Is one-anastomosis gastric bypass a good revisional bariatric surgery? A single center retrospective cohort study

Abstract

Introduction: The rate of revisional surgeries following sleeve gastrectomy (SG) has increased. One-anastomosis gastric bypass (OAGB) appears to have multiple advantages as a primary bariatric procedure. As revisional surgery is still being investigated.Aim: Evaluation of the efficacy and safety of OAGB performed as a post-SG revisional surgery.Material and methods: A single-center, retrospective cohort study was conducted using a routinely collected database of adults undergoing revisional OAGB after SG. A survey of patients was conducted, obtaining information on changes in body weight and improvement in gastroesophageal reflux disease (GERD) and obesity-related diseases.Results: The study group included 74 patients: 59 women (80%) and 15 men, mean age of 41.619.21 years. The most common indication for OAGB was weight regain. The follow-up was up to 7 years, the mean time was 3.581.21 years. The mean preoperative body mass index (BMI) was 40.386.15. All patients experienced significant weight loss, reaching a BMI of 33.61 (27.28-37.13) at the last observation. After surgery, 35% of patients achieved successful weight loss and 48% of patients achieved remission or improvement of GERD.Conclusion: Revisional OAGB seems to be a good alternative after a failed SG in terms of obesity-related diseases recurrence, not of weight regain. Long-term follow-up revealed that only a third of patients achieved successful weight loss. When proposing revisional OAGB, the risk of complications - mainly anemia and the possibility of de novo GERD should be considered.Keywords: one-anastomosis gastric bypass (OAGB), revisional surgery, obesity, gastroesophageal reflux disease (GERD)