Impact of one-anastomosis gastric bypass and laparoscopic sleeve gastrectomy on metabolic parameters in morbidly obese patients: A comparative review.

Muhmmad Dilawaiz Mujahid, Ayesha Mahnoor, Afifa Saadia, Muhammad Usman, Muhammad Akram, Randomized Controlled Trial, Dr. Muhmmad Dilawaiz Mujahid
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Abstract

Objective: To compare one-anastomosis gastric bypass and laparoscopic sleeve gastrectomy in morbidly obese patients in terms of frequency of dyslipidemia, mean AST, mean ALT, mean HbA1C and mean FPG. Study Design: Randomized Controlled Trial Setting: Department of General Surgery, Allied Hospital, Faisalabad. Period: October 20, 2022, to June 20, 2023, Methods: Morbidly obese individuals were randomly assigned to either undergo laparoscopic sleeve gastrectomy (Group A) or one-anastomosis gastric bypass (Group B). The study, led by a consultant with 3 years of post-fellowship experience, conducted comprehensive patient assessments, including BMI calculations and metabolic profiling. Monthly follow-ups continued until the 6th month, after which lipid profiles, alanine transaminase (ALT), aspartate transaminase (AST), hemoglobin A1C (HbA1C) and fasting plasma glucose (FPG), results were obtained from the hospital pathology lab. The comparative analysis revealed superior outcomes in Group B, the one-anastomosis gastric bypass cohort, as compared to Group A (laparoscopic sleeve gastrectomy), spanning multiple parameters. Results: The mean FPG in Group A was 5.52±0.26, compared to 5.56±0.25 in Group B. Mean HbA1c was 6.65±0.24 in Group A and 6.26±0.19 in Group B. AST levels were comparable, with 24.13±3.31 in Group A and 24.23±3.48 in Group B, yielding a p-value of 0.896. Similarly, ALT levels showed no significant difference between the groups (24.55±3.46 in Group A and 23.92±3.35 in Group B, p-value=0.414). Conclusion: One-anastomosis gastric bypass demonstrated superior efficacy over laparoscopic sleeve gastrectomy in morbidly obese patients, showcasing favorable outcomes in terms of dyslipidemia, AST, ALT, HbA1C, and FPG.
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单吻合器胃旁路术和腹腔镜袖带胃切除术对病态肥胖患者代谢指标的影响:对比综述。
目的比较单吻合器胃旁路术和腹腔镜袖带胃切除术治疗病态肥胖患者的血脂异常频率、平均谷草转氨酶、平均谷丙转氨酶、平均 HbA1C 和平均 FPG。研究设计:随机对照试验:费萨拉巴德联合医院普外科。时间: 2022 年 10 月 20 日至 6 月2022 年 10 月 20 日至 2023 年 6 月 20 日:随机分配病态肥胖者接受腹腔镜袖带胃切除术(A 组)或单吻合胃旁路术(B 组)。该研究由一名有 3 年研究员经验的顾问领导,对患者进行全面评估,包括 BMI 计算和代谢分析。每月一次的随访持续到第 6 个月,之后从医院病理实验室获得血脂概况、丙氨酸转氨酶 (ALT)、天冬氨酸转氨酶 (AST)、血红蛋白 A1C (HbA1C) 和空腹血浆葡萄糖 (FPG) 的结果。对比分析表明,与 A 组(腹腔镜袖带胃切除术)相比,B 组(单吻合器胃旁路手术组)在多个参数上都取得了更好的疗效。研究结果A 组的平均 FPG 为 5.52±0.26,B 组为 5.56±0.25;A 组的平均 HbA1c 为 6.65±0.24,B 组为 6.26±0.19;A 组的 AST 水平为 24.13±3.31,B 组为 24.23±3.48,P 值为 0.896。同样,ALT 水平在各组之间无明显差异(A 组为 24.55±3.46,B 组为 23.92±3.35,P 值=0.414)。结论在病态肥胖患者中,单吻合器胃旁路术的疗效优于腹腔镜袖带胃切除术,在血脂异常、谷草转氨酶、谷丙转氨酶、血红蛋白A1C和血脂指数(FPG)方面均显示出良好的疗效。
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