Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass. Sci Rep. 2021;11:4421. [PMID: 33627710 DOI: 10.1038/s41598-021-83807-8]

Short-Term Weight Loss Outcomes of 104 Mini-Gastric Bypass or One-Anastomosis Gastric Bypass Operations: Retrospective study

Objectives

This study aimed to examine the short-term effects of mini-gastric bypass (MGB) or one-anastomosis gastric bypass (OAGB) procedures on weight loss in individuals with obesity.

Methods

This retrospective study was conducted in Medicano Hospital, Erbil, Iraq, from January 2019 to May 2020. Preoperative body mass index (BMI), age, height and preoperative weight were recorded as baseline measures. Weight-related changes were evaluated during a follow-up phase of 48 weeks.

Results

A total of 104 patients with obesity underwent MGB or OAGB surgery. The mean baseline parameters of the subjects before surgery included 1.64 m for height, 122.9 kg for weight and 45.6 kg/m2 for BMI. During the 48-week follow-up period, there was a substantial reduction in mean weight, which dropped from 122.9 kg at baseline to 75.5 kg at week 48. The weight change (in percentage) gradually increased from -11.8% at week 12 to -37.9% at week 48, without statistically significant association with demographic factors or chronic diseases. From week 12 to week 48, the percentage of excess weight loss (%EWL) increased substantially from 26.8% to 86.1%. The results of the subgroup analysis indicated that the %EWL was considerably higher among those aged 30 or older at week 36 and singles at week 48.

Conclusion

This study's results illustrate the efficacy of MGB or OAGB procedures in significantly reducing weight in the short term. The %EWL increased with the follow-up time and was significantly associated with age and marital status.

A Comprehensive Review of the Literature: Does an Optimal Type of Anastomosis Exist for One Anastomosis Gastric Bypass?

One anastomosis gastric bypass (OAGB) is a popular bariatric procedure known for its efficacy in promoting weight loss and improving metabolic outcomes. However, the optimal anastomotic technique for OAGB remains a subject of debate. This literature review comprehensively examines the three primary anastomotic techniques - linear stapled, circular stapled, and hand-sewn - to determine their suitability for OAGB. Linear stapled anastomosis is favored for its shorter operative time and lower complication rates, such as a reduced incidence of gastrojejunal stenosis. However, its larger anastomotic diameter increases the risk of marginal ulcers due to greater exposure of the gastric mucosa to bile and gastric acids. Circular stapled anastomosis offers a uniform and consistent lumen, which may reduce the risk of postoperative stenosis but is associated with a higher incidence of strictures and ulcers, making it less ideal for use in OAGB. Hand-sewn anastomosis, while time-intensive, provides superior control over anastomotic size and tension, resulting in the lowest rates of strictures and anastomotic leaks, although its effectiveness is highly dependent on surgical expertise. Overall, the current literature lacks large-scale, multicenter studies directly comparing these techniques in the context of OAGB. Future research should focus on randomized controlled trials to establish the most effective and safe anastomotic method for this procedure. Understanding the nuanced benefits and drawbacks of each technique is crucial for optimizing clinical outcomes in OAGB.

Assessment of weight change patterns following Roux en Y gastric bypass, one anastomosis gastric bypass and sleeve gastrectomy using change-point analysis

We aimed to assess the weight loss trend following Roux en Y Gastric Bypass (RYGB), One Anastomosis Gastric Bypass (OAGB), and Sleeve Gastrectomy (SG), utilizing a change-point analysis. A retrospective cohort study was conducted on 8640 patients, from 2009 to 2023. The follow-up period extended to 7 years, with a median follow-up of 3 years (interquartile range: 1.4-5). Following metabolic bariatric surgery, four weight loss phases (three change points) were observed. The primary, secondary, and tertiary phases, transitioned at 12.64-13.73 days, 4.2-4.8 months, and 11.3-13.1 months post-operation, respectively, varying based on the type of procedure. The weight loss rate decreased following each phase and plateaued after the tertiary phase. The nadir weight was achieved 11.3-13.1 months post-procedure. There was no significant difference in the %TWL between males and females, however, males achieved their nadir weight significantly earlier. Half of the maximum %TWL was achieved within the first 5 months, with the greatest reduction rate in the first 2 weeks. Our findings inform healthcare providers of the optimal timing for maximum weight loss following each surgical method and underscore the importance of close patient monitoring in the early postoperative period.

