Long-Term Outcomes of One-Anastomosis Gastric Bypass in Class IV and Class V Obesity: A Comparative Analysis with Sleeve Gastrectomy.

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Obesity Facts Pub Date : 2025-06-28 DOI:10.1159/000547167

Adi Litmanovich, Amit Netzer, Avner Leshem, Andrei Keidar, Shai Meron Eldar, Guy Lahat, Adam Abu-Abeid

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引用次数: 0

Abstract

Introduction: Metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity. However, the optimal approach for patients with a BMI ≥ 50 kg/m² remains unclear. This study compares the perioperative and long-term outcomes of one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) in this high-risk population.

Methods: A retrospective analysis of a prospectively maintained database was conducted, including all patients with BMI ≥ 50 kg/m² who underwent OAGB or SG at a tertiary center between 2015 and 2024. Patients with previous MBS were excluded. Baseline characteristics, perioperative complications, weight loss outcomes, and resolution of obesity-related diseases were analyzed.

Results: A total of 121 patients were included: 76 underwent SG, and 45 underwent OAGB. The mean preoperative BMI was higher, and the rate of men was lower in the SG group (55±5.4 vs. 52.2±2.7, p =0.0009 and 38.2% vs. 60%, p=0.024, respectively). 90-day postoperative complications did not differ between the groups (SG: 14.5% vs. OAGB: 11.1%, p = 0.78), nor did major complications rate (SG: 2.6% vs. OAGB: 0%, p = 0.53). One perioperative mortality was observed in the SG group (1.3%). At five-year follow-up, OAGB patients showed significantly greater total weight loss (36.7±11.3% vs. 27.1±13%, p=0.01). Conversion surgery trends were higher in SG (9.1% vs. 2.6%, p =0.13), primarily for weight regain. Obesity-related disease resolution rates were high and comparable between groups except for hypertension resolution which was higher in OAGB (p=0.04).

Conclusions: Both OAGB and SG are safe and effective for patients with BMI ≥ 50 kg/m². providing substantial weight loss and disease improvement. In this study, OAGB was associated with higher weight loss outcomes. Larger multi-institutional studies are needed to confirm these findings.

查看原文本刊更多论文

一次吻合胃旁路术治疗IV型和V型肥胖患者的远期疗效：与袖式胃切除术的比较分析。

简介：代谢和减肥手术（MBS）是治疗严重肥胖最有效的方法。然而，对于BMI≥50 kg/m²的患者，最佳方法仍不清楚。本研究比较了单吻合式胃旁路术（OAGB）和袖式胃切除术（SG）在这一高危人群中的围手术期和远期疗效。方法：回顾性分析前瞻性维护的数据库，包括2015年至2024年间在三级中心接受OAGB或SG治疗的BMI≥50 kg/m²的所有患者。既往MBS患者被排除在外。分析基线特征、围手术期并发症、减肥结果和肥胖相关疾病的解决。结果：共纳入121例患者，其中SG 76例，OAGB 45例。SG组患者术前BMI平均值较高，男性患病率较低（55±5.4比52.2±2.7,p= 0.0009； 38.2%比60%，p=0.024）。90天术后并发症组间无差异（SG: 14.5% vs OAGB: 11.1%, p = 0.78），主要并发症发生率组间无差异（SG: 2.6% vs OAGB: 0%, p = 0.53）。SG组围手术期死亡率为1例（1.3%）。在5年随访中，OAGB患者的总体重下降明显更大（36.7±11.3% vs. 27.1±13%,p=0.01）。SG患者的转换手术趋势更高（9.1% vs. 2.6%, p =0.13），主要是为了体重恢复。肥胖相关疾病的清除率很高，各组之间具有可比性，但高血压的清除率在OAGB组较高（p=0.04）。结论：对于BMI≥50 kg/m²的患者，OAGB和SG均安全有效。提供大量的体重减轻和疾病改善。在这项研究中，OAGB与更高的减肥结果相关。需要更大规模的多机构研究来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Facts 医学-内分泌学与代谢

CiteScore

6.80

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Obesity Facts'' publishes articles covering all aspects of obesity, in particular epidemiology, etiology and pathogenesis, treatment, and the prevention of adiposity. As obesity is related to many disease processes, the journal is also dedicated to all topics pertaining to comorbidity and covers psychological and sociocultural aspects as well as influences of nutrition and exercise on body weight. The editors carefully select papers to present only the most recent findings in clinical practice and research. All professionals concerned with obesity issues will find this journal a most valuable update to keep them abreast of the latest scientific developments.