Comparing the Efficacy and Safety of Roux-en-Y Gastric Bypass with One-Anastomosis Gastric Bypass with a Biliopancreatic Limb of 200 or 160 cm: 1-Year Results of the Tehran Obesity Treatment Study (TOTS).

Abstract:

PURPOSE:One-anastomosis gastric bypass (OAGB) has raised concerns about nutritional complications possibly attributed to the biliopancreatic limb (BPL) length. We aimed to assess the results of a conservative approach of OAGB compared with the original OAGB and Roux-en-Y gastric bypass (RYGB) in a 1-year follow-up study. MATERIALS AND METHODS:This retrospective study was conducted based on prospectively maintained data in a cohort of patients who underwent either RYGB with a Roux limb of a 150 cm and a BPL of 50 cm (n = 145), OAGB with a 200-cm BPL (n = 272), or OAGB with a 160-cm BPL (n = 383), from March 2013 to 2017 at three university hospitals by a single surgical team. RESULTS:Groups were comparable regarding age and sex. Mean preoperative body mass indexes of the RYGB, OAGB-160, and OAGB-200 groups were 44.5 ± 5.8, 45.6 ± 6.3, and 46.7 ± 6.4 kg/m2, respectively. One-year follow-up rates were 83.4%, 85.3%, and 82.5% for the RYGB, OAGB-200, and OAGB-160 groups, respectively. One-year percent total weight loss values were 33.8 ± 6.7 after OAGB-160 and 35.3 ± 6.9 after OAGB-200 (P = 0.056), which were significantly greater compared with 30.9 ± 8.9 after RYGB (P < 0.001). All groups were comparable regarding remission of type 2 diabetes mellitus, hypertension, dyslipidemia, and fatty liver. Mean operative time was longer with RYGB than with either OAGB techniques. Groups were comparable for postoperative complications except for the incidence of protein-calorie malnutrition (PCM), occurring in 11 patients (4.7%) after OAGB-200, 7 of whom required revisional surgery, in one patient (0.3%) after OAGB-160 who responded to parenteral alimentation, but in no patients after RYGB. CONCLUSION:After 1 year, OAGB with a 160-cm BPL was as effective as OAGB with a 200-cm BPL and RYGB, but safer than OAGB-200. This approach also avoided the need for revisional surgery following postoperative malnutrition.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Khalaj A,Mousapour P,Motamedi MAK,Mahdavi M,Valizadeh M,Hosseinpanah F,Barzin M

doi

10.1007/s11695-020-04681-3

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

3528-3535

issue

9

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-020-04681-3

journal_volume

30

pub_type

杂志文章
  • Preoperative preparatory program has no effect on morbidly obese patients undergoing a Lap-Band operation.

    abstract:BACKGROUND:A preoperative preparatory program may help morbidly obese patients cope with postoperative pain and vomiting, and reduce length of nursing care. METHODS:A preoperative preparatory program was given to randomly selected morbidly obese women about to undergo a Lap-Band stomach reduction operation. RESULTS:S...

    journal_title:Obesity surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1381/096089299765553115

    authors: Hörchner R,Tuinebreijer W

    更新日期:1999-06-01 00:00:00

  • Role of preoperative imaging with multidetector computed tomography in the management of patients with gastroesophageal reflux disease symptoms after laparoscopic sleeve gastrectomy.

    abstract:BACKGROUND:The aims of the study were to evaluate if multidetector computed tomography (MDCT) can be helpful and useful in the decision-making process in sleeve patients with gastroesophageal reflux disease (GERD) symptoms and to demonstrate the reproducibility and accuracy of the technique. METHODS:Twenty-three patie...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-013-1003-2

    authors: Rengo M,Bellini D,Iorio O,De Cecco CN,Rizzello M,Cavallaro G,Carabotti M,Laghi A,Silecchia G

    更新日期:2013-12-01 00:00:00

  • Plicated Sleeve Gastrectomy with Combined Mesocolon and Greater Omentum Fixation After T-Shaped Omentoplasty: How to Do it?

