Elghadban Hosam, Shoma Ashraf, Abdallah Emad, Negm Ahmed, Abdullah Elsayed, Hamed Hossam, Ghareeb Sameh, Lotfy Ahmed, Taki-Eldin Ahmed
General Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
Anesthesia Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
J Obes. 2025 Mar 30;2025:4161005. doi: 10.1155/jobe/4161005. eCollection 2025.
Vertical banded gastroplasty (VBG) was historically a popular restrictive bariatric procedure, but long-term failure rates due to weight regain, stenosis, and gastroesophageal reflux have necessitated revisional interventions. One anastomosis gastric bypass (OAGB), also known as mini-gastric bypass, has emerged as a viable revisional option due to its technical simplicity, lower complication rates, and promising metabolic outcomes. This study evaluates the safety, efficacy, and outcomes of OAGB as a revisional procedure following failed VBG, based on our center's experience and a review of the current literature. Seventy-one patients who underwent revisional OAGB after failed open VBG between February 2014 and February 2020 were included in this retrospective study. Three years outcomes regarding weight loss (the percentage of excess body weight loss (EBWL %) and change in body mass index (BMI)), co-morbidities resolution, morbidity, and mortality were assessed. The EBWL % after revisional OAGB was 68.2 ± 9.4%, 65.9 ± 2.5%, and 59.6 ± 7.4% after 1, 2, and 3 years, respectively. The mean BMI before revisional surgery was 41.8 ± 3.7 kg/m,which decreased to 31.9 ± 4.2 kg/m 3 years after the revisional surgery. After 1 year, there was a remarkable resolution of obesity-related co-morbidities, the remission of type 2 diabetes mellitus was 85.7%, and of hypertension was 80%. Remission of other comorbidities was also observed. Bile reflux was encountered in 6 cases (8.5%), two of them required surgical intervention. OAGB is a feasible and effective revisional procedure after failed open VBG. However, the risk of bile reflux should be considered to justify these findings; further prospective randomized controlled trials are required.
垂直束带胃成形术（VBG）在历史上是一种流行的限制性减肥手术，但由于体重反弹、狭窄和胃食管反流导致的长期失败率使得需要进行修正干预。单吻合口胃旁路术（OAGB），也称为迷你胃旁路术，因其技术简单、并发症发生率较低以及有前景的代谢结果，已成为一种可行的修正选择。本研究基于我们中心的经验并回顾当前文献，评估OAGB作为VBG失败后的修正手术的安全性、有效性和结果。本回顾性研究纳入了2014年2月至2020年2月间在开放式VBG失败后接受修正OAGB的71例患者。评估了三年的减肥结果（超重体重减轻百分比（EBWL%）和体重指数（BMI）变化）、合并症缓解情况、发病率和死亡率。修正OAGB后的EBWL%在1年、2年和3年后分别为68.2±9.4%、65.9±2.5%和59.6±7.4%。修正手术前的平均BMI为41.8±3.7kg/m²，修正手术后3年降至31.9±4.2kg/m²。1年后，肥胖相关合并症有显著缓解，2型糖尿病缓解率为85.7%，高血压缓解率为80%。其他合并症也有缓解。6例（8.5%）出现胆汁反流，其中2例需要手术干预。OAGB是开放式VBG失败后一种可行且有效的修正手术。然而，应考虑胆汁反流的风险以证实这些结果；需要进一步的前瞻性随机对照试验。
