One Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass: A Randomized Prospective Trial

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Metabolic Surgery

Background:

• One anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) are established bariatric procedures.
• Limited long-term randomized data exists comparing OAGB and RYGB beyond two years.

Purpose of the Study:

• To compare the 3-year outcomes of OAGB versus RYGB in patients with morbid obesity.
• To evaluate weight loss, comorbidity remission, and adverse events between the two surgical techniques.

Main Methods:

• A randomized prospective study involving 38 patients (20 OAGB, 18 RYGB) aged 18-65.
• Patients were assessed at 6, 12, 24, and 36 months post-surgery.
• Key metrics included Body Mass Index (BMI), percentage total weight loss (TWL%), percentage excess weight loss (EWL%), and comorbidity remission.

Main Results:

• At 3 years, both OAGB and RYGB groups showed similar mean BMIs (28.80 vs 29.17 kg/m²; p=0.822).
• Percentage total weight loss and excess weight loss were comparable between the OAGB and RYGB groups.
• Comorbidity remission rates were similar; however, de novo reflux developed in 4 OAGB patients but none in RYGB patients (p=0.066).

Conclusions:

• Both OAGB and RYGB are effective bariatric procedures for treating morbid obesity.
• The procedures demonstrate similar efficacy in managing obesity-related comorbidities over a 3-year period.
• While effective, OAGB may be associated with a higher incidence of de novo reflux compared to RYGB.