5-Year Results of Banded One-Anastomosis Gastric Bypass: a Pilot Study in Super-Obese Patients
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ORIGINAL CONTRIBUTIONS
5-Year Results of Banded One-Anastomosis Gastric Bypass: a Pilot Study in Super-Obese Patients Karl A. Miller 1,2,3
&
Marcus Radauer 2 & J. N. Buchwald 4 & T. W. McGlennon 5 & Elisabeth Ardelt-Gattinger 6
Received: 5 February 2020 / Revised: 20 June 2020 / Accepted: 22 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The novel banded one-anastomosis gastric bypass (B-OAGB) procedure has not previously been reported in superobese patients over the long term. In this pilot study, outcomes in patients with a mean baseline body mass index (BMI, kg/m2) of ≥ 50 who underwent B-OAGB were evaluated through 5-year follow-up. Patients and Methods Total weight loss (TWL), excess weight loss (EWL), BMI evolution, and changes in type 2 diabetes biomarkers were analyzed prospectively in super-obese patients who underwent B-OAGB. Paired samples t tests were used to assess weight outcome change from baseline through 5-year follow-up and 95% CIs were calculated. The Bariatric Outcomes and Reporting System (BAROS) was used to assess surgical success at 3 time points. Results Between October 2013 and February 2014, a 12-patient pilot cohort (mean baseline BMI 57.5 ± 6.3) underwent BOAGB. No perioperative complications were observed within 30 days. Five-year mean BMI was 31.2 ± 5.4, a BMI loss of 25.9 (TWL 45.3 ± 7.5%; EWL 72.2 ± 12.8%). Between 11 and 24 months following surgery, 3 patients required band removal; each had one complication (1 stasis esophagitis and recurrent vomiting; 1 hypoalbuminemia; 1 anemia). There was no mortality. Long-term B-OAGB BAROS subscale and composite scores were comparable to other major bariatric procedures. Conclusions In a pilot study of super-obese patients who underwent B-OAGB, excellent durable BMI loss of 25.9 kg/m2 (EWL 72.2%) at 5 years was achieved with an acceptable level of reoperation. More B-OAGB long-term follow-up studies are necessary to provide definitive conclusions regarding this combination bariatric procedure. Keywords Banded one-anastomosis gastric bypass . B-OAGB . TWL . EWL . RYGB . LAGB . MGB . SG . Gastroesophageal reflux . Iron deficiency anemia
Introduction Super obesity is associated with substantially increased risk of morbidity and mortality. Life expectancy for patients with super obesity (body mass index (BMI, kg/m2) ≥ 50) is * Karl A. Miller [email protected] 1
Diakonissen Wehrle Private Hospital, Salzburg, Austria
2
Hospital Hallein, Salzburg, Austria
3
Bariatric and Metabolic Unit, Diakonissen & Wehrle Private Clinic, Guggenbichlerstrasse 20, A-5026 Salzburg, Austria
4
Division of Scientific Research Writing, Medwrite Medical Communications, Maiden Rock, WI, USA
5
McGlennon MotiMetrics (M3), Maiden Rock, WI, USA
6
University of Salzburg, Salzburg, Austria
markedly shorter, by up to 9.8 years, than for those with a normal BMI [1]. Yet, published mid- and long-term outcomes for super-obese patients who have undergone bariatric surgery are scant. While Roux-en-Y gastric bypass (R
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