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A Prospective Study on Short-Term Changes in Serum Nutrient Levels After Sleeve Gastrectomy and One Anastomosis Gastric Bypass (OAGB)

Received: 22 October 2021    Accepted: 12 November 2021    Published: 19 November 2021
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Abstract

In Egypt, sleeve gastrectomy and one anastomosis gastric bypass (OAGB) are popular bariatric procedures. The current study was conducted to compare between these two procedures regarding short-term weight loss, comorbidity improvement, vitamin and micronutrient changes. This prospective study included 40 cases who were divided into two equal groups; sleeve gastrectomy and OAGB groups. All cases received the standard perioperative care. Our primary outcome was serum nutrient changes (hemoglobin, iron, calcium, vitamin D, and vitamin B 12), while secondary outcomes included weight loss parameters along with the improvement of obesity related comorbidities. These data were recorded 3, 6, and 12 months after operation, and then compared to the corresponding baseline values. Demographic criteria were comparable between the two groups, apart from diabetes which was more prevalent in the OAGB group. Both groups were followed by a significant and comparable weight loss at the short-term after operation. Both groups were associated with significant improvement in DM and hypertension at 12 months. Most evaluated vitamin and nutrient levels were comparable between the two groups except for hemoglobin, iron and vitamin B 12 levels, which were significantly higher with sleeve gastrectomy at 6- and 12-month follow up. Both sleeve gastrectomy and OAGB are effective bariatric procedures that could achieve satisfactory weight loss and improvement of comorbidities. However, OAGB carries higher risk of iron, hemoglobin and vitamin B 12 deficiency.

Published in Journal of Surgery (Volume 9, Issue 6)
DOI 10.11648/j.js.20210906.13
Page(s) 264-270
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sleeve Gastrectomy, One Anastomosis, Gastric Bypass, Vitamin Deficiency, Malnutrition

