Shahmiri Shahab Shahabi, Esparham Ali, Sedaghat Hossein Khadem, Safari Shiva, Daryabari Seyed Nooredin, Pazouki Abdolreza, Kermansaravi Mohammad
Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat-E Fatemeh Hospital, Tehran, Iran.
Obes Surg. 2025 Feb;35(2):525-534. doi: 10.1007/s11695-024-07628-0. Epub 2025 Jan 7.
Previous studies showed a high conversion rate and failure of restrictive procedures, including sleeve gastrectomy (SG), adjustable gastric banding (AGB), gastric plication (GP), and vertical banded gastroplasty (VBG) in a long-term follow-up. The current study aims to evaluate the efficacy and safety of a revisional one anastomosis gastric bypass (OAGB) for weight loss and treatment of obesity-related problems after primary metabolic and bariatric restrictive procedures.
A retrospective study on prospectively collected data was conducted on a sample of 151 patients who experienced insufficient weight loss or weight regain after primary restrictive surgeries and underwent OAGB as a revisional procedure.
A total of 151 patients with a history of previous restrictive metabolic and bariatric surgery who underwent a revisional OAGB were included in this study. The restrictive procedures consisted of SG (n = 79), AGB (n = 45), GP (n = 15), and VBG (n = 12). Total weight loss percent (%TWL) after the revisional OAGB was 27.03 ± 9.12, 27.74 ± 10.05, 24.62 ± 9.87, and 24.34 ± 8.05 after 12, 24, 60, and 84 months, respectively. After 24 months of follow-up, TWL was significantly higher in the GP group compared to the AGB group. However, weight loss outcomes were not significantly different after 60 months of follow-up. The revisional OAGB was associated with a significant resolution of obesity-related problems, including type 2 diabetes (55.55%), hypertension (50%), dyslipidemia (77%), and obstructive sleep apnea (100%) after 2 years of follow-up. There was no serious complication after the revisional OAGB in the short- and long-term follow-up.
OAGB is an efficient and safe option as a conversion surgery after restrictive procedures.
既往研究显示，在长期随访中，包括袖状胃切除术（SG）、可调节胃束带术（AGB）、胃折叠术（GP）和垂直束带胃成形术（VBG）在内的限制性手术的转化率和失败率较高。本研究旨在评估改良单吻合口胃旁路术（OAGB）在原发性代谢和减重限制性手术后减重及治疗肥胖相关问题的疗效和安全性。
对前瞻性收集的数据进行回顾性研究，样本为151例在原发性限制性手术后体重减轻不足或体重反弹且接受OAGB作为改良手术的患者。
本研究共纳入151例有既往限制性代谢和减重手术史且接受改良OAGB的患者。限制性手术包括SG（n = 79）、AGB（n = 45）、GP（n = 15）和VBG（n = 12）。改良OAGB术后12、24、60和84个月时的总体重减轻百分比（%TWL）分别为27.03±9.12、27.74±10.05、24.62±9.87和24.34±8.05。随访24个月后，GP组的TWL显著高于AGB组。然而，随访60个月后体重减轻结果无显著差异。随访2年后，改良OAGB与肥胖相关问题的显著缓解相关，包括2型糖尿病（55.55%）、高血压（50%）、血脂异常（77%）和阻塞性睡眠呼吸暂停（100%）。改良OAGB在短期和长期随访中均未出现严重并发症。
OAGB作为限制性手术后的转换手术是一种有效且安全的选择。
