Gricks Benjamin, Eldredge Thomas, Bessell Justin, Shenfine Jon
Department of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Discipline of Surgery, University of Adelaide, Adelaide, South Australia, Australia.
ANZ J Surg. 2022 Sep;92(9):2123-2128. doi: 10.1111/ans.17702. Epub 2022 May 1.
The One Anastomosis Gastric Bypass (OAGB) is a relatively novel procedure. Studies have demonstrated that it is at least as effective as other bariatric procedures but with fewer major complications and shorter operating time, yet OAGB is performed less partially due to a paucity of supportive evidence. We report the outcomes of a prospectively maintained database of patients undergoing laparoscopic OAGB.
All OAGB procedures performed by two surgeons across two hospitals from 2016 to 2019 were recorded in a prospectively maintained database. Patients with at least 1 year of follow up were included in this study and missing data was obtained from patient records. The primary outcome was percentage excess weight loss (EWL). The secondary outcome was surgical complication rate.
Three hundred and twenty-five patients with a mean pre-operative body mass index of 43.3 kg/m were included. The majority (85.2%) had a biliopancreatic limb length of 150 cm. The median EWL was 74.2% and 79.4% of patients achieved at least 50% EWL. There were no deaths, the overall re-operation rate was 4.9% and 1.9% of patients developed stomal ulcers. Seven patients went on to have a Roux-en-Y conversion predominantly for symptomatic reflux.
OAGB leads to excellent weight loss and is at least as safe as more commonly performed procedures, it may be a suitable treatment for a greater number of patients than it is being offered to at present.
单吻合口胃旁路术（OAGB）是一种相对新颖的手术。研究表明，它至少与其他减肥手术一样有效，但主要并发症更少，手术时间更短，然而由于缺乏支持性证据，OAGB的实施较少。我们报告了一个前瞻性维护的接受腹腔镜OAGB患者数据库的结果。
2016年至2019年期间，两位外科医生在两家医院进行的所有OAGB手术都记录在前瞻性维护的数据库中。本研究纳入了至少随访1年的患者，并从患者记录中获取缺失数据。主要结局是超重减轻百分比（EWL）。次要结局是手术并发症发生率。
纳入了325例患者，术前平均体重指数为43.3kg/m。大多数患者（85.2%）的胆胰支长度为150cm。EWL中位数为74.2%，79.4%的患者实现了至少50%的EWL。无死亡病例，总体再次手术率为4.9%，1.9%的患者发生吻合口溃疡。7例患者主要因症状性反流而转为Roux-en-Y手术。
OAGB导致显著的体重减轻，并且至少与更常用的手术一样安全，对于更多患者来说，它可能是一种比目前应用更合适的治疗方法。
