Mini-gastric Bypass-one Anastomosis Gastric Bypass Research Articles

Stapleless vs Stapled Gastric Bypass vs Hypocaloric Diet: a Three-Arm Randomized Controlled Trial of Body Mass Evolution with Secondary Outcomes for Telomere Length and Metabolic Syndrome Changes.

Obesity and metabolic syndrome (MetS) reduce life expectancy and are challenging to resolve. This randomized controlled trial (RCT) of patients with obesity and MetS undergoing surgical vs nonsurgical treatment compared changes in BMI, and secondarily, telomere length (as a biomarker of life expectancy) and changes in MetS components (insulin resistance, dyslipidemia, hypertension). Study design was a single-center, prospective, three-arm RCT. Group 1 patients underwent novel unstapled laparoscopic one anastomosis gastric bypass with an obstructive stapleless pouch and anastomosis (LOAGB-OSPAN); Group 2, stapled laparoscopic mini-gastric bypass-one anastomosis gastric bypass (LMGB-OAGB); and Group 3, nonsurgical weight loss therapy via a hypocaloric diet with energy restriction (HDER). The primary outcome measure was change in BMI; secondary outcome measures included change in leukocyte telomere length and other MetS components. Of 96 participants screened, 60 were randomly allocated to 3 groups: LOAGB-OSPAN group (n = 20), LMGB-OAGB group (n = 20), and HDER group (n = 20). At post-treatment month 12, respective BMI changes: BMI -12.13 (-8.34, -15.93); -16.04 (-11.7, 20.37); -2,76 (-3.84, -9.36) (p < 0.01). The two surgical groups experienced significant change in telomere length: LOAGB-OSPAN 2.02 (1.61, 2.41), p = 0.001; LMGB-OAGB 2.07 (1.72, 2.43), p = 0.001; and HDER 0.28 (0.22, 0.78), p = 0.26. The surgical groups were also more effective in treating MetS components. There were no deaths. Adverse events: LOAGB-OSPAN (n = 2) (Clavien-Dindo grade II); LMGB-OAGB (n = 8) (grade I (n = 6) and grade II (n = 2). Compared with hypocaloric diet therapy, both bariatric procedures resulted in greater BMI loss, and secondarily, a significant increase in telomere length, and greater MetS resolution. ClinicalTrials.gov , NCT03667469, registered on 11 September 2018.

Mini-gastric Bypass—One Anastomosis Gastric Bypass in the Armamentarium of Bariatric Surgeon: a Narrative Review of Complications

Obesity continues to be a major cause of significant mortality and morbidity across the world. Multiple comorbidities like hypertension, hyperlipidaemia, and diabetes mellitus have been associated with obesity. Bariatric surgery has emerged as a most effective tool for sustainable weight loss in obese individuals. Mini-gastric bypass (MGB) has an advantage of being technically simple and having a shorter learning curve. The objective of the present article is to review the results of mini-gastric bypass based on the available literature. Electronic database search including EMBASE, Web of Science, MEDLINE First Search, OVID, Google Scholar, EBSCO host, Science Direct, and PubMed was performed from inception till October 2020. Mini-gastric Bypass had a short learning curve, took less operative time, and had shorter hospital stay when compared to Roux-en-Y gastric bypass. Mini-gastric bypass had comparable results with Roux-en-Y gastric bypass and better results than sleeve gastrectomy in terms of weight loss and comorbidity resolution. In terms of complications, both had similar marginal ulcer rates, malabsorption rates, and nutritional deficiency rates. Mini-gastric bypass-one anastomosis gastric bypass is documented to be better than Roux-en-Y gastric bypass in terms of internal herniation rates, dumping syndrome, and reactive hypoglycaemia rates. Mini-gastric bypass-one anastomosis gastric bypass is comparable to established bariatric procedures like Roux-en-Y gastric bypass both in terms of efficacy and safety and should be considered a mainstream procedure.

The Early Results of the Laparoscopic Mini-Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index.

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients' BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (Conclusion Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.

