Roux-en-Y Versus One Anastomosis Gastric Bypass as Redo-Operations Following Sleeve Gastrectomy: A Retrospective Study
Corresponding Author
Karl Peter Rheinwalt
Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital Cologne, Schoensteinstr. 63, 50825 Cologne, Germany
[email protected]Search for more papers by this authorSandra Schipper
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH University Clinic and Helmholtz Institute for Biomedical Engineering, 52074 Aachen, Germany
Search for more papers by this authorAndreas Plamper
Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital Cologne, Schoensteinstr. 63, 50825 Cologne, Germany
Search for more papers by this authorPatrick Hamid Alizai
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorJonel Trebicka
Translational Hepatology, Department of Internal Medicine I, University Clinic Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
Search for more papers by this authorMaximilian Joseph Brol
Translational Hepatology, Department of Internal Medicine I, University Clinic Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
Search for more papers by this authorAndreas Kroh
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorSophia Schmitz
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorChetan Parmar
Department of Surgery, Whittington Health NHS Trust, N19 5NF London, UK
Search for more papers by this authorUlf Peter Neumann
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorTom Florian Ulmer
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorCorresponding Author
Karl Peter Rheinwalt
Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital Cologne, Schoensteinstr. 63, 50825 Cologne, Germany
[email protected]Search for more papers by this authorSandra Schipper
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH University Clinic and Helmholtz Institute for Biomedical Engineering, 52074 Aachen, Germany
Search for more papers by this authorAndreas Plamper
Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital Cologne, Schoensteinstr. 63, 50825 Cologne, Germany
Search for more papers by this authorPatrick Hamid Alizai
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorJonel Trebicka
Translational Hepatology, Department of Internal Medicine I, University Clinic Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
Search for more papers by this authorMaximilian Joseph Brol
Translational Hepatology, Department of Internal Medicine I, University Clinic Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
Search for more papers by this authorAndreas Kroh
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorSophia Schmitz
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorChetan Parmar
Department of Surgery, Whittington Health NHS Trust, N19 5NF London, UK
Search for more papers by this authorUlf Peter Neumann
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorTom Florian Ulmer
Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
Search for more papers by this authorKarl Peter Rheinwalt and Sandra Schipper have contributed equally to this work.
Abstract
Background
Aim of this study was to improve knowledge about the best conversional bariatric procedure following sleeve gastrectomy (SG).
Methods
Data of conversional Roux-en-Y gastric bypass (RYGB) and of one anastomosis gastric bypass (OAGB) after SG were collected prospectively and analyzed retrospectively. Weight loss parameters, gastroesophageal reflux disease (GERD) and comorbidities outcomes were recorded.
Results
Total of 123 patients (90 female, mean age 44 ± 0.9 years, mean body mass index (BMI) 42 ± 0.8 kg/m2) had either RYGB (n = 68) or OAGB (n = 55). Perioperative mortality was zero. Mean surgery time was significantly shorter for OAGB (168 ± 7.2 vs. 201 ± 6.8 min). Perioperative complication rates were not significantly (ns) different between RYGB and OAGB. Total body weight loss (TBWL) in RYGB and OAGB was 18 ± 2.2% and 18 ± 1.9% (12 months) and 18 ± 3.0% and 23 ± 2.6% (24 months; ns), respectively. Length of (individualized) biliopancreatic limb (BPL) correlated significantly with weight loss. Remission rates after 12 months of RYGB and OAGB for arterial hypertension (aHt) were 89% and 92%, for obstructive sleep apnea (OSAS) 56% and 82%, for Type 2 diabetes mellitus (T2DM) 100% and 92%, for osteoarthritis 64% and 85% and for GERD 89% versus 87% (ns), respectively. Nutritional deficiencies were comparable in RYGB (n = 11) and OAGB (n = 14) group (ns).
Conclusion
Both RYGB and OAGB are effective conversional procedures after SG, leading to comparable TBWL, BMI-loss and high remission rates of comorbidities including GERD. Significantly shorter operation times were in favor of OAGB. BPL, which was longer in OAGB was significantly related to higher %TBWL and %BMI-loss compared to RYGB.
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