Mohak Bariatrics and Robotics Center, SAIMS Campus, Indore-Ujjain Highway, Indore, Madhya Pradesh, India.
Obes Surg. 2020 Apr;30(4):1303-1309. doi: 10.1007/s11695-019-04369-3.
Banded sleeve gastrectomy (BSG), a modification of the laparoscopic sleeve gastrectomy (SG), and one anastomotic gastric bypass/mini-gastric bypass (OAGB/MGB), a modification to the Roux-en-Y gastric bypass (RYGB), have been reported to enhance weight loss and minimize significant weight regain when compared with the SG and RYGB respectively. However, there has not been any report or study comparing these two operations.
We did a retrospective cohort study comparing these two operations and present a review and analysis with follow-up for 6 years.
A review of all the operations performed at MBRSC in 2011 from a prospectively maintained database was done. Patients who had either a BSG or OAGB/MGB were identified. Data on the patients' profile, co-morbid conditions, perioperative complications, late complications, weight loss, resolution of comorbidities, and changes in quality of life (QLF) were collected reviewed and analyzed.
Sixty-eight patients were identified who had a primary BSG and 55 who had an OAGB/MGB in 2011. The follow-up rate, the age, BMI, and gender composition were similar in both groups. There were more patients with type 2 diabetes (T2D) in the BSG group than in the OAGB/MGB group (44.1% vs. 27.2%). The incidences of hypertension (HTN) and obstructive sleep apnea (OSA) were higher in the OAGB/MGB group (62% vs. 36% and 96.3% vs. 2.9% respectively). The weight loss was faster in the OAGB/MGB group in the first year, but by the sixth year, the weight loss was slightly higher in the BSG group (84% vs. 79%). Resolution rate of T2D and HTN was higher after the OAGB/MGB group, 86.6% vs. 75.7% and 85.3% vs. 64.0% respectively. There was a 20% incidence of nutrient deficiencies in OAGB/MGB group and none in the BSG group.
Both operations produced excellent weight loss and maintenance in the short to intermediate term. There was better resolution of T2D and HTN after OAGB/MGB at the expense of a higher incidence of nutrient deficiency and some protein caloric malnutrition. There is need for prospective and larger series studies to confirm these findings.
带袖套胃切除术（BSG）是腹腔镜袖套胃切除术（SG）的改良术式，吻合型胃旁路/迷你胃旁路术（OAGB/MGB）是 Roux-en-Y 胃旁路术（RYGB）的改良术式，与 SG 和 RYGB 相比，BSG 和 OAGB/MGB 分别能增强减重效果并最大程度减少显著体重反弹。然而，目前尚无任何比较这两种手术的报道或研究。
我们进行了一项回顾性队列研究，比较了这两种手术，并进行了随访 6 年的回顾和分析。
对 MBRSC 于 2011 年从前瞻性维护数据库中进行的所有手术进行了回顾。确定了接受 BSG 或 OAGB/MGB 的患者。收集并分析了患者特征、合并症、围手术期并发症、晚期并发症、体重减轻、合并症缓解情况以及生活质量（QLF）变化的数据。
2011 年，共确定了 68 例原发性 BSG 患者和 55 例 OAGB/MGB 患者。两组的随访率、年龄、BMI 和性别构成相似。BSG 组中 2 型糖尿病（T2D）患者多于 OAGB/MGB 组（44.1% vs. 27.2%）。OAGB/MGB 组高血压（HTN）和阻塞性睡眠呼吸暂停（OSA）的发生率更高（62% vs. 36%和 96.3% vs. 2.9%）。OAGB/MGB 组在第一年的体重减轻速度更快，但在第六年时，BSG 组的体重减轻略高（84% vs. 79%）。OAGB/MGB 组 T2D 和 HTN 的缓解率更高，分别为 86.6% vs. 75.7%和 85.3% vs. 64.0%。OAGB/MGB 组有 20%的营养素缺乏发生率，而 BSG 组则没有。
两种手术在短期至中期均能产生极好的减重效果并维持。OAGB/MGB 术后 T2D 和 HTN 的缓解效果更好，但营养素缺乏和一些蛋白质热量营养不良的发生率更高。需要进行前瞻性和更大系列的研究来证实这些发现。
