains to be further elucidated regarding these metabolic procedures' therapeutic outcomes and side effects. METHOD A retrospective study was conducted in our center to compare the surgical safety and 1-year outcomes of OAGB and SG + LoopDJB regarding type 2 diabetes mellitus (T2DM) remission, weight loss, gastrointestinal disorders, and nutritional status in T2DM patients matched by gender, age, and BMI. RESULTS The baseline characteristics were comparable between groups. Compared with OAGB, SG + LoopDJB had longer operative time and length of stay (LOS) but similar major postoperative complications. At 1-year follow-up, OAGB has similar diabetes remission (both 91.9%), weight loss effect (28.1 ± 7.1% vs. 30.2 ± 7.0% for %TWL), and lipidemia improvement to SG + LoopDJB (P > 0.05). However, OAGB presented a higher incidence of hypoalbuminemia (11.9% vs. 2.4%, P = 0.026) but a low incidence of gastroesophageal reflux disease (GERD) symptoms (9.5% vs. 26.2%, P = 0.046) than SG + LoopDJB. There was no statistical difference regarding other gastrointestinal disorders and nutritional deficiencies between groups. CONCLUSION Both OAGB and SG + LoopDJB show comparable, favorable outcomes in weight loss, T2DM remission, and lipidemia improvement at the 1-year follow-up. Pylorus preservation, while increasing surgical difficulty and the risk of de novo GERD, may reduce the risk of postoperative hypoalbuminemia.
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Affiliation(s)
- Yiming Si
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Shibo Lin
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Wei Guan
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - JiaJia Shen
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Hui Liang
- Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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Ivano VK, Hatto M, Teramoto F, Macedo PRAD, Gestic MA, Utrini MP, Chaim FDM, Ramos AC, Callejas-Neto F, Chaim EA, Cazzo E. Effects of bariatric surgery on renal function: a retrospective cohort study comparing one-year outcomes between one-anastomosis gastric bypass and Roux-en-Y gastric bypass. SAO PAULO MED J 2024; 142:e2023161. [PMID: 38836818 DOI: 10.1590/1516-3180.2023.0161.r1.08022024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 02/08/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Evidence on the effect of one-anastomosis gastric bypass (OAGB) on renal function is limited. OBJECTIVE To compare the evolution of estimated renal function observed 1 year after OAGB and Roux-en-Y gastric bypass (RYGB) in individuals with obesity. DESIGN AND SETTING Observational, analytical, and retrospective cohort study. Tertiary-level university hospital. METHODS This study used a prospectively collected database of individuals who consecutively underwent bariatric surgery. Renal function was assessed by calculating the estimated glomerular filtration rate (eGFR), according to the Chronic Kidney Disease Epidemiology Collaboration. The one-year variation in the eGFR was compared between the procedures. RESULTS No significant differences in age, sex, obesity-associated conditions, or body mass index were observed among individuals who underwent either OAGB or RYGB. OAGB led to a significantly higher percentage of total (P = 0.007) and excess weight loss (P = 0.026). Both OAGB and RYGB led to significantly higher values of eGFR (103.9 ± 22 versus 116.1 ± 13.3; P = 0.007, and 102.4 ± 19 versus 113.2 ± 13.3; P < 0.001, respectively). The one-year variation in eGFR was 11 ± 16.2% after OAGB and 16.7 ± 26.3% after RYGB (P = 0.3). Younger age and lower baseline eGFR were independently associated with greater postoperative improvement in renal function (P < 0.001). CONCLUSION Compared with RYGB, OAGB led to an equivalent improvement in renal function 1 year after the procedure, along with greater weight loss.
