Sitembile Lee, MS1, Chike Okolocha1, Aliu Sanni, MDFACS2. 1Philadelphia College of Osteopathic Medicine GA campus, 2Eastside Bariatric and General Surgery
Introduction: Roux-en-y gastric bypass (RYGB) is the most popular bariatric procedure performed worldwide, accounting for 45% of all bariatric procedures. However, in patients with a body mass index (BMI) ≥60 kg/m2 (super-super obese) the RYGB procedure can be technically challenging. This has led to the adoption of a single –stage treatment such as one anastomosis (mini) gastric bypass (OAGB/MGB) in the super-super obese patients. Proponents of the OAGB/MGB claim the clinical outcomes are comparable to the RYGB. The aim of this study is to compare the outcomes of the two procedures by examining the literature.
Methods: A systematic review was conducted through PubMed to identify relevant studies from 2001-2015 with comparative data on RYGB versus OAGB/MGB on super-super obese populations. The primary outcome was the percentage excess weight loss (%EWL). Other outcomes include operative times, complication rates and length of hospital stay. Results were expressed as standard difference in means with standard error. Statistical analysis was done using random-effects meta-analysis to compare the mean value of the two groups (Comprehensive Meta Analysis Version 3.3.070 software; Biostat Inc., Englewood, NJ).
Results: Five out of 203 studies were quantitatively assessed and included for meta-analysis. Among the 5 studies, 1003 patients underwent the OAGB/MGB and 916 underwent the RYGB. Patients in the OAGB/MGB group had a higher %EWL (0.502± 0.151, p = 0.001) when compared to the RYGB group. The operative times (-1.248 ± 0.054, p <0.05) and length of hospital stay (-0.106 ± 0.051, p = 0.039) were shorter in the OAGB/MGB patients when compared to the RYGB patients. Post- operative complication rates, early vs late, were similar in both groups (-0.031 ± 0.100, p = 0.759, 0.123 ± 0.288, p = 0.671) respectively.
Conclusion: OAGB/MGB is a safe and effective alternative to RYGB for surgical management of super-super obese patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86714
Program Number: P551
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster