Pawanindra Lal, MD, Anubhav Vindal, MD. Maulana Azad Medical College, New Delhi, India
INTRODUCTION: While Sleeve Gastrectomy (SG) has established itself as the commonest bariatric procedure, single anastomosis mini-gastric bypass (MGB) has become popular with claims of equivalent outcomes as with roux-en-Y gastric bypass (RYGB). Present study was done to compare the intra-operative and post-operative outcomes of MGB as compared to Sleeve Gastrectomy (SG) in the Indian population in a tertiary care teaching hospital.
MATERIAL & METHODS: Between January 2015 and July 2017, 46 patients underwent MGB (Group A – 22 cases) and Sleeve Gastrectomy (Group B- 24 cases) in a prospective study, including 5 super-obese patients in each group. Data of 40 patients (20 in each group at 30 months with a follow-up of 3-31 months in LSG and 12-24 months in MGB, was analyzed for peri-operative and post operative complications, weight loss achieved and resolution of co-morbidities.
RESULTS: Both groups were comparable for BMI at baseline [MGB = 45.39 kg/m2 (42.98-58.02) vs. SG = 43.67 kg/m2 (39.9-69.4) p = 0.657]. Mean operation time was significantly lower in SG 135.8 vs. 166.8 min, p < 0.01) but the mean hospital stay was significantly lower in the MGB (3.4 vs. 5.4 days, p < 0.001). Percentage EWL in SG group of 24 patients at 3 months was 42.22 (40.34-44.78) and in 20 patients at 30 months is 70.45 (68.34-72.43). In the MGB group of 22 patients, % EWL at 3 months was 51.23 (47.23-54.01) and in 20 patients at 24 months is 78.74 (76.34-81.23). There were no mortalities in either groups. Two cases of staple line bleeding were seen in SG group, one of which required re-exploration. There was one leak which closed at 8 weeks on conservative management. No complications were noted in the MGB group.
Resolution of co morbidities like DM, HTN and OSA was observed in both groups while this resolution was observed significantly early at 6,8 and 2 weeks in the MGB group as compared to 12,12 and 4 weeks for SG respectively. The mean hemoglobin and Albumin levels showed no significant difference before and after surgery in either groups.
CONCLUSIONS: MGB achieved superior weight loss at 3 months and 24 months and had a lower complication rate compared with SG. Resolution of co-morbidites was faster in MGB compared with SG Thus, MGB may be a viable alternative to RYGB as it appears to be better to SG for the treatment of morbidly and super-obese patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88593
Program Number: P665
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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