Consultant Surgeon, Whittington Hospital, London, United Kingdom; Honorary Associate Professor, University College London, United Kingdom.
Speciality Surgical Registrar, Whittington Hospital, London, United Kingdom.
Int J Surg. 2020 Sep;81:32-38. doi: 10.1016/j.ijsu.2020.07.007. Epub 2020 Jul 29.
One Anastomosis/Mini Gastric Bypass (OAGB-MGB) is rapidly gaining popularity and is now the third common bariatric procedure performed in the world. The aim of this review is to look at the role of this operation as a revisional bariatric surgery (RBS).
Literature review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Total 17 studies were eligible.
This review reports cumulative results of 1075 revisional OAGB-MGB procedures. Primary procedures included gastric banding (LAGB), Sleeve gastrectomy (SG), vertical banded gastroplasty (VBG) and gastric plication. The mean age was 43.1 years and female to male ratio was 3.04: 1. The body mass index (BMI) at primary procedure was 47.05 kg/m. The mean BMI at revisional surgery was 41.6 kg/m (range 28-70.8). The mean time between the primary and the secondary operation was 46.5 months (3-264). The mean follow-up was 2.44 years (6-60 months). The mean operative time was 119.3 min. The mean length of hospital stay was 4.01 days (2-28). The median limb length was 200 cm (range 150-250 cm). Leak rate was 1.54%. Marginal ulcer rate was 2.44%. Anemia rate was 1.9%. Mortality was 0.3%. The excess weight loss (%EWL) at 1 year and 2 years was 65.2% and 68.5% respectively.
We conclude that there is evidence to consider OAGB-MGB as a safe and effective choice for RBS. Randomised studies with long term follow-up are suggested for the future.
单吻合口胃旁路手术（OAGB-MGB）迅速普及，现已成为全球第三大常见的减重手术。本综述旨在探讨该术式作为减重手术翻修术（RBS）的作用。
按照 PRISMA（系统评价和荟萃分析的首选报告项目）和 AMSTAR（系统评价方法学质量评估）指南进行文献回顾。共纳入 17 项研究。
本综述报告了 1075 例减重手术翻修 OAGB-MGB 手术的累积结果。初次手术包括胃束带术（LAGB）、胃袖状切除术（SG）、垂直捆扎胃成形术（VBG）和胃折叠术。平均年龄为 43.1 岁，男女比例为 3.04:1。初次手术时的体重指数（BMI）为 47.05kg/m2。翻修手术时的 BMI 平均为 41.6kg/m2（范围 28-70.8）。初次手术和二次手术之间的平均时间为 46.5 个月（3-264）。平均随访时间为 2.44 年（6-60 个月）。平均手术时间为 119.3 分钟。平均住院时间为 4.01 天（2-28）。胃旁路术吻合口的肠袢长度中位数为 200cm（范围 150-250cm）。漏诊率为 1.54%。边缘性溃疡发生率为 2.44%。贫血发生率为 1.9%。死亡率为 0.3%。术后 1 年和 2 年的额外体重减轻率（%EWL）分别为 65.2%和 68.5%。
我们的结论是，有证据表明 OAGB-MGB 是 RBS 的一种安全有效的选择。建议未来开展长期随访的随机研究。