    abstract:INTRODUCTION:This technique aims to evaluate fixation of the sleeved distal part of the stomach to the root of the transverse mesocolon and greater omentum after its shortening in a T-shaped design. METHODS:Sleeve gastrectomy is done in a standard five-port technique. Then, we fix the distal end of the staple line usi...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-019-04382-6

    authors: Abdallah E,Fikry M,Rady O,Elfeki H

    更新日期:2020-03-01 00:00:00

  • A Clinical Study of Protein Sparing Modified Fast (PSMF) Administered Preoperatively to Morbidly Obese Patients: comparison of PSMF with natural food products to originally prepared PSMF.

    abstract::Morbidly obese patients are generally in a malnutritional state with an extremely high operative risk. In order to reduce the operative risk, surgeons should make every effort before the operation. A protein sparing modified fast (PSMF) may exhibit its high effectiveness when taken at least for 2 weeks preoperatively....

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089292765560510

    authors: Kawamura I I,Chen CC,Yamazaki K,Miyazawa Y,Isono K

    更新日期:1992-02-01 00:00:00

  • Gut Microbiota Modifications and Weight Regain in Morbidly Obese Women After Roux-en-Y Gastric Bypass.

    abstract:INTRODUCTION:The relationship between late post-bariatric surgery weight regain and gut microbiota is not completely understood. OBJECTIVE:To analyze the profile of gut microbiota among patients with and without late weight regain after post-Roux-en-Y gastric bypass (RYGB) and to compare it with a control group (CG) c...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-04956-9

    authors: Faria SL,Santos A,Magro DO,Cazzo E,Assalin HB,Guadagnini D,Vieira FT,Dutra ES,Saad MJA,Ito MK

    更新日期:2020-12-01 00:00:00

  • Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients.

    abstract:BACKGROUND:Various techniques of laparoscopic Roux-en-Y gastric bypass have been described. We completely standardized this procedure to minimize its sometimes substantial morbidity and mortality. This study describes our experience with the standardized fully stapled laparoscopic Roux-en-Y gastric bypass (FS-LRYGB) an...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-009-9933-4

    authors: Dillemans B,Sakran N,Van Cauwenberge S,Sablon T,Defoort B,Van Dessel E,Akin F,Moreels N,Lambert S,Mulier J,Date R,Vandelanotte M,Feryn T,Proot L

    更新日期:2009-10-01 00:00:00

  • Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass.

    abstract:BACKGROUND:There is no consensus on the ideal gastrojejunostomy anastomosis (GJA) technique in laparoscopic Roux-en-Y gastric bypass (LRYGB). We reviewed our experience with three GJA techniques (hand-sewn (HSA), linear-stapled (LSA), and 25-mm circular-stapled (CSA)) to determine which anastomosis technique is associa...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-011-0470-6

    authors: Bendewald FP,Choi JN,Blythe LS,Selzer DJ,Ditslear JH,Mattar SG

    更新日期:2011-11-01 00:00:00

  • Skin Changes Due to Massive Weight Loss: Histological Changes and the Causes of the Limited Results of Contouring Surgeries.

    abstract:PURPOSE:Outcomes of body contouring surgeries in patients who previously had obesity are limited because of the loss of skin quality. This study aimed to evaluate the morphometric characteristics of collagen and elastic fibers of the skin in the abdominal epigastric region of patients who had massive weight loss follow...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-020-05100-3

    authors: Rocha RI,Junior WC,Modolin MLA,Takahashi GG,Caldini ETEG,Gemperli R

    更新日期:2020-11-04 00:00:00

  • Sleep apnea: is routine preoperative screening necessary?

    abstract:BACKGROUND:Because perioperative complications of unrecognized obstructive sleep apnea (OSA) can be severe, many bariatric surgery programs routinely screen all patients. However, many obese non-bariatric surgery patients do not get screened. We wanted to evaluate the need for routine preoperative OSA screening. METHO...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-012-0806-x

    authors: Nepomnayshy D,Hesham W,Erickson B,MacDonald J,Iorio R,Brams D

    更新日期:2013-03-01 00:00:00

  • Intermittent obstructive jaundice following gastric band placement.

