Original Article   

Minerva Surgery 2022 Jul 05

DOI: 10.23736/S2724-5691.22.09580-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The effect of Roux-en-Y gastric bypass compared with omega-loop gastric bypass on weight loss, perioperative surgical events, and comorbidities

Omar THAHER ¹ ✉, Roland S. CRONER ², Martin HUKAUF ³, Jamal DRIOUCH ¹, Christine STROH ⁴

¹ Department of Surgery, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany; ² Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Magdeburg, Germany; ³ StatConsult Society for Clinical and Health Services Research GmbH, Magdeburg, Germany; ⁴ Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Gera, Germany

BACKGROUND: In comparison to conservative therapy, bariatric surgery has shown many reasonable results. The current study investigates whether Omega-Loop-Gastric-Bypass (OAGB) or Roux-en-Y Gastric-Bypass (RYGB) improves weight loss,
comorbidities, and perioperative complications.
METHODS: 28,683 patients after RYGB and OAGB were included in our study. Outcome criteria were perioperative morbidity, perioperative complications, and remission of comorbidities after one year of follow-up.
RESULTS: 14,253 patients had completed a one-year follow-up (13,483 patients by RYGB and 770 by OAGB). BMI reduction was a significant difference in favor of OAGB (17.5 ± 5.6 kg/m2 for OAGB vs. 15.2 ± 5.0 for RYGB; p<0.001). The %EWL was not significantly different between the two groups (p=0.073). There was also no significant difference in perioperative complications between the two groups (overall p>5%). Significant differences in favor of OAGB were observed in remission of insulin-dependent diabetes mellitus (IDDM) (p<0.001), and sleep apnea (p=0.002). Remission of reflux was more observed in RYGB than OAGB (p<0.001). Operating time was significantly higher in RYGB than OAGB (p<0.001).
CONCLUSIONS: Compared with RYGB, OAGB showed significant advantages in many respects. In particular, remission of comorbidities was significantly better after OAGB than in patients after RYGB during the one-year follow-up period. Nevertheless, many other factors such as medical history, long-term expected goals of bariatric surgery, and preexisting comorbidities should be taken into account when determining indications between the two procedures. Further studies with longer follow-up periods should be conducted to determine the efficacy of the two methods more accurately.

KEY WORDS: Gastric Bypass; Omega-loop-gastric-bypass; Follow-up; Perioperative complications; Comorbidities