Which one is better for non-alcoholic fatty liver disease, the Roux-en-Y gastric bypass or one anastomosis gastric bypass? A paired liver biopsy report

BackgroundLiver complications are one of the predictable outcomes of chronic obesity and bariatric surgery is one of the best way of diminishing them. This study was designed to compare the Roux-en-Y gastric bypass (RYGB) and Mini-Gastric bypass/One Anastomosis gastric bypass (MGB/OAGB) on non-alcoholic fatty liver disease (NAFLD). MethodsIn this prospective study, 76 patients were operated with the RYGB or MGB/OAGB from 2016 to 2018. The weight, liver enzymes and liver pathology reports were evaluated at the base line. We asked all of the patients to come for second liver sampling one year after the surgery. All of the data analyzed by SPSS software. Resultssecondary biopsy was taken from 43.4% of the patients one year after the surgery. According to Brunt system classification, in the RYGB and MGB/OAGB groups, 12.5% and 52.9% of them had no NAFLD respectively and 87.5% and 41.2% of them had Grade 1 NAFLD respectively. One patient (5.9%) in the MGB/OAGB group had Grade II NAFLD. The improvement of NAFLD was significantly better after the MGB/OAGB surgery (P = 0.021). ConclusionsBoth RYGB and MGB/OAGB methods have predictable beneficial effects on weight loss, however, MGB/OAGB can improve NAFLD better than RYGB in short-term follow-up.

Indications, Operative Techniques, and Outcomes for Revisional Operation Following Mini-Gastric Bypass-One Anastomosis Gastric Bypass: a Systematic Review.

In addition to being a relatively reversible and less complex operation, mini-gastric bypass-one anastomosis gastric bypass (MGB-OAGB) has demonstrated comparable weight loss and metabolic improvement rates with Roux-en-Y gastric bypass (RYGB). However, surgical strategies for managing its failures and late complications were poorly defined. This article aims to review the indications, operative techniques, and outcomes for revisional surgery following MGB-OAGB. A systematic review was performed using the PubMed database from 1997 to 2019. Of 179 included patients, 89 underwent revision to RYGB; 52 to sleeve gastrectomy (SG); 32 reversal to original anatomy; and 6 underwent partial revision with gastro-gastrostomy alone. Most common indications were severe malnutrition, chronic bile reflux, intractable marginal ulcerations, and insufficient weight loss. Postoperative complication rates ranged from 5 to 35%.

Adenocarcinoma of oesophagus involving gastro-oesophageal junction following mini-gastric bypass/one anastomosis gastric bypass.

Mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) is an emerging weight loss surgical procedure. There are serious concerns not only regarding the symptomatic biliary reflux into the stomach and the oesophagus but also the increased risk of malignancy after MGB/OAGB. A 54-year-old male, with a body mass index (BMI) of 46.1 kg/m2, underwent Robotic MGB at another centre on 22nd June 2016. His pre-operative upper gastrointestinal endoscopy was not done. He lost 58 kg within 18 months after the surgery and attained a BMI of 25.1 kg/m2. However, 2-year post-MGB, the patient had rapid weight loss of 19 kg with a decrease in BMI to 18.3 kg/m2 within a span of 2 months. He also developed progressive dysphagia and had recurrent episodes of non-bilious vomiting. His endoscopy showed eccentric ulcerated growth in lower oesophagus extending up to the gastro-oesophageal junction and biopsy reported adenocarcinoma of oesophagus. MGB/OAGB has a potential for bile reflux with increased chances of malignancy. Surveillance by endoscopy at regular intervals for all patients who have undergone MGB/OAGB might help in early detection of Barrett's oesophagus or carcinoma of oesophagus or stomach.