    abstract::Complications of laparoscopic adjustable gastric banding occur in 10 - 20% of patients. However, hepatobiliary complications of this procedure are very rare. We report a unique case of gastric band misplacement around the hepato-duodenal ligament. The patient developed obstructive jaundice several months after the gas...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-007-9029-y

    authors: Arkadopoulos N,Palamarou C,Koureas A,Sechopoulos P,Marinis A,Kostopanagiotou K,Dafnios N,Smyrniotis V

    更新日期:2007-02-01 00:00:00

  • Laparoscopic standard biliopancreatic diversion: technique and preliminary results.

    abstract:BACKGROUND:A technique for standard laparoscopic BPD was developed. METHODS:Standard laparoscopic BPD was performed in 26 morbidly obese patients with mean BMI 43. Details of the technique, using 6 trocars, and instrumentation are described. Intestinal limb lengths were measured fully stretched, and the gastric remnan...

    journal_title:Obesity surgery

    pub_type: 杂志文章,评审

    doi:10.1381/096089202762552692

    authors: Scopinaro N,Marinari GM,Camerini G

    更新日期:2002-04-01 00:00:00

  • Metabolic syndrome: a new multidisciplinary service line.

    abstract::That obesity in the USA has reached epidemic proportions is undeniable: one in three American adults is obese. High levels of obesity yield adverse microeconomic and macroeconomic effects, but assessing the viability of bariatric surgery in this respect requires careful consideration of its efficacy, its economic cost...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-010-0330-9

    authors: Frezza EE,Wachtel M

    更新日期:2011-03-01 00:00:00

  • Monogenic Obesity Mutations Lead to Less Weight Loss After Bariatric Surgery: a 6-Year Follow-Up Study.

    abstract:OBJECTIVES:Bariatric surgery is emerging as the most effective treatment option for patients with obesity. Hypothalamic arcuate nucleus plays an important role in metabolic homeostasis. However, the influence of mutations related to the feeding center on weight loss after bariatric surgery is still unclear. We aimed to...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-018-03623-4

    authors: Li Y,Zhang H,Tu Y,Wang C,Di J,Yu H,Zhang P,Bao Y,Jia W,Yang J,Hu C

    更新日期:2019-04-01 00:00:00

  • The incidence of clinical postoperative thrombosis after gastric surgery for obesity during 16 years.

    abstract:BACKGROUND:Suggested risk factors for postoperative thrombosis such as high fatty acid levels, hypercholesterolemia and diabetes are common in obese patients. METHODS:In a retrospective study, the case records of 328 patients operated for obesity by gastric procedure from September 1977 until December 1993 were analyz...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089297765555575

    authors: Eriksson S,Backman L,Ljungström KG

    更新日期:1997-08-01 00:00:00

  • A Comparison of the Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Body Mass Composition as Measured by Air Displacement Plethysmography.

    abstract:BACKGROUND:The laparoscopic sleeve gastrectomy (LSG) is now the most commonly performed bariatric surgery in the world. Multiple studies have demonstrated the equivalence between the LSG and Roux-en-Y gastric bypass (RYGB) with regard to weight loss and comorbidity resolution. Few studies have examined the differences ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-019-04178-8

    authors: Kavanagh R,Smith J,Avgenackis E,Jones D,Nau P

    更新日期:2020-02-01 00:00:00

  • The utility of routine postoperative upper gastrointestinal swallow studies following laparoscopic sleeve gastrectomy.

    abstract::Laparoscopic sleeve gastrectomy (LSG) has grown in popularity in recent years for the treatment of morbid obesity. Controversy exists regarding the usefulness of upper gastrointestinal (UGI) swallow studies on the first postoperative day in detecting possible complications. The aim of our study was to determine the ef...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-014-1243-9

    authors: Mizrahi I,Tabak A,Grinbaum R,Beglaibter N,Eid A,Simanovsky N,Hiller N

    更新日期:2014-09-01 00:00:00

  • Dehydroepiandrosterone-sulfate modifies human fatty acid composition of different adipose tissue depots.

