Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Surg Obes Relat Dis. 2021 Aug;17(8):1489-1496. doi: 10.1016/j.soard.2021.04.013. Epub 2021 Apr 24.
This review evaluates the indications and outcomes of one-anastomosis/mini gastric bypass (OAGB/MGB) reversal to normal anatomy. A systematic literature search and meta-analysis was performed in PubMed, Web of Science, and Scopus for articles published by October 1, 2020, including the keywords "one anastomosis gastric bypass," "OAGB," "mini gastric bypass," "MGB," "reversal," "reverse," "malnutrition," and "reversal bariatric surgery". After examining 182 papers involving 11,578 patients, 14 studies were included. A reversal was performed in 119 patients on average 23.6 months after the primary OAGB/MGB surgery. The mean body mass index (BMI) was 22.92 ± 3.47 kg/m and the mean albumin level was 25.17 ± 4.21 g/L at reversal. The mean length of the common channel (CC) was 383.57 ± 159.35 cm, with a mean biliopancreatic limb (BPL) length of 214.21 ± 48.45 cm. Pooled estimation of the meta-analysis of prevalence studies reported a prevalence of 1% for reversal. The major signs and symptoms of protein-energy malnutrition were the leading causes of the reversal of OAGB/MGB. Bleeding, leakage, and death due to severe liver failure were the most reported complications after reversal, with an overall incidence of 10.9%. In conclusion, OAGB/MGB reversal has a prevalence of 1% and has a complication rate of 10.9%. Protein-energy malnutrition with hypoalbuminemia was the most common etiology. The mean lengths of BPL and CC were reported as 215 cm and 380 cm, respectively, in the cases. Therefore, special attention should be paid to malnutrition in all OAGB/MGB patients during follow-up to prevent severe malnutrition and subsequent increase in reversal procedures.
这篇综述评估了单吻合口/迷你胃旁路术（OAGB/MGB）向正常解剖结构逆转的适应证和结果。在 PubMed、Web of Science 和 Scopus 中进行了系统的文献检索和荟萃分析，检索时间截至 2020 年 10 月 1 日，使用的关键词包括“one anastomosis gastric bypass”、“OAGB”、“mini gastric bypass”、“MGB”、“reversal”、“reverse”、“malnutrition”和“reversal bariatric surgery”。在检查了 182 篇涉及 11578 名患者的论文后，纳入了 14 项研究。在初次 OAGB/MGB 手术后平均 23.6 个月进行了逆转手术。逆转时的平均体重指数（BMI）为 22.92±3.47kg/m2，平均白蛋白水平为 25.17±4.21g/L。共同通道（CC）的平均长度为 383.57±159.35cm，胆胰支（BPL）的平均长度为 214.21±48.45cm。荟萃分析中流行率研究的汇总估计报告，逆转的流行率为 1%。蛋白质-能量营养不良的主要体征和症状是 OAGB/MGB 逆转的主要原因。逆转后最常见的并发症是出血、漏液和因严重肝功能衰竭导致的死亡，总发生率为 10.9%。总之，OAGB/MGB 逆转的流行率为 1%，并发症发生率为 10.9%。低白蛋白血症的蛋白质-能量营养不良是最常见的病因。报道的 BPL 和 CC 的平均长度分别为 215cm 和 380cm。因此，在随访期间，应特别注意所有 OAGB/MGB 患者的营养不良，以防止严重营养不良和随后增加逆转手术。