Effect of different bariatric surgery methods on metabolic syndrome in patients with severe obesity

Bariatric surgery (BS) has been as a currently developed treatment of choice for metabolic syndrome (MetS). Which, in turn, is well-known as serious public health concern. Therefore, this study assessed the outcomes of different procedures of BS and possible predictors for improving MetS. This single-center retrospective cohort analysis included bariatric candidates between 2009 and 2017. The operational approach was chosen based on the patient's condition, as well as the patient's metabolic profile and the surgeon's experience. All desired information was evaluated at baseline and 6, 12, and 24 months after the operation. Of the 1111 patients included, 918 (82.6%) were female. There was no considerable trend in the improvement of MetS over the follow-up period of each surgery group. After 6 to 24 months of follow-up, waist circumference reduction was significant in all three types of surgery, and sleeve gastrectomy resulted in the best (but not significant) improvement rates after 24 months (P = 0.079). One anastomosis gastric bypass had highest decrease in percentage of excess weight loss than other procedures (P < 0.001). Each year increase in age was associated with a 4% decrease in MetS remission. In addition, the male gender, was correlated with MetS improvement positively (P = 0.049). Each one-unit increase in hemoglobin A1c (HbA1c) reduced the MetS remission rate by 40%. All three methods of BS were similarly effective in MetS. Consider the predictive value of age, gender, and HbA1c before determining the optimum procedure for each patient is recommended.

One Anastomosis Gastric Bypass vs. Sleeve Gastrectomy in the Remission of Type 2 Diabetes Mellitus: A Retrospective Analysis on 3 Years of Follow-Up

Background. Obesity is a prevalent condition associated with various comorbidities, impacting mortality, fertility, and quality of life. Its relationship with type 2 diabetes mellitus (DMII) is well established, with nearly 44% prevalence. Bariatric surgery has proven crucial for treating both obesity and DMII. The comparison between surgical techniques, such as sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB), remains controversial in terms of glycemic control efficacy. This retrospective study aimed to assess DMII remission efficacy between SG and OAGB after 36 months. Methods. From January 2016 to September 2020, 201 patients who underwent SG and OAGB for morbid obesity associated with DMII were accurately followed-up with for 36 months, focusing on %HbA1c, DMII remission, anthropometric results, and nutrient deficiency. Results. Although DMII remission did not exhibit statistical significance between the groups (82% vs. 93%, SG vs. OAGB, p = 0.051), OAGB demonstrated a more robust association with glycemic control (Odds Ratio 0.51) throughout the entire follow-up and yielded superior anthropometric outcomes. Notably, nutrient deficiencies, excluding cholecalciferol, iron, and riboflavin, did not show significant intergroup differences. Conclusions. This study contributes valuable insights into the extended-term efficacy of SG and OAGB in DMII remission. The nuanced findings underscore the multifaceted nature of metabolic outcomes, suggesting that factors beyond weight loss influence diabetes resolution. Larger comparative studies are warranted to comprehensively address this issue.

Bariatric surgery trends and progress in Taiwan: 2010-2021

INTRODUCTION

Taiwan is a leading country regarding bariatric surgery in Asia-Pacific. Since 2010, the Taiwan Society for Metabolic and Bariatric Surgery (TSMBS) has been accountable for the national evolution of bariatric surgery and inaugurated a national database accordingly. This study aimed to analyze the bariatric surgery trends and progress in Taiwan from 2010 to 2021.

MATERIALS AND METHODS

The TSMBS database was collected on the basis of structured inquiries filled out by bariatric surgeons in Taiwan. All patients involving bariatric surgery were included. The data were stratified with the following objectives, including the types of bariatric procedures, demographic characteristics, and perioperative variables. A nationwide database was comprehensively analyzed and evaluated to determine the trends in the applications of the procedure.

RESULTS

Data of 30,026 patients were enrolled. A 2.5-fold increase was observed in bariatric procedures, from 1218 in 2010 to 3005 in 2021. Within 12 years, female accounts for 61.8 %. The revisional rate was 3.40 % during the exploration stage (2010-2013), 2.77 % during the maturity stage (2013-2018), and 5.10 % during the expansion stage (2019-2021). The top five of primary bariatric surgery is sleeve gastrectomy (SG, 63.05 %), gastric clipping surgery (GC, 11.17 %), Roux-en-Y gastric bypass (RYGB, 9.34 %), one anastomosis gastric bypass (OAGB, 8.80 %), and sleeve plus surgery (SG plus, 4.43 %).

CONCLUSION

The trends and progress of Taiwan's bariatric surgery within recent decades are presented in this article. Taiwan's bariatric surgery case number has increased steadily from 2010 to 2021. Amongst all, SG has become the most dominant procedure since 2011 while OAGB takes up second place in 2020.