    abstract:BACKGROUND:Dehydroepiandrosterone-sulfate (DHEA-S) has been described as a protector agent against obesity-related pathologies, although the mechanism of action is still unknown. We have shown that DHEA-S acts on adipose tissue (AT), altering the fatty acid (FA) profile in rodents. Thus, we could hypothesize that some ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-009-0064-8

    authors: Hernandez-Morante JJ,Cerezo D,Cruz RM,Larque E,Zamora S,Garaulet M

    更新日期:2011-01-01 00:00:00

  • The Impact of Bariatric Surgery on Cardiopulmonary Function: Analyzing VO2 Recovery Kinetics.

    abstract:PURPOSE:To assess cardiopulmonary capacity, autonomic heart function, and oxygen recovery kinetics during exercise testing before and after bariatric surgery. METHODS:This is a prospective cohort study. Symptom-limited cardiopulmonary exercise testing was performed with 24 patients, 1 week before and 4 months after ba...

    journal_title:Obesity surgery

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11695-018-3469-4

    authors: Remígio MI,Santa Cruz F,Ferraz Á,Remígio MC,Parente G,Nascimento I,Brandão D,Dornelas de Andrade AF,de Moraes Neto F,Campos J

    更新日期:2018-12-01 00:00:00

  • Trends in Bariatric Surgery: Procedure Selection, Revisional Surgeries, and Readmissions.

    abstract:BACKGROUND:There are limited data quantifying national trends, post-operative readmissions, and revisional surgeries for bariatric procedures. We hypothesized that there is a trend away from Roux en Y gastric bypass (RYGB) and laparoscopic adjustable gastric bands (LAGB) in favor of vertical sleeve gastrectomies (VSG)....

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-015-1974-2

    authors: Abraham A,Ikramuddin S,Jahansouz C,Arafat F,Hevelone N,Leslie D

    更新日期:2016-07-01 00:00:00

  • Prevalence and co-occurrence of upper and lower functional gastrointestinal symptoms in patients eligible for bariatric surgery.

    abstract:BACKGROUND:Obesity is considered as a risk factor for many functional digestive disorders. The aim of the present study was to evaluate the prevalence and the association of functional digestive symptoms affecting the upper and the lower digestive tract in patients eligible for bariatric surgery. METHODS:Before surger...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-011-0396-z

    authors: Fysekidis M,Bouchoucha M,Bihan H,Reach G,Benamouzig R,Catheline JM

    更新日期:2012-03-01 00:00:00

  • Type 1 Diabetes Mellitus and Bariatric Surgery: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Type 1 diabetes mellitus (T1DM) has a rising global prevalence. Although it is vastly outnumbered by type 2 diabetes mellitus rates, it remains a persistent worldwide source of morbidity and mortality. Increasingly, its sufferers are afflicted by obesity and its complications. The objective of the study is t...

    journal_title:Obesity surgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s11695-015-1999-6

    authors: Ashrafian H,Harling L,Toma T,Athanasiou C,Nikiteas N,Efthimiou E,Darzi A,Athanasiou T

    更新日期:2016-08-01 00:00:00

  • A Nationwide Safety Analysis of Discharge on the First Postoperative Day After Bariatric Surgery in Selected Patients.

    abstract:BACKGROUND:Enhanced recovery after surgery has led to early recovery and shorter hospital stay after laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). This study aims to assess feasibility and outcomes of postoperative day (POD) 1 discharge after LRYGB and LSG from the Metabolic a...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-018-3489-0

    authors: Ardila-Gatas J,Sharma G,Lloyd SJ,Khorgami Z,Tu C,Schauer PR,Brethauer SA,Aminian A

    更新日期:2019-01-01 00:00:00

  • Bariatric surgery outcomes in a European Centre of Excellence (CoE).

    abstract::Bariatric Surgery Centres of Excellence have been promoted by the International Federation for the Surgery of Obesity and Metabolic Disorders European Chapter to improve outcomes and security of patients. A retrospective analysis of our prospective database has been performed. Between May 2001 and September 2012, we o...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-013-0980-5

    authors: Fort JM,Vilallonga R,Lecube A,Gonzalez O,Caubet E,Mesa J,Armengol M

    更新日期:2013-08-01 00:00:00

  • Metabolic Effects of Endoscopic Duodenal Mucosal Resurfacing: a Systematic Review and Meta-analysis.

