Whittington Hospital, N19 5NF, London, UK.
UCLH, London, UK.
Obes Surg. 2020 Feb;30(2):725-735. doi: 10.1007/s11695-019-04293-6.
One anastomosis/mini gastric bypass (OAGB-MGB) is now an established bariatric procedure for patients suffering from obesity. The purpose of this review is to evaluate the role of this operation in patients with body mass index (BMI) ≤ 35 kg/m.
A literature review was performed as per preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.
This review reports cumulative results of 376 OAGB-MGB procedures with a mean age of 44.28 years and mean BMI of 29.16 kg/m (range 22-35). Females represented 67.67% of the patients. The leak rate was 0.27%. The mean follow-up was 32.6 months (6-84 months). The mean operative time was 89.45 min. The median limb length was 120 cm (range 100-200 cm). The mean fasting plasma glucose (FPG) decreased from 196.97 to 103.28 mg/dL. The mean HbA1c came down from 9.13% preoperatively to 6.14% postoperatively. The total cholesterol levels came down from a mean of 197.8 mg/dL preoperatively to 120.6 mg/dL postoperatively. The low-density lipoprotein (LDL) and triglyceride levels came down from 127.7 and 209.3 mg/dL to 81 and 94.8 mg/dL, respectively. Mortality was 0%. Marginal ulceration rate of 6.3% and an anaemia rate of 4.7% were reported. Low albumin was reported in 1 (0.2%) patient. The mean BMI came down to 23.76 kg/m at 12 months.
We conclude that there is now satisfactory evidence to consider OAGB-MGB as a safe and effective metabolic procedure for diabetic patients with BMI ≤ 35 kg/m. Randomised studies comparing different bariatric procedures with longer term follow-up are needed.
单吻合口/迷你胃旁路术（OAGB-MGB）现已成为肥胖症患者的一种成熟减重手术。本综述旨在评估该手术在 BMI≤35kg/m²的患者中的作用。
按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行文献复习。
本综述报告了 376 例 OAGB-MGB 手术的累积结果，患者平均年龄为 44.28 岁，平均 BMI 为 29.16kg/m²（范围 22-35）。女性占患者的 67.67%。漏诊率为 0.27%。平均随访时间为 32.6 个月（6-84 个月）。平均手术时间为 89.45 分钟。吻合支长度中位数为 120cm（范围 100-200cm）。空腹血浆葡萄糖（FPG）均值从 196.97mg/dL 降至 103.28mg/dL。术前平均糖化血红蛋白（HbA1c）为 9.13%，术后降至 6.14%。总胆固醇水平从术前平均 197.8mg/dL 降至术后 120.6mg/dL。低密度脂蛋白（LDL）和甘油三酯水平分别从 127.7mg/dL 和 209.3mg/dL 降至 81mg/dL 和 94.8mg/dL。死亡率为 0%。报道了 6.3%的边缘溃疡发生率和 4.7%的贫血发生率。1 例（0.2%）患者出现低白蛋白血症。12 个月时平均 BMI 降至 23.76kg/m²。
我们的结论是，现在有令人满意的证据表明，对于 BMI≤35kg/m²的糖尿病患者，OAGB-MGB 是一种安全有效的代谢手术。需要随机研究比较不同的减重手术，并进行更长期的随访。
