Department of Surgery, Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, Kuwait; Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
Department of Weight Loss and Health Management Center, E-DA Dachang Hospital, Kaohsiung, Taiwan; Department of Asia Obesity Medical Research Center, E-DA Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Surg Obes Relat Dis. 2021 May;17(5):968-975. doi: 10.1016/j.soard.2021.01.010. Epub 2021 Jan 21.
Laparoscopic 1- (single-) anastomosis gastric bypass (OAGB) was developed as a simplified technique of Roux-en-Y gastric bypass (RYGB), but super long-term data are lacking.
To evaluate the risks and long-term results of OAGB over a period of 20 years.
Tertiary teaching hospital.
A total of 2223 patients underwent OAGB from 2001 to 2020; the mean age was 35.3 ± 11.4 years (range, 14-71 yr), 70.2% were female, and the mean body mass index was 40.2 ± 11.9 kg/m. All data were kept in a prospective bariatric database. Patients were divided into 4 groups, based on the 5-year period in which their surgery was performed, and a retrospective analysis was conducted.
The means for operating time, intraoperative blood loss, and length of hospital stay after OAGB were 131.9 ± 40.1 minutes, 38.5 ± 30.7 mL, and 4.5 ± 4.0 days, respectively. There were 27 patients (1.2%) with 30-day postoperative major complications overall, but the group rate decreased to .4% in the last 5-year period. At postoperative years 5, 10, and 15, the percentages of total weight loss were 31.9%, 29.6%, and 29.5%, respectively, and the percentages of excess weight loss were 77.2%, 68.4%, and 65.5%, respectively. Among 739 patients (33.2%) with type 2 diabetes (T2D), the rates of complete remission (glycated hemoglobin < 60%) at 5, 10, and 15 years were 67.3%, 73.8%, and 66.7%, respectively. The weight loss and antimetabolic effects were similar in each 5-year period, but a significant malnutrition effect was observed. A total of 113 (5.1%) patients needed revision surgery at follow-up, due to malnutrition (n = 51), weight regain (n = 24), acid or bile reflux (n = 22), marginal ulcer (n = 8), ileus (n = 3), and other causes (n = 5). At 15 years, the overall revision rate was 11.9% (27/226), and 80% of the patients were very satisfied with their procedures.
Our results showed that OAGB is a safe and durable primary bariatric procedure, with sustained weight loss and a high resolution of T2D up to 20 years post surgery in Taiwan, although malnutrition is a major side effect.
腹腔镜 1 吻合（单吻合）胃旁路术（OAGB）作为 Roux-en-Y 胃旁路术（RYGB）的简化技术而发展，但缺乏长期数据。
评估 OAGB 在 20 年期间的风险和长期结果。
三级教学医院。
2001 年至 2020 年期间，共有 2223 例患者接受了 OAGB 手术；平均年龄为 35.3±11.4 岁（范围 14-71 岁），70.2%为女性，平均体重指数为 40.2±11.9kg/m²。所有数据均保留在一个前瞻性减重数据库中。根据手术进行的 5 年时间段，将患者分为 4 组，并进行回顾性分析。
OAGB 的手术时间、术中出血量和术后住院时间平均值分别为 131.9±40.1 分钟、38.5±30.7mL 和 4.5±4.0 天。总体而言，术后 30 天有 27 例（1.2%）患者发生重大并发症，但在最后 5 年期间，该组发生率降至 0.4%。术后 5 年、10 年和 15 年，总减重百分比分别为 31.9%、29.6%和 29.5%，超重减轻百分比分别为 77.2%、68.4%和 65.5%。在 739 例（33.2%）2 型糖尿病（T2D）患者中，术后 5 年、10 年和 15 年完全缓解（糖化血红蛋白<60%）的比例分别为 67.3%、73.8%和 66.7%。在每个 5 年期间，体重减轻和代谢效果相似，但观察到明显的营养不良效应。在随访中，共有 113 例（5.1%）患者因营养不良（n=51）、体重反弹（n=24）、酸或胆汁反流（n=22）、边缘性溃疡（n=8）、肠梗阻（n=3）和其他原因（n=5）需要接受修正手术。15 年后，总修正率为 11.9%（27/226），80%的患者对手术非常满意。
我们的结果表明，OAGB 是一种安全且持久的原发性减重手术，在台湾，其减重效果可持续 20 年，T2D 缓解率高，可达 20 年，但营养不良是一个主要的副作用。