The life expectancy of patients with metabolic syndrome after weight loss: study protocol for a randomized clinical trial (LIFEXPE-RT)

BackgroundTo date, surgeons and physicians have found positive results treating metabolic syndrome with surgical and non-surgical weight loss therapies. The purpose of this study was to evaluate changes in telomere length in patients with metabolic syndrome after weight loss.Methods/designThis study is a three-arm randomized controlled trial. The first group is composed of patients who have undergone stapleless bypass surgery (one anastomosis gastric bypass with an obstructive stapleless pouch and anastomosis (LOAGB-OSPAN)). The second group of patients underwent standard gastric bypass surgery (laparoscopic mini-gastric bypass-one anastomosis gastric bypass (LMGB-OAGB). The patients in the third group received non-surgical weight loss therapy, including a hypocaloric diet with energy restriction (− 500 kcal/day).The aim is to compare changes—telomere length, body mass index, comorbidities, and quality of life—in patients with metabolic syndrome after weight loss.DiscussionTo the best of our knowledge, this is the first randomized study to simultaneously compare the effects of surgical and non-surgical weight loss on changes in telomere length. It could provide a solution to the growing problem of metabolic syndrome. Normalization of the body mass index results in improvements in the health of patients with metabolic syndrome.Trial registrationClinicalTrials.gov, NCT03667469. Registered on 11 September 2018.

A353 - Mini gastric bypass-one anastomosis gastric bypass long-term results

Background: The aim of this study is to confirm the efficacy, safety and side effects of Mini gastric bypass-one anastomosis gastric bypass (MGB-OAB) at long-term and assess the quality of life of the patients after surgery.

MGB-OAGB: Effect of Biliopancreatic Limb Length on Nutritional Deficiency, Weight Loss, and Comorbidity Resolution.

Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB) has been approved as a mainstream metabolic/bariatric procedure by IFSO. Still there are lots of concerns regarding nutritional deficiency after MGB-OAGB. The purpose of this retrospective analysis is to evaluate the effect of biliopancreatic limb (BPL) length on weight loss, comorbidity resolution, and nutritional deficiencies in patients 1year after MGB-OAGB and to find suitable BPL length. One hundred and one patients who underwent MGB-OAGB were divided into three groups of 150cm, 180cm, and 250cm depending on the length of BPL bypassed. The nutritional parameters (vitamin D3, vitamin B12, serum iron, serum ferritin, total protein, serum albumin, serum globulin), anthropometric measurements (weight, BMI), and comorbidity resolution (T2DM, hypertension) were compared between the three groups at 1-year follow-up. There was statistically significant difference in number of patients having deficiencies in all the nutritional parameters except globulin between 150cm and 250cm groups (P < 0.05). While on comparing 180- and 250-cm group, a statistically significant difference was present in vitamin D3, vitamin B12, and total protein (P < 0.05) only. The difference was statistically insignificant between the three groups on T2DM, hypertension resolution, and %EWL but TWL between 150cm vs 180cm and 150cm vs 250cm showed significant difference. A 150-cm BPL length is adequate with very minimal nutritional complications and good results. A 180-cm BPL can be used in super obese while a 250-cm BPL should be used with utmost care as it results in significant nutritional deficiencies.

Evidence of the Mini-/One-anastomosis-gastric-Bypass for being a standard procedure in obesity and metabolic surgery

The Mini gastric bypass/One anastomosis gastric bypass (MGB/OAGB) was the third most commonly performed procedure in Germany, with 13.9% of all obesity and metabolic procedures in 2017 (StuDoQ|MBE). This article reviews the currently published evidence for MGB/OAGB and the historical evidence on one anastomosis reconstruction. Asystematic literature search was performed in MEDLINE via PubMed and in Clinicaltrials.gov. from inception to 13 March 2018. Atotal of 35studies met the inclusion criteria: 19retrospective studies, 8retrospective comparative trials, 2systematic reviews, 3 systematic reviews and meta-analyses and 3randomized clinical trials. A total of eight randomized clinical trials regarding MGB/OAGB are currently registered at Clinicaltrials.gov. In this study 35 eligible studies were included reporting data on >15,000 patients. The 30-day mortality rate ranged from 0-0.9% and severe complications needing intervention ranged from 0.8-7%, whereas perioperative morbidity ranged from 3.2-10.8%. The use of MGB/OAGB induced substantial weight loss with atotal weight loss of 31-38% after 1 year and 23-32% after 5years. Moreover, it showed aresolution or improvement in all major obesity-related diseases. Studies evaluating endpoints, such as end organ damage in diabetes, reduction of cardiovascular events and extending survival are missing and are available only for the Roux-enY gastric bypass. This systematic review confirms the advantages of MGB/OAGB regarding weight loss and the antidiabetic effect in the short-term in comparison to Roux-enY gastric bypass and sleeve gastrectomy. The role of bile reflux as apossible risk factor for neoplastic lesions in the long-term remains apoint of discussion. The results of the registered randomized controlled trials will provide a better evidence in the future.

