一种吻合胃旁路手术的长期预后：5年及以上的系统回顾和荟萃分析。

IF 3.1 3区医学 Q1 SURGERY

Obesity Surgery Pub Date : 2025-10-15 DOI:10.1007/s11695-025-08339-w

Anuja Mitra, Amit Bhambri, Matyas Fehervari, Chetan Parmar

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引用次数: 0

摘要

背景：单吻合术胃旁路术（OAGB）已成为全球第三大减肥手术。尽管有短期疗效的证据，但长期结果仍未得到充分研究。方法：这项符合prisma标准的系统评价和荟萃分析评估了OAGB作为主要和修订手术的长期（≥5年）结局。系统地进行了质量评价和偏倚评价。结果：分析包括来自14个国家的32项研究，19125例患者（76%为原发性OAGB），平均随访6.7年。5年时，平均体重减轻75%，5年后增加到77%。肥胖相关疾病的解决是实质性的：2型糖尿病（80%），阻塞性睡眠呼吸暂停（89%）和高血压（61%）。并发症极少：胆汁反流（4%）、边缘溃疡（2%）和营养不良（1%）。对于修订后的OAGB， 5年的EWL为71%。据报道，在OAGB后，3%的患者转成其他减肥手术（所有RYGB）。结论：该分析证明了OAGB对持续体重减轻和肥胖相关疾病改善≥5年的有效性，支持其作为主要和修订的减肥干预措施在长期肥胖管理中的作用。

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Long-Term Outcomes of One Anastomosis Gastric Bypass: A Systematic Review and Meta-Analysis of 5-Year and Beyond.

Background: One-anastomosis gastric bypass (OAGB) has gained global prominence as the third most performed bariatric procedure. Despite evidence of short-term efficacy, long-term outcomes remain understudied.

Methods: This PRISMA-compliant systematic review and meta-analysis evaluated long-term (≥ 5 years) outcomes of OAGB as primary and revisional procedures. Quality assessment and bias evaluation were conducted systematically.

Results: Analysis included 32 studies with 19,125 patients (76% primary OAGB) from 14 countries with mean follow-up of 6.7 years. At five years, mean excess weight loss(EWL) was 75%, increasing to 77% beyond five years. Obesity associated diseases resolution was substantial: type 2 diabetes (80%), obstructive sleep apnea (89%), and hypertension (61%). Complications were minimal: bile reflux (4%), marginal ulceration (2%), and malnutrition (1%). For revisional OAGB, %EWL at five years was 71%. The conversion rate to other bariatric procedures (all RYGB) was reported in 3% of patients following OAGB.

Conclusion: This analysis demonstrates OAGB's effectiveness for sustained weight loss and obesity associated diseases improvement at ≥ 5 years, supporting its role in long-term obesity management as a primary and revisional bariatric intervention.

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.