National introduction of one-anastomosis gastric bypass in the UK National Bariatric Surgery Registry - a cohort study.

IF 12.5 2区医学 Q1 SURGERY International journal of surgery Pub Date : 2024-09-23 DOI:10.1097/JS9.0000000000002005

Andrew C Currie, Alan Askari, Chetan Parmar, James Byrne, Ahmed R Ahmed, Chris M Pring, Omar A Khan, Peter K Small, Kamal Mahawar

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Abstract

Aim: There is a paucity of evidence regarding the national introduction of newer bariatric metabolic surgery procedures. This study assessed the impact of introducing one-anastomosis gastric bypass (OAGB) in bariatric surgical practice in the UK on 30-day postoperative morbidity and early postoperative weight loss.

Methods: Patients who underwent primary BMS in the UK National Bariatric Surgical Registry (2010-2019) were identified. Patient characteristics, 30-day postoperative morbidity, and 12-month total body weight loss (TBWL) were also assessed. Multivariate regression was performed for associations between 30-day postoperative morbidity and 12-month TBWL, with SG as a reference. Learning effects were assessed by factoring in the institutional OAGB caseload (0-24/25-49/50+ cases).

Results: A total of 59,226 patients underwent primary BMS during the study period (RYGB, 38,434; SG, 24,702; AGB, 12,627; OAGB, 3,408; and Others, 276). The 30-day postoperative morbidity was lower for OAGB 1.8% (51/2,802) compared to RYGB 4.2% (1,391/32,853) and SG 3.4% (725/21,333) but higher than AGB 1.2% (123/9,915), while on multivariate regression, OAGB was associated with reduced morbidity once the institution caseload exceeded 50 operations (OR 0.35 (95% CI, 0.22-0.56; P<0.001) and no statistical difference to SG at lesser caseloads. Overall, 12-month greater than 25% TBWL was seen in 69.4% (27736/39971) (RYGB: 82.9% (17617/21246)), SG: 65.4% (7383/11283)), AGB: 23.9% (1382/5572)) and OAGB: 82.9% (1328/1601)). On multivariate regression, OAGB was associated with the highest 12-month TBWL once the institution caseload exceeded 50 operations (OR 3.47 (95% CI 2.75-4.39; P<0.001).

Conclusion: OAGB has been safely implemented in UK national bariatric surgery practice. It has lower reported postoperative morbidity and comparable weight loss to RYGB or SG, despite being offered to patients with more severe and complex obesity.

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英国国家减肥手术登记处在全国范围内引入单吻合胃旁路术--一项队列研究。

目的：关于在全国范围内引进较新的减肥代谢外科手术的证据很少。本研究评估了在英国减肥手术实践中引入单吻合胃旁路术（OAGB）对术后30天发病率和术后早期体重减轻的影响：方法：对英国国家减肥手术登记处（2010-2019 年）中接受初级 BMS 的患者进行识别。还评估了患者特征、术后 30 天发病率和 12 个月总体重减轻 (TBWL)。以 SG 为参照，对术后 30 天发病率与 12 个月总体重减轻之间的关系进行了多变量回归。评估学习效应时考虑到了医院的 OAGB 病例数（0-24/25-49/50+ 例）：研究期间，共有 59,226 名患者接受了初级 BMS（RYGB，38,434 例；SG，24,702 例；AGB，12,627 例；OAGB，3,408 例；其他，276 例）。与 RYGB 的 4.2% (1,391/32,853) 和 SG 的 3.4% (725/21,333) 相比，OAGB 的术后 30 天发病率较低，为 1.8% (51/2,802) ，但高于 AGB 的 1.2% (123/9,915)：OAGB 已在英国全国减肥手术实践中安全实施。尽管 OAGB 适用于更严重、更复杂的肥胖症患者，但其术后发病率较低，减重效果与 RYGB 或 SG 相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.