Musella Mario, Susa Antonio, Manno Emilio, De Luca Maurizio, Greco Francesco, Raffaelli Marco, Cristiano Stefano, Milone Marco, Bianco Paolo, Vilardi Antonio, Damiano Ivana, Segato Gianni, Pedretti Laura, Giustacchini Piero, Fico Domenico, Veroux Gastone, Piazza Luigi
Advanced Biomedical Sciences Department, "Federico II" University, AOU "Federico II" - Via S. Pansini 5 Building, 12 80131, Naples, Italy.
Clinica "S. Maria Maddalena", Rovigo, Italy.
Obes Surg. 2017 Nov;27(11):2956-2967. doi: 10.1007/s11695-017-2726-2.
In recent years, several articles have reported considerable results with the Mini/One Anastomosis Gastric Bypass (MGB/OAGB) in terms of both weight loss and resolution of comorbidities. Despite those positive reports, some controversies still limit the widespread acceptance of this procedure. Therefore, a multicenter retrospective study, with the aim to investigate complications following this procedure, has been designed.
To report the complications rate following the MGB/OAGB and their management, and to assess the role of this approach in determining eventual complications related especially to the loop reconstruction, in the early and late postoperative periods, the clinical records of 2678 patients who underwent MGB/OAGB between 2006 and 2015 have been studied.
Intraoperative and early complications rates were 0.5 and 3.1%, respectively. Follow-up at 5 years was 62.6%. Late complications rate was 10.1%. A statistical correlation was found for perioperative bleeding both with operative time (p < 0.001) or a learning curve of less than 50 cases (p < 0.001). A statistical correlation was found for postoperative duodenal-gastro-esophageal reflux (DGER) with a preexisting gastro-esophageal-reflux disease (GERD) or with a gastric pouch shorter than 9 cm, (p < 0.001 and p = 0.001), respectively. An excessive weight loss correlated with a biliopancreatic limb longer than 250 cm (p < 0.001).
Our results confirm MGB/OAGB to be a reliable bariatric procedure. According to other large and long-term published series, MGB/OAGB seems to compare very favorably, in terms of complication rate, with two mainstream procedures as standard Roux-en-Y gastric bypass (RYGBP) and laparoscopic sleeve gastrectomy (LSG).
近年来,多篇文章报道了迷你/单吻合口胃旁路术(MGB/OAGB)在减重和合并症解决方面取得了显著成效。尽管有这些积极的报道,但一些争议仍然限制了该手术的广泛接受。因此,设计了一项多中心回顾性研究,旨在调查该手术后的并发症。
为了报告MGB/OAGB术后的并发症发生率及其处理方法,并评估该手术方式在确定尤其是与肠袢重建相关的最终并发症方面在术后早期和晚期的作用,研究了2006年至2015年间接受MGB/OAGB手术的2678例患者的临床记录。
术中并发症发生率和早期并发症发生率分别为0.5%和3.1%。5年随访率为62.6%。晚期并发症发生率为10.1%。发现围手术期出血与手术时间(p < 0.001)或手术例数少于50例的学习曲线(p < 0.001)均存在统计学相关性。发现术后十二指肠-胃-食管反流(DGER)与既往存在的胃食管反流病(GERD)或胃囊短于9 cm分别存在统计学相关性(p < 0.001和p = 0.001)。过度减重与胆胰袢长于250 cm相关(p < 0.001)。
我们的结果证实MGB/OAGB是一种可靠的减重手术。根据其他已发表的大型长期系列研究,就并发症发生率而言,MGB/OAGB似乎与两种主流手术即标准Roux-en-Y胃旁路术(RYGBP)和腹腔镜袖状胃切除术(LSG)相比具有很大优势。