Short Term Outcomes of Laparoscopic Roux-En-Y Gastric Bypass Versus Laparoscopic One Anastomosis Gastric Bypass in Super Obese Patients: Randomized Clinical Trial

Abstract

Background: One anastomosis gastric bypass (OAGB) has several apparent advantages over Roux-En-Y Gastric Bypass (RYGB). However, symptomatic biliary reflux and its potential risks have prevented its widespread adoption. The aim of this study was to assess the short term outcomes of LOAGB in comparison to LRYGB in treatment of patients with super obesity regarding weight loss, resolution/improvement of co-morbidities and impact on patients’ quality of life (QoL). Methods: One hundred adult patients with super obesity were randomly divided into 2 matched groups, 50 patients each; group I underwent LRYGB and group II underwent LOAGB. Results: The operative time was significantly longer in LRYGB (176.4±27.29 vs. 110.5±14.13 minutes, p<0.05). The frequency and severity of the early postoperative complications were comparable between both groups. No mortality or re-admission was reported in both groups. There are no patients lost to follow-up. Although, the mean Excess weight loss percent (EWL%) was 57% vs 64.7% and 69.7% vs 75.5% at one and two years follow-up in group I and II respectively, the differences were statistically insignificant. T2DM remission/improvement rates at 12th month were 88.9% and 94.1% in group I and II respectively without a statistically insignificant difference. In comparison to the preoperative Qol score, the postoperative score showed a statistically significant improvement (from 0.31 to 6 and from 0.41 to 6.32 in group I and II respectively). Conclusions: LOAGB had a shorter operative time and a tendency towards a higher EWL%, a better remission of obesity-related comorbidities and improvement in the patients QoL with comparable short term operative and postoperative complications. Thus, LOAGB can be considered an acceptable alternative to LRYGB in management of super obese patients.