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Affiliation(s)
- Victor Kenzo Ivano
- MD. Postgraduate Student, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Marcelo Hatto
- MD. Postgraduate Student, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Fernanda Teramoto
- MD. Medical Resident, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Paolla Ravida Alves de Macedo
- MD. Medical Resident, Department of Surgery School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Martinho Antonio Gestic
- MD, MSc. Assistant lecturer, Department of Surgery, School of Medical Sciences, Universidade State University of Campinas (UNICAMP), Campinas (SP), Brazil
| | - Murillo Pimentel Utrini
- MD. Assistant Lecturer, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Felipe David Mendonça Chaim
- MD, PhD. Assistant Lecturer, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Almino Cardoso Ramos
- MD, PhD. Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Francisco Callejas-Neto
- MD, MSc. Assistant Professor, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Elinton Adami Chaim
- MD, PhD. Full Professor, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Everton Cazzo
- MD, PhD. Associate Professor, Department of Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
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Kermansaravi M, Shahsavan M, Ebrahimi R, Mousavimaleki A, Gholizadeh B, Valizadeh R, ShahabiShahmiri S, Carbajo MA. Effect of anti-reflux suture on gastroesophageal reflux symptoms after one anastomosis gastric bypass: a randomized controlled trial. Surg Endosc 2024; 38:2562-2570. [PMID: 38499781 DOI: 10.1007/s00464-024-10792-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/09/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Gastroesophageal reflux disease (GERD) is an issue after one anastomosis gastric bypass (OAGB) and modification of OAGB with adding an anti-reflux system may decrease the incidence of postoperative GERD. This study aimed to compare the efficacy of the anti-reflux mechanism to treat preoperative GERD and prevent de novo GERD. METHODS A prospective randomized clinical trial study was conducted on patients with a body mass index of 40 and more from August 2020 to February 2022. Patients undergoing one anastomosis gastric bypass with and without anti-reflux sutures (groups A and B, respectively). These patients had follow-ups for one year after the surgery. GERD symptoms were assessed in all the patients using the GERD symptom questionnaire. RESULTS The mean age was 39.5 ± 9.8 years and 40.7 ± 10.2 years in groups A and B respectively. GERD symptoms remission occurred in 76.5% and 68.4% of patients in groups A and B, respectively. The incidence of de novo GERD symptoms was lower in group A, compared to group B (6.2% and 16.1% in groups A and B respectively), without any statistically significant difference (p-value: 0.239). CONCLUSION GERD symptoms and de novo GERD after OAGB seems to be under-reported after OAGB. This study suggests that applying an anti-reflux suture can decrease de novo GERD symptoms.
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Affiliation(s)
- Mohammad Kermansaravi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, School of Medicine, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran.
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran.
| | - Masoumeh Shahsavan
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ebrahimi
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, School of Medicine, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mousavimaleki
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, School of Medicine, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Barmak Gholizadeh
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, School of Medicine, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Shahab ShahabiShahmiri
- Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Minimally Invasive Surgery Research Center, School of Medicine, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran
| | - Miguel A Carbajo
- Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain
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Robert M, Poghosyan T, Maucort-Boulch D, Filippello A, Caiazzo R, Sterkers A, Khamphommala L, Reche F, Malherbe V, Torcivia A, Saber T, Delaunay D, Langlois-Jacques C, Suffisseau A, Bin S, Disse E, Pattou F. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass at 5 years (YOMEGA): a prospective, open-label, non-inferiority, randomised extension study. Lancet Diabetes Endocrinol 2024; 12:267-276. [PMID: 38452784 DOI: 10.1016/s2213-8587(24)00035-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/16/2024] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The multicentre randomised trial YOMEGA (NCT02139813) comparing the one anastomosis gastric bypass (OAGB) with the Roux-en-Y gastric bypass (RYGB) confirmed the non-inferiority of OAGB on weight loss outcomes at 24 months. We aimed to report weight loss, metabolic, and safety outcomes at 5 years. METHODS YOMEGA is a prospective, open-label, non-inferiority, randomised trial conducted at nine centres in France. Inclusion criteria were BMI of 40 kg/m2 or more, or 35 kg/m2 or