One Anastomosis Gastric Bypass Versus Roux‑en‑Y Gastric Bypass for Obesity: An Updated Meta‑analysis and Systematic Review of Randomized Controlled Trials

Abstract

Introduction: Roux-en-Y gastric bypass (RYGB) is currently regarded as the predominant method for bariatric surgery. However, one anastomosis gastric bypass (OAGB) emerged after RYGB as a more straightforward and readily reversible operation. This systematic review and meta-analysis aims to compare both procedures and update the currently existing evidence. Methods: We systematically searched PubMed, Scopus, and the Cochrane Central Register for randomized controlled trials (RCTs) that compared OAGB with RYGB as primary operations. Results: Twelve studies were included in this meta-analysis, with a total of 904 patients. Total weight loss percentage (TWL%) was statistically higher in the OAGB group at 6 months (95% CI:0.80 to 2.94; P= 0.006) with no differences in 12,24,36 months compared to RYGB. On the other hand, OAGB exhibited a significantly higher excess weight loss percentage (EWL%) compared to RYGB at 12 months (95% CI: 3.08 to 9.73; P=0.0002). EWL% was comparable in both procedures at 6,24,60 months of follow-up. There were no statistically significant differences in terms of resolution of comorbidities related to obesity. De Novo gastro-esophageal reflux disease (GERD) (RR 2.58; 95% CI 1.55 to 4.3; P=0.0003) and marginal ulcers (RR 2.7; CI 95% 1.07 to 6.84; P = 0.04) were significantly higher in patients who underwent OAGB in comparison to RYGB. Conclusion: In conclusion, OAGB is not inferior to RYGB in terms of weight loss parameters and comorbidities resolution. However, OAGB can lead to a higher risk of development of marginal ulcers and De Novo GERD.