    abstract::Duodenal mucosal resurfacing (DMR) is an innovative endoscopic bariatric and metabolic therapy (EBMT) emerging in recent years. It uses the duodenum to achieve better glycemic and weight control. This study aimed to evaluate in a critical and systematic way the metabolic effects of this procedure. Electronic searches ...

    journal_title:Obesity surgery

    pub_type: 杂志文章,评审

    doi:10.1007/s11695-020-05170-3

    authors: de Oliveira GHP,de Moura DTH,Funari MP,McCarty TR,Ribeiro IB,Bernardo WM,Sagae VMT,Freitas JR Jr,Souza GMV,de Moura EGH

    更新日期:2021-01-08 00:00:00

  • Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea.

    abstract:INTRODUCTION:Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese ...

    journal_title:Obesity surgery

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11695-017-2635-4

    authors: Tirado R,Masdeu MJ,Vigil L,Rigla M,Luna A,Rebasa P,Pareja R,Hurtado M,Caixàs A

    更新日期:2017-09-01 00:00:00

  • Food Intolerance 1 Year After Banded Roux-En-Y Gastric Bypass.

    abstract::The purpose of this study is to evaluate the food intolerance after banded Roux-en-Y gastric bypass (RYGB), correlating the data of food ingestion. METHODS: This is an observational prospective study, which evaluated the individuals before and 3, 6, and 12 months after banded RYGB. We performed an anthropometric evalu...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1007/s11695-018-3544-x

    authors: Gobato RC,Cazzo E,Baltieri L,Modena DAO,Chaim EA

    更新日期:2019-02-01 00:00:00

  • What are gastric banding patients eating one year post-surgery?

    abstract:BACKGROUND:There is a paucity of evidence-based dietary management guidelines for patients post-laparoscopic adjustable gastric banding, including no consensus recommendations for macronutrient intake. We examined the macronutrient intake across a multi-centre cohort of post-bariatric surgery patients and compared thes...

    journal_title:Obesity surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s11695-012-0741-x

    authors: McGrice MA,Porter JA

    更新日期:2012-12-01 00:00:00

  • Laparoscopic gastric banding in adolescents.

    abstract:BACKGROUND:Adolescent obesity has undesirable short- and long-term effects. Laparoscopic adjustable gastric banding has been considered a procedure of choice for adolescent morbid obesity. We retrospectively evaluated our single-team banding experience in the adolescent population. METHODS:We reviewed the medical and ...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089206778663823

    authors: Yitzhak A,Mizrahi S,Avinoach E

    更新日期:2006-10-01 00:00:00

  • In Terms of Nutrition, the Most Suitable Method for Bariatric Surgery: Laparoscopic Sleeve Gastrectomy or Roux-en-Y Gastric Bypass? A Systematic Review and Meta-analysis.

    abstract::This study assesses the differences in postoperative nutritional status between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). We searched the literature from PubMed, Web of Science, Embase, and the Cochrane Library database. Twenty-nine articles were included, with a total of...

    journal_title:Obesity surgery

    pub_type: 杂志文章,评审

    doi:10.1007/s11695-020-04488-2

    authors: Gu L,Fu R,Chen P,Du N,Chen S,Mao D,Chen B,Mao F,Khadaroo PA,Jin Q

    更新日期:2020-05-01 00:00:00

  • Sixth Time Bariatric-Related Surgery for Intractable Nausea, Vomiting, Abdominal Pain, Diarrhea and Weight Loss Failure.

    abstract::A 42-year-old patient with a sixth bariatric-related surgical procedure is presented. The steps taken for the management of her intractable nausea, vomiting, abdominal pain, unacceptable weight loss and diarrhea are described, together with the rationale therefor. Bariatric reoperative surgical procedure and outcome a...

    journal_title:Obesity surgery

    pub_type: 杂志文章

    doi:10.1381/096089295765558006

    authors: Cowan GS Jr

    更新日期:1995-05-01 00:00:00