more with comorbidities. Key exclusion criteria were severe gastro-oesophageal reflux disease or Barrett's oesophagus and previous bariatric surgery. Patients were randomly assigned (1 :1) to OAGB (one gastrojejunal anastomosis with a 200 cm biliopancreatic limb) or RYGB (with a 150 cm alimentary limb and a 50 cm biliary limb), stratified by centre, with blocks of variable size. The primary endpoint of this extension study was percentage excess BMI loss and was analysed in the per-protocol population, including patients with data who were operated on with the technique randomly assigned to them and excluding patients with major deviations from the protocol during the follow-up (change of surgical technique, death, or withdrawal of consent). Non-inferiority was concluded for the primary endpoint if the upper bound of the CI was less than the non-inferiority limit (7 percentage points). YOMEGA is registered with ClinicalTrials.gov, NCT02139813, and the 5-year follow-up of YOMEGA is registered with ClinicalTrials.gov, NCT05549271. FINDINGS Between May 13, 2014, and March 2, 2016, 253 patients were randomly assigned to OAGB (n=129) or RYGB (n=124), and from these patients 114 in the OAGB group and 118 in the RYGB group were included in the per-protocol analysis. In the per-protocol population, at baseline, mean age was 43·0 years (SD 10·8), mean BMI was 44·0 kg/m2 (5·6), 54 (23%) patients were male and 178 (77%) were female; 55 (27%) of 207 patients had type 2 diabetes. After 5 years, mean percentage excess BMI loss was -75·6% (SD 28·1) in the OAGB group versus -71·4% (SD 29·8) in the RYGB group, confirming non-inferiority (mean difference -4·1% [90% CI -12·0 to 3·7], p=0·0099). Remission of type 2 diabetes was similar in both groups. Nutritional status did not differ; the most common adverse event was clinical gastro-oesophageal reflux disease, occurring in 27 (41%) of 66 patients in the OAGB group versus 14 (18%) of 76 patients in the RYGB group (p=0·0030). Among serious adverse events, ten (8%) of 127 patients converted from OAGB to RYGB. 171 (68%) of 253 patients were followed up. INTERPRETATION OAGB was not inferior to RYGB regarding percentage excess BMI loss at 5 years with similar metabolic outcomes. The high rate of clinical gastro-oesophageal reflux disease after OAGB raises questions about its long-term consequences, which need to be further investigated. FUNDING Medtronic.
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Affiliation(s)
- Maud Robert
- Department of Digestive and Bariatric Surgery, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France; CarMeN Laboratory INSERM Unit 1060, Lyon 1 University, Lyon, France.
| | - Tigran Poghosyan
- Digestive, Esogastric, and Bariatric Surgery Department, Hôpital Bichat-Claude Bernard, Université Paris Cité, UMRS-INSERM1149, Paris, France
| | - Delphine Maucort-Boulch
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Université Lyon1, Lyon, France
| | | | - Robert Caiazzo
- General and Endocrine Surgery, Université de Lille, Inserm U1190, Centre Hospitalier et Universitaire de Lille, Institut Pasteur de Lille, Lille, France
| | - Adrien Sterkers
- Department of Digestive, Hepatobiliary Surgery, Centre Hospitalier Privé Saint Grégoire, Saint Gregoire, France
| | - Lita Khamphommala
- Department of Digestive, Hepatobiliary Surgery, Centre Hospitalier Privé Saint Grégoire, Saint Gregoire, France
| | - Fabian Reche
- Digestive Surgery Department, CHU Grenoble, Grenoble, France
| | - Vincent Malherbe
- General and Endocrine Surgery Department, Hôpital Privé Drôme et Ardèche, Guilherand-Granges, France
| | - Adriana Torcivia
- Department of Digestive, Hepatobiliary Surgery, Hôpital Pitié Salpétrière, Paris, France
| | - Toufic Saber
- Department of General Surgery, Lebanese American Medical Center, Saint John Hospital, Beyrouth, Lebanon
| | - Dominique Delaunay
- Department of Digestive and Bariatric Surgery, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Carole Langlois-Jacques
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Université Lyon1, Lyon, France
| | - Augustin Suffisseau
- Digestive, Esogastric, and Bariatric Surgery Department, Hôpital Bichat-Claude Bernard, Université Paris Cité, UMRS-INSERM1149, Paris, France
| | - Sylvie Bin
- Clinical Research Unit, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Disse
- CarMeN Laboratory INSERM Unit 1060, Lyon 1 University, Lyon, France; Department of Endocrinology, Diabetology and Nutrition, Specialized Center for Obesity Management, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Benite, France
| | - François Pattou
- General and Endocrine Surgery, Université de Lille, Inserm U1190, Centre Hospitalier et Universitaire de Lille, Institut Pasteur de Lille, Lille, France
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Stefura T, Mulek R, Krefft M, Wysocki M, Zając M, Rusinek J, Wierdak M, Pędziwiatr M, Major P. Comparison of revisional surgeries after OAGB versus RYGB: Results from the multicenter Polish Revision Obesity Surgery Study (PROSS). POLISH JOURNAL OF SURGERY 2024; 96:63-68. [PMID: 38940250 DOI: 10.5604/01.3001.0054.2678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
<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>.
