Postoperative Outcomes and Advantages of Hand-Sewn Laparoscopic One-Anastomosis Gastric Bypass: Experience on 805 Patien
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ORIGINAL CONTRIBUTIONS
Postoperative Outcomes and Advantages of Hand-Sewn Laparoscopic One-Anastomosis Gastric Bypass: Experience on 805 Patients Mehran Sohrabi Maralani 1 & Sina Azadnajafabad 1 & Fezzeh Elyasinia 1 & Maryam Abolhasani 2 & Mohammadjavad Bagheri 1 & Farhad Kor 1 & Amir Ashrafi 1 & Mohammad Talebpour 1 Received: 29 April 2020 / Revised: 13 September 2020 / Accepted: 15 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose One-anastomosis gastric bypass (OAGB) is a novel laparoscopic approach. The anastomosis of OAGB can be sewn either with a stapler or manually. The aim of this study is to determine the outcome of hand-sewn OAGB. Materials and Methods A total of 805 consecutive patients were retrospectively enrolled in this study. Data collection included change in weight, body mass index (BMI), symptoms, and complications before surgery and continued during annual follow-up visits up to 5 years. Inclusion criteria were patients with a BMI of higher than 40 kg/m2 or higher than 35 kg/m2 with one severe comorbidity. Patients with BMI > 50 kg/m2 were referred to dieticians. Results The follow-up rate ranged from 93 to 50% at the 1-year and 5-year visits after surgery, respectively. Mean weight and BMI of patients before surgery were 121.93 kg (± 22.92) and 44.79 kg/m2 (± 6.07), respectively. Mean of annual BMI in 5 years of follow-up were 27.83, 27.26, 28.90, 29.45, and 29.56 kg/m2. Excess weight loss (EWL) in 5 years of follow-up were 85.7%, 89.5%, 78.9%, 77.7%, and 76.0%. Reflux was present in 202 patients (25.1%) before surgery and resolved in 153 cases (75.7%) 1 year after surgery. Procedure-specific early complication was an anastomosis leak in one patient, which led to death. Two cases of malnutrition necessitating reversal and two severe reflux disorders leading to Roux-en-Y bypass surgery were remarkable late complications. Conclusion Hand-sewn anastomosis could represent an efficient and safe technique in the management of patients undergoing OAGB surgery with acceptable outcomes and rare adverse complications. Keywords Morbid obesity . One-anastomosis gastric bypass . Mini-gastric bypass . Bariatric surgery . Postoperative complications . Revision . Follow-up study
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04981-8) contains supplementary material, which is available to authorized users. * Mohammad Talebpour [email protected]
Mohammadjavad Bagheri [email protected]
Mehran Sohrabi Maralani [email protected]
Farhad Kor [email protected]
Sina Azadnajafabad [email protected]
Amir Ashrafi [email protected]
Fezzeh Elyasinia [email protected]
1
Department of Surgery, Laparoscopic Ward, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Maryam Abolhasani [email protected]
2
Primary Prevention of Cardiovascular Diseases Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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