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Does One-Anastomosis Gastric Bypass Provide Better Outcomes Than Sleeve Gastrectomy in Patients With Bmi Greater Than 50? a Systematic Review and Meta-Analysis Publisher Pubmed



Barzin M1 ; Ebadinejad A1 ; Aminian A2 ; Khalaj A3 ; Ghazy F1 ; Koohi F1 ; Hosseinpanah F1 ; Ramezani Ahmadi A4 ; Valizadeh M1 ; Abiri B1
Authors
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Authors Affiliations
  1. 1. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of General Surgery, Bariatric and Metabolic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States
  3. 3. Department of Surgery, Tehran Obesity Treatment Center, Faculty of Medicine, Shahed University, Tehran, Iran
  4. 4. Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: International journal of surgery (London, England) Published:2023


Abstract

In patients with BMI greater than 50, sleeve gastrectomy (SG) may not be adequate to treat obesity. To determine whether one-anastomosis gastric bypass (OAGB) can provide better outcomes compared with SG in patients with BMI greater than 50, a systematic review and meta-analysis was conducted, including a total of nine retrospective studies with a total of 2332 participants. There was a significant difference in the percentage of excess weight loss [weighted mean difference (WMD): 8.52; 95% CI: 5.81-11.22; P<0.001) and percentage of total weight loss (WMD: 6.65; 95% CI: 5.05-8.24; P<0.001). No significant differences were seen in operative time (WMD: 1.91; 95% CI: -11.24 to 15.07; P=0.77) and length of stay in hospital (WMD: -0.41; 95% CI: -1.18 to 0.37; P=0.30) between the two groups. There were no significant differences between OAGB with SG in Clavien-Dindo grades I-III [odds ratio (OR): 1.56; 95% CI: 0.80-3.05], or grade IV complications (OR: 0.72; 95% CI: 0.18-2.94). The meta-analysis on remission of type 2 diabetes indicated a comparable effect between SG and OAGB (OR: 0.77; 95% CI: 0.28-2.16). The OAGB group had a significantly higher rate of remission of hypertension compared with the SG group (OR: 1.63; 95% CI: 1.06-2.50). The findings of this meta-analysis suggest that the OAGB accomplished a higher percentage of total weight loss and percentage of excess weight loss at short-term and mid-term follow-up but, there was no major difference between the OAGB and SG operations in terms of perioperative outcomes, complications, and diabetes remission. Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
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