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Affiliation(s)
- Tomasz Stefura
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland, Malopolska Burn and Plastic Centre, Ludwik Rydygier's Specialist Hospital in Krakow, Poland
| | - Rafał Mulek
- EuroMediCare Specialist Hospital and Clinic, Wroclaw, Poland
| | - Michał Krefft
- EuroMediCare Specialist Hospital and Clinic, Wroclaw, Poland
| | - Michał Wysocki
- Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital in Krakow, Krakow, Poland
| | - Maciej Zając
- Students' Scientific Group at the II Department of Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Jakub Rusinek
- Students' Scientific Group at the II Department of Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Wierdak
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Michał Pędziwiatr
- 2nd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland
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Nakanishi H, Mosleh KA, Al-Kordi M, Farsi S, Chaudhry S, Marrero K, Scott Davis S, Kermansaravi M, Parmar C, Clapp B, Ghanem OM. One Anastomosis Gastric Bypass as Revisional Surgery Following Sleeve Gastrectomy: A Systematic Review and Meta-Analysis. Obes Surg 2024; 34:429-441. [PMID: 38198098 DOI: 10.1007/s11695-024-07056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Although sleeve gastrectomy (SG) is the most performed metabolic and bariatric surgery (MBS) worldwide, some patients require conversional procedures due to weight recurrence or late complications. Recently, one-anastomosis gastric bypass (OAGB) gained popularity as a viable option to address those problems. The aim of this meta-analysis is to assess the safety and efficacy of conversional OAGB after primary SG in the management of patients with obesity. METHODS Cochrane, Embase, PubMed, Scopus, and Web of Science were searched for articles from their inception to February 2023 by two independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42023403528). RESULTS From 1,117 studies screened, twenty studies met the eligibility criteria, with a total of 1,057 patients with obesity undergoing conversional OAGB after primary SG. The mean age ranged from 28.2 to 49.5 years, and 744 patients (75.2%) were women. At one year after revisional OAGB, the pooled mean percent excess weight loss (%EWL) was 65.2% (95%CI: 56.9, 73.4, I2 = 97%). The pooled mean %EWL after conversional OAGB was 71.1% (95%CI: 62.2, 80.0, I2 = 90%) at two years and 71.6% (95%CI: 61.0, 82.2, I2 = 50%) at five years. Additionally, resolution rates of diabetes and hypertension were 65.4% (95%CI: 0.522, 0.785, I2 = 65%) and 58.9% (95%CI: 0.415, 0.762, I2 = 89%), respectively. CONCLUSIONS Our meta-analysis demonstrated OAGB as an effective conversional procedure after primary SG in terms of weight loss and obesity-associated medical problems for selected patients. Despite the promising results, further randomized controlled studies with larger sample sizes and more extended follow-up periods are necessary to determine if the OAGB is the best conversional surgery after SG.
