Comparison of revisional surgeries after OAGB vs RYGB: Results from Multicenter Polish Revision Obesity Surgery Study (PROSS)

Abstract

Introduction: The Roux-en-Y gastric bypass (RYGB) is a leading bariatric surgery globally. The One Anastomosis Gastric Bypass (OAGB), a modification of RYGB, ranks as the third most common bariatric procedure in Poland. While clinical trials show OAGB outcomes are comparable to RYGB regarding weight loss, remission of comorbidities, and hormonal impact, there's limited data on long-term outcomes and complications.Materials and Methods: A retrospective study analyzed patients undergoing revisional bariatric surgeries from January 2010 to January 2020 across 12 Polish centers. Inclusion criteria included patients aged 18 and above who underwent prior OAGB or RYGB. Those with incomplete primary surgery data and follow-up post-revision were excluded. Data gathered covered parameters like anthropometrics, comorbidities, and perioperative details. Patients were categorized based on their initial surgery: OAGB or RYGB. Primary endpoints covered reasons for and types of revisional surgeries, and weight changes; secondary endpoints included postoperative complications and length of hospital stay (LOS).Results: 27 patients participated, with a mean age of 38.187 years. Differences between OAGB (13 patients) and RYGB (14 patients) groups included median initial body weight (100kg vs 126 kg, p<0.016), number of postoperative complications (9 vs 3, p=0.021), median LOS (3 vs 4.5 days, p=0.03). GERD was the primary reason for OAGB revisions (69.2%), whereas insufficient weight loss led RYGB revisions (42.9%). Conclusions: RYGB patients commonly needed revisions due to weight issues, whereas reoperations in the OAGB patients were conducted due to postoperative complications. Postoperative complications and LOS were similar between groups.The importance of research for the development of the field: The results of research may have an influence on clinical surgeons' decisions regarding operation technique choice.