Early safety outcomes of laparoscopic one anastomosis gastric bypass in patients with class III, IV, and V obesity.

Abstract

The extremely obese patient deserves special consideration: significant comorbidities, technical difficulties, and increased postoperative morbidity and mortality are all expected in this patient population. The study compared early postoperative complications (≤30-day) following one-anastomosis gastric bypass (OAGB) morbidity in patients with morbid obesity class IV obesity, body mass index (BMI) ≥50-59.9kg/m2, and class V obesity, BMI ≥60 patients. We retrospectively reviewed perioperative OAGB outcomes in three BMI groups. Operative time, length of stay (LOS), and overall early postoperative complication rates were studied. Patient-reported complications were ranked by Clavien-Dindo Classification (CDC). Between January 2017-December 2021, consecutive patients with obesity class III (n=2950), IV (n=256), and V (n=23) underwent OAGB. BMI groups were comparable in sex, age, and associated comorbidities. Mean operative time was significantly longer in the higher BMI groups: class III (66.5±25.6min), IV (70.5±28.7min), and V (80.0±34.7min), respectively (p=0.018); no difference in LOS. In respective BMI classes, ≤30-day complication rates were 3.2%, 3.5%, and 4.3% (p=0.926). The respective number of patients with CDC grades of one to two were 45 (1.5%), 6 (2.3%), and 1 (4.3%), p=0.500; and in grade ≥3a, 25 (0.8%), 1 (0.4%), 0 (0.0%), p=0.669. There was 0.06% mortality (n=2 in 3229), both in BMI class III. OAGB is a safe BS procedure in patients with class III, IV, and V obesity in the perioperative term with comparable ≤30-day morbidity in the three BMI groups.