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MGB/OAGB: 180cm intestinal bypassed length works for patients with a BMI40–45 and 45–50 

Fri, 06/19/2020 - 12:12
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Researchers from Iran performing laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) have reported that 180cm intestinal bypassed length works for patients with a BMI40–45 and 45–50 with significant decreases in weight and BMI, and improvements in glycolipid profiles.

The study, ‘Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index’, published in the Journal of Obesity, by researchers from Isfahan University of Medical Sciences, Isfahan, Iran, aimed to assess short-term metabolic and nutritional effects of MGB/OAGB with a loop bypass length of 180cm in two BMI groups (BMI40–45 and 45–50).

“Based on the importance of selecting the best technique of gastric bypass surgery, preventing secondary malabsorption and metabolic complications, and due to controversial findings of previous studies, we aimed to assess short-term metabolic and nutritional effect of MGB/OAGB with 180-centimeter (cm) intestinal bypass length in patients with a BMI of 40–45 and 45–50 kg/m2,” the authors write.

The prospective cross-sectional study included 50 patients and 25 patients were allocated into two groups according to their preoperative BMI (40–45 and 45–50). Demographic information including gender, height, first BMI and laboratory results were collected and reassessed at 15, 30, 90 and 180 days post-operatively.

Outcomes

The mean age of the patients was 45 ± 8.36 years (range: 36–55) in group 1 and 46 ± 5.49 years in group 2 (range: 35–58) (p=0.15) and 24% and 40% of groups 1 and 2 were male, respectively (p=0.22). There were no early post-operative or late complications or any reoperations.

The weight (kg) for group 1 (BMI40-45) at baseline, 15 day, 30 days, three months and six months was 113.80±8.65, 106.88±9.02, 101.72±7.92, 91.20±8.20 and 81.04±7.71, respectively, demonstrating statistically significant reductions in body weight (<0.001). The weight for group 2 (BMI45-50) at baseline, 15 day, 30 days, three months and six months was 132.56±11.86, 125.68±10.11, 120.64±9.88, 109.72±11.43 and 95.96±11.53, respectively, demonstrating statistically significant reductions in body weight (<0.001).

The BMI for group 1 (BMI40-45) at baseline, 15 day, 30 days, three months and six months was 41.53±1.44, 37.50±7.16, 37.15±1.64, 33.25±1.94 and 29.44±2.42, respectively, demonstrating statistically significant reductions in BMI (<0.001). The BMI for group 2 (BMI45-50) at baseline, 15 day, 30 days, three months and six months was 48.36±2.28, 45.88±2.48, 44.03±2.26, 39.96±2.22 and 34.89±1.82, respectively, demonstrating statistically significant reductions in BMI  (<0.001).

The excess weight loss for group 1 (BMI40-45) at 15 days, 30 days, three months and six months was 14.79±4.79, 23.04±5.73, 44.24±12.92 and 60.51±24.26, respectively, demonstrating statistically significant reductions in excess weight loss (<0.001). The excess weight loss for group 2 (BMI45-50) at 15 days, 30 days, three months and six months was 10.77±4.11, 15.45±6.06, 29.12±15.22 and 46.64±19.04, respectively, demonstrating statistically significant reductions in excess weight loss (<0.001).

Laboratory data three and six months after the surgery showed a decline in both groups in fasting blood sugar, triglycerides, total cholesterol, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase levels. Iron, ferritin, vitamin D, and vitamin B12 levels initially decreased and increased afterwards, probably due to supplements, none of the changes were statistically significant.

“We suggest researchers evaluate each single anastomosis length between two different groups of patients and different intestinal bypass length for patients with the same BMI to reach to a consensus for choosing appropriate intestinal bypass length for patients with different BMI category,” the recommended. “Furthermore, larger sample size, randomised controlled trials, and longer postoperative follow-up can decrease the biases of choosing the patients and evaluating the results of bariatric surgery in the long term.”

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