One-Anastomosis Gastric Bypass Best Balances Metabolic Outcomes, Perioperative Safety

In a network meta-analysis comparing the three most commonly used metabolic surgery procedures, one-anastomosis gastric bypass (OAGB) appeared the overall frontrunner for maximizing weight loss and type 2 diabetes remission. Researchers published their findings in Obesity Surgery.

“The findings from this network meta-analysis suggest that OAGB offers comparable metabolic control through weight loss and type 2 diabetes remission to Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy whilst minimizing perioperative complications,” wrote a research team from England. “Therefore, OAGB should be considered more strongly as a primary metabolic surgical procedure.”

The network meta-analysis included 20 randomized controlled trials involving 1803 adults who underwent OAGB, RYGB, or sleeve gastrectomy. Researchers compared weight loss, type 2 diabetes remission, and perioperative complications with each procedure.

Differences in excess weight loss between procedures were minor at years 1 and 2 but appeared greatest with OAGB. However, any differences disappeared by years 3 through 5, according to the study. Type 2 diabetes remission was more likely with RHGB or OAGB compared with sleeve gastrectomy.

RHGB had higher rates of perioperative complications compared with OAGB or sleeve gastrectomy, while network meta-analysis identified no difference in the risk of perioperative complications between OAGB and sleeve gastrectomy.

“When the potential benefits of excess weight loss and type 2 diabetes remission were considered against the risk of perioperative complications, OAGB appears to offer the optimal balance of these factors across all time points,” researchers wrote.

Reference:
Currie AC, Askari A, Fangueiro A, Mahawar K. Network meta-analysis of metabolic surgery procedures for the treatment of obesity and diabetes. Obes Surg. 2021;31(10):4528-4541. doi:10.1007/s11695-021-05643-z