Results of The Comparative Study of 200 Cases: One Anastomosis Gastric Bypass vs Roux-en-Y Gastric Bypass

Obesity has experienced worldwide increase and surgery has become the treatment that has achieved the best results. Several techniques have been described; the most popular are vertical gastrectomy (GV) and the Roux-en-Y gastric bypass (RYGB). However, mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) has gained popularity due to its simplicity and good results. To comparatively evaluate the results of MGB/OAGB with those of RYGB with 1-year follow-up. The paper presents a comparative case and control study of 100 patients that underwent MGB/OAGB surgery and another 100 with RYGB surgery, operated between 2008 and 2016. Patients were not submitted to revision surgery and had the following pre-operative variables: age 40.46 ± 12.4 vs. 39.43 ± 10.33years; sex 64 and 54 women, 36 and 46 men; BMI 44.8 ± 12.06 and 45.29 ± 8.82kg/m2; 50 and 54 cases with comorbidities, respectively, these being non-significant differences. The surgical time was 69.01 ± 4.62 (OAGB) vs. 88.98 ± 3.44min; the time of hospitalization was 2days, reaching a BMI of 27.7 ± 7.85 and 29 ± 4.52kg/m2, with an excess weight loss 1year after surgery of 89.4 vs. 85.9%, respectively. The morbidity rates are 9% for OAGB and 11% for the RYGB. There was a comorbidity resolution of 84.4 and 83.7% respectively, without mortality. The results show the benefits of both techniques, OAGB being the easiest to perform and with less surgical time.

Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement.

The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has played an integral role in educating both the metabolic surgical and the medical community at large about the role of innovative and new surgical and/or endoscopic interventions in treating adiposity-based chronic diseases.The mini gastric bypass is also known as the one anastomosis gastric bypass. The IFSO has agreed that the standard nomenclature should be the mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB). The IFSO commissioned a task force (Appendix 1) to determine if MGB-OAGB is an effective and safe procedure and if it should be considered a surgical option for the treatment of obesity and metabolic diseases.The following position statement is issued by the IFSO MGB-OAGB task force and approved by the IFSO Scientific Committee and Executive Board. This statement is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence. It will be reviewed in 2years.

Evaluation of Weight Loss Indicators and Laparoscopic One-Anastomosis Gastric Bypass Outcomes

Mini-gastric bypass/One-anastomosis gastric bypass (MGB-OAGB) is an effective bariatric technique for treating overweight and obesity, controlling and improving excess-weight-related comorbidities. Our study evaluated OAGB characteristics and resulting weight evolution, plus surgical success criteria based on various excess weight loss indicators. A prospective observational study of 100 patients undergoing OAGB performed by the same surgical team (two-year follow-up). Surgical characteristics were: surgery duration, associated complications, bowel loop length, hospital stay, and weight loss at 6 postoperative points. 100 patients were treated (71 women, 29 men); mean initial age was 42.61 years and mean BMI, 42.61 ± 6.66 kg/m2. Mean surgery duration was 97.84 ± 12.54 minutes; biliopancreatic loop length was 274.95 ± 23.69 cm. Average hospital stay was 24 hours in 98% of patients; no surgical complications arose. Weight decreased significantly during follow-up (P < 0.001). Greatest weight loss was observed at 12 months postsurgery (68.56 ± 13.10 kg). Relative weight loss showed significant positive correlation, with greatest weight loss at 12 months and %excess BMI loss > 50% achieved from the 3-month follow-up in 92.46% of patients. OAGB seems to be effective in treating obesity, with short hospital stays. Relative weight loss correlates optimally with absolute outcomes, but both measures should be used to evaluate surgical results.