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Affiliation(s)
- Hayato Nakanishi
- St George's University of London, London, SW17 0RE, UK
- University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus
| | | | | | - Soroush Farsi
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Shahrukh Chaudhry
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Katie Marrero
- Carle Foundation Hospital General Surgery Residency, Champaign, IL, USA
| | - S Scott Davis
- Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-e Rasool Hospital, Tehran, Iran
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital NHS Trust, London, UK
- University College London, London, UK
| | - Benjamin Clapp
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, USA
| | - Omar M Ghanem
- Department of Surgery, Mayo Clinic, Rochester, MN, USA.
- Division of Metabolic and Abdominal Wall Reconstructive Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
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Karagul S, Senol S, Karakose O, Uzunoglu K, Kayaalp C. One Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass: A Randomized Prospective Trial. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:256. [PMID: 38399543 PMCID: PMC10890302 DOI: 10.3390/medicina60020256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/21/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: One anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) surgeries are effective methods used in bariatric surgery. There are limited randomized studies comparing these procedures over more than 2 years. Here, we aimed to compare the 3-year results of two bariatric procedures. Materials and Methods: Patients included in this randomized prospective study were compared in OAGB and RYGB groups. A total of 55 patients, aged between 18 and 65, were eligible for the study. Thirteen patients who did not accept randomization were excluded. Patients were evaluated at 6, 12, 24, and 36 months postoperatively. Results: Three patients were excluded from the study due to loss of communication during the clinical follow-up and one due to death by amyotrophic lateral sclerosis, which started in the eighth month after surgery. The study was completed with a total of 38 patients (OAGB; n = 20, RYGB; n = 18). Patients in the two groups were similar in terms of age, gender, body mass index (BMI), and obesity-related comorbidities. At the end of 3-year follow-up, BMI in the OAGB and RYGB groups was 28.80 ± 4.53 kg/m2 and 29.17 ± 5.36 kg/m2, respectively (p = 0.822). Percentage total weight loss (TWL%) was similar. No significant differences were found between the groups regarding percentage excess weight loss (EWL%). Remission of comorbidities was similar. De novo refluxes developed in four OAGB patients; there were no occurrences of these in RYGB patients (p = 0.066). Conclusions: Both OAGB and RYGB are effective in the treatment of morbid obesity. The two procedures are similarly successful in terms of obesity-related comorbidities.
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Affiliation(s)
- Servet Karagul
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Serdar Senol
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Oktay Karakose
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Kevser Uzunoglu
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Cuneyt Kayaalp
- Private Clinic of Gastroenterological Surgery, 34363 Istanbul, Turkey;
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11
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Petrucciani N, Silecchia G. Is one anastomosis better than two in laparoscopic primary gastric bypass surgery? Minerva Surg 2024; 79:4-6. [PMID: 37539673 DOI: 10.23736/s2724-5691.23.10037-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- Niccolò Petrucciani
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, Rome, Italy -
| | - Gianfranco Silecchia
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University, Rome, Italy
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12
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Yu J, Zhang H, Liu Q, Li H, Wu L, Qi T, Song Z, Huang H, He J, Ding Y. New Mouse Models of Roux-en Y Gastric Bypass and One Anastomosis Gastric Bypass for Type 2 Diabetes. Obes Surg 2023; 33:3163-3176. [PMID: 37635165 DOI: 10.1007/s11695-023-06768-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/25/2023] [Accepted: 07/25/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Current bariatric surgery models primarily utilize mice with obesity, overlooking those with type 2 diabetes (T2DM). These models have limitations in replicating clinical procedures accurately and achieving broad applicability. This study aimed to develop novel mouse models of Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) surgeries specifically designed for T2DM research, utilizing simplified surgical techniques closely resembling clinical procedures. METHODS Eight-week-old C57/Bl6 mice, except for the Blank-Control group, were induced with T2DM by combining a high-fat diet and streptozotocin injection. RYGB involved creating a 10% gastric pouch, a 4-cm biliopancreatic limb (BL), and a 4-cm Roux limb (RL). Similarly, OAGB maintained a 10% gastric pouch and a 4-cm BL. To assess the efficacy of these models, we measured the body weight and fasting blood glucose (FBG) and conducted intraperitoneal glucose tolerance test (IPGTT), insulin tolerance test (ITT), and liver B-ultrasound, as well as a histopathological analysis of multiple organs 12 weeks post-operation. RESULTS The survival rates in the Blank-Control, T2DM-Sham, T2DM-RYGB, and T2DM-OAGB groups were 100% (6/6), 100% (6/6), 85.7% (6/7), and 100% (6/6), respectively. Both RYGB and OAGB surgeries similarly led to sustained weight loss, reduced the FBG levels, improved the IPGTT and ITT results, and alleviated the histopathological manifestations in multiple organs. CONCLUSION The innovative mouse models of RYGB and OAGB surgeries effectively improve T2DM. Both surgeries demonstrate comparable efficacy in ameliorating T2DM, even when utilizing a gastric pouch of the same size and the same length of BL in OAGB.
