Purpose: This study aimed to assess the outcomes of revisional procedures, namely Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) following unsuccessful laparoscopic sleeve gastrectomy.
Materials And Methods: This systematic review and meta-analysis included 817 patients (404 in OAGB group, 413 in RYGB group) from seven retrospective comparative studies. Data on sample size, demographics, perioperative complications, operative time, pre- and post-revisional body mass index, total weight loss, and global weight loss over follow-up were extracted.
Results: The mean operative time was 98.2-201 minutes for RYGB versus 78.7-168 minutes for OAGB. Despite classical RYGB gastric bypass taking longer, mini gastric bypass resulted in greater weight loss than RYGB, with a mean difference of -5.84 (95% confidence interval [CI], -6.74 to -4.94; P<0.00001; I=0%), greater total weight loss, and a higher diabetes remission rate (odds ratio [OR], 0.32; 95% CI, 0.14 to 0.71). However, OAGB was associated with a significantly higher incidence of postoperative gastroesophageal reflux than RYGB (52 vs. 31: OR, 0.40; 95% CI, 0.24 to 0.67; P=0.0005; I=0%).
Conclusion: OAGB was performed more quickly and boasted greater total weight loss and higher diabetes remission rates compared to RYGB after failed sleeve gastrectomy. However, OAGB also demonstrated a higher incidence of postoperative gastroesophageal reflux disease. Thus, careful patient selection is essential when considering OAGB.
Trial Registration: PROSPERO Identifier: CRD42023474966.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771971 | PMC |
| http://dx.doi.org/10.17476/jmbs.2023.12.2.57 | DOI Listing |
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