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Affiliation(s)
- Jinlong Yu
- Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510280, People's Republic of China.
| | - Hongbin Zhang
- Southern Medical University School of Laboratory Medicine and Biotechnology, Guangzhou, Guangdong Province, 510280, People's Republic of China.
- Department of Basic Medical Research, General Hospital of Southern Theater Command of PLA, Guangzhou, Guangdong Province, 510280, People's Republic of China.
| | - Qing Liu
- Department of General Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510280, People's Republic of China
| | - Heng Li
- Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510282, People's Republic of China
| | - Liangping Wu
- Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510282, People's Republic of China
| | - Tengfei Qi
- Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510282, People's Republic of China
| | - Zhigao Song
- Department of Cardiovascular Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510280, People's Republic of China
| | - Hongyan Huang
- Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510282, People's Republic of China
| | - Jipei He
- Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510282, People's Republic of China
| | - Yunfa Ding
- Surgical Center for Obesity and Diabetes, Jinshazhou Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510282, People's Republic of China
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Dowgiałło-Gornowicz N, Jaworski P, Walędziak M, Lech P, Kucharska A, Major P. Predictors of complete remission of type 2 diabetes in patients over 65 years of age - a multicenter study. Obes Surg 2023; 33:2269-2275. [PMID: 37402119 PMCID: PMC10345030 DOI: 10.1007/s11695-023-06705-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION The type 2 diabetes (T2D) improvement rate in the elderly is high after bariatric and metabolic surgery, but not all patients achieve complete remission of disease. There are some predictors for T2D remission after bariatric surgery in patients of different ages, but there are few studies describing these factors in elderly patients. The study aimed to determine predictors for diabetes remission after bariatric surgery among patients over 65 years of age. MATERIAL AND METHODS A retrospective study analyzed patients over 65 years with T2D who underwent laparoscopic bariatric procedures in European country from 2008 to 2022. Multivariate logistic regression analysis was performed to obtain significant, independent risk factors. RESULTS The group consisted of 146 patients divided into two groups: responders (R) and nonresponders (NR). The complete remission of T2D was achieved in 51 (34.9%) patients. There were 95 (65.1%) patients in the NR group with partial remission, improvement, or no changes in T2D. The mean follow-up was 50.0 months. In a multivariate logistic regression analysis, a T2D duration of less than 5 years was found to be a predictor to T2D remission (OR = 5.5, p = 0.002), %EWL significantly corresponded to T2D remission (OR = 1.090, p = 0009). CONCLUSION Bariatric and metabolic surgery appears to be a good option for T2D treatment in elderly patients. A shorter duration of T2D before surgery and higher %EWL after surgery were independent predictors of T2D remission in patients over 65 years of age.
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Affiliation(s)
- Natalia Dowgiałło-Gornowicz
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045, Olsztyn, Poland.
| | - Paweł Jaworski
- Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, 00-416, Warsaw, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, 04-141, Warsaw, Poland
| | - Paweł Lech
- Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045, Olsztyn, Poland
| | - Alicja Kucharska
- Department of General Surgery, Pro-Medica Hospital, 19-300, Ełk, Poland
| | - Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College, 30-688, Cracow, Poland
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