References
[1] Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. Adv Exp Med Biol. 2017; 960: 1-17. https://doi.org/10.1007/978-3-319-48382-5_1.
[2] Wu C, Bai R, Yan W, Yan M, Song M. Clinical Outcomes of One Anastomosis Gastric Bypass Versus Sleeve Gastrectomy for Morbid Obesity. Obes Surg. 2020; 30 (3): 1021-31. https://doi.org/10.1007/s11695-019-04303-7.
[3] Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, et al. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017; 27 (9): 2279-89. https://doi.org/10.1007/s11695-017-2666-x.
[4] Bassiony AI, Sabry A, Shiha O, ElGeidie A, Nassar MK. The Short-Term Renal Effects of Bariatric Surgery: A Comparative Study Between Sleeve Gastrectomy and One Anastomosis Gastric Bypass Operations Among Egyptian Patients With Severe Obesity. Obes Surg. 2020; 30 (11): 4494-504. https://doi.org/10.1007/s11695-020-04841-5.
[5] Welbourn R, Hollyman M, Kinsman R, Dixon J, Liem R, Ottosson J, et al. Bariatric Surgery Worldwide: Baseline Demographic Description and One-Year Outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019; 29 (3): 782-95. https://doi.org/10.1007/s11695-018-3593-1.
[6] Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018; 28 (12): 3783-94. https://doi.org/10.1007/s11695-018-3450-2.
[7] Peterli R, Wölnerhanssen BK, Peters T, Vetter D, Kröll D, Borbély Y, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial. Jama. 2018; 319 (3): 255-65. https://doi.org/10.1001/jama.2017.20897.
[8] Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial. Jama. 2018; 319 (3): 241-54. https://doi.org/10.1001/jama.2017.20313.
[9] García-Caballero M, Carbajo M. One anastomosis gastric bypass: a simple, safe and efficient surgical procedure for treating morbid obesity. Nutr Hosp. 2004; 19 (6): 372-5.
[10] Rutledge R, Kular K, Manchanda N. The Mini-Gastric Bypass original technique. Int J Surg. 2019; 61: 38-41. https://doi.org/10.1016/j.ijsu.2018.10.042.
[11] Mahawar KK, Parmar C, Graham Y. One anastomosis gastric bypass: key technical features, and prevention and management of procedure-specific complications. Minerva Chir. 2019; 74 (2): 126-36. https://doi.org/10.23736/s0026-4733.18.07844-6.
[12] Robert M, Espalieu P, Pelascini E, Caiazzo R, Sterkers A, Khamphommala L, et al. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. Lancet. 2019; 393 (10178): 1299-309. https://doi.org/10.1016/s0140-6736(19)30475-1.
[13] Musella M, Vitiello A. The YOMEGA non-inferiority trial. Lancet. 2019; 394 (10207): 1412. https://doi.org/10.1016/s0140-6736(19)31875-6.
[14] Magouliotis DE, Tasiopoulou VS, Svokos AA, Svokos KA, Sioka E, Zacharoulis D. One-Anastomosis Gastric Bypass Versus Sleeve Gastrectomy for Morbid Obesity: a Systematic Review and Meta-analysis. Obes Surg. 2017; 27 (9): 2479-87. https://doi.org/10.1007/s11695-017-2807-2.
[15] Brethauer SA, Kim J, el Chaar M, Papasavas P, Eisenberg D, Rogers A, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015; 11 (3): 489-506. https://doi.org/10.1016/j.soard.2015.02.003.
[16] Bruzzi M, Rau C, Voron T, Guenzi M, Berger A, Chevallier JM. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015; 11 (2): 321-6. https://doi.org/10.1016/j.soard.2014.09.004.
[17] Musella M, Susa A, Greco F, De Luca M, Manno E, Di Stefano C, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014; 28 (1): 156-63. https://doi.org/10.1007/s00464-013-3141-y.
[18] Noun R, Skaff J, Riachi E, Daher R, Antoun NA, Nasr M. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012; 22 (5): 697-703. https://doi.org/10.1007/s11695-012-0618-z.
[19] Prasad P, Tantia O, Patle N, Khanna S, Sen B. An analysis of 1-3-year follow-up results of laparoscopic sleeve gastrectomy: an Indian perspective. Obes Surg. 2012; 22 (3): 507-14. https://doi.org/10.1007/s11695-012-0599-y.
[20] Rawlins L, Rawlins MP, Brown CC, Schumacher DL. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013; 9 (1): 21-5. https://doi.org/10.1016/j.soard.2012.08.014.
[21] Cal P, Deluca L, Jakob T, Fernández E. Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial. Surg Endosc. 2016; 30 (5): 1812-5. https://doi.org/10.1007/s00464-015-4450-0.
[22] Thereaux J, Corigliano N, Poitou C, Oppert JM, Czernichow S, Bouillot JL. Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥ 50 kg/m2. Surg Obes Relat Dis. 2015; 11 (4): 785-90. https://doi.org/10.1016/j.soard.2014.11.022.
[23] Kansou G, Lechaux D, Delarue J, Badic B, Le Gall M, Guillerm S, et al. Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: One year outcomes. Int J Surg. 2016; 33 Pt A: 18-22. https://doi.org/10.1016/j.ijsu.2016.07.051.
[24] Seetharamaiah S, Tantia O, Goyal G, Chaudhuri T, Khanna S, Singh JP, et al. LSG vs OAGB-1 Year Follow-up Data-a Randomized Control Trial. Obes Surg. 2017; 27 (4): 948-54. https://doi.org/10.1007/s11695-016-2403-x.
[25] Kular KS, Manchanda N, Rutledge R. Analysis of the five-year outcomes of sleeve gastrectomy and mini gastric bypass: a report from the Indian sub-continent. Obes Surg. 2014; 24 (10): 1724-8. https://doi.org/10.1007/s11695-014-1264-4.
[26] Bashah M, Aleter A, Baazaoui J, El-Menyar A, Torres A, Salama A. Single Anastomosis Duodeno-ileostomy (SADI-S) Versus One Anastomosis Gastric Bypass (OAGB-MGB) as Revisional Procedures for Patients with Weight Recidivism After Sleeve Gastrectomy: a Comparative Analysis of Efficacy and Outcomes. Obes Surg. 2020; 30 (12): 4715-23. https://doi.org/10.1007/s11695-020-04933-2.
[27] Zamaninour N, Pazouki A, Kermansaravi M, Seifollahi A, Kabir A. Changes in Body Composition and Biochemical Parameters Following Laparoscopic One Anastomosis Gastric Bypass: 1-Year Follow-Up. Obes Surg. 2021; 31 (1): 232-8. https://doi.org/10.1007/s11695-020-04901-w.
[28] Lee WJ, Wang W, Lee YC, Huang MT, Ser KH, Chen JC. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008; 18 (3): 294-9. https://doi.org/10.1007/s11695-007-9367-9.
[29] Deitel M, Rutledge R. Mini-gastric bypass: Prevention and management of complications in performance and follow-up. Int J Surg. 2019; 71: 119-23. https://doi.org/10.1016/j.ijsu.2019.09.003.
[30] Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Huang MT. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005; 242 (1): 20-8. https://doi.org/10.1097/01.sla.0000167762.46568.98.
[31] Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001; 11 (3): 276-80. https://doi.org/10.1381/096089201321336584.
[32] Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005; 15 (9): 1304-8. https://doi.org/10.1381/096089205774512663.
[33] Serra-Planas E, Aguilera E, Granada ML, Soldevila B, Salinas I, Reverter JL, et al. High prevalence of vitamin D deficiency and lack of association with subclinical atherosclerosis in asymptomatic patients with Type 1 Diabetes Mellitus from a Mediterranean area. Acta Diabetol. 2015; 52 (4): 773-9. https://doi.org/10.1007/s00592-014-0699-3.
[34] Moizé V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-En-Y gastric bypass in a mediterranean population. J Acad Nutr Diet. 2013; 113 (3): 400-10. https://doi.org/10.1016/j.jand.2012.11.013.
[35] Aarts EO, Janssen IM, Berends FJ. The gastric sleeve: losing weight as fast as micronutrients? Obes Surg. 2011; 21 (2): 207-11. https://doi.org/10.1007/s11695-010-0316-7.
[36] Luger M, Kruschitz R, Winzer E, Schindler K, Grabovac I, Kainberger F, et al. Changes in Bone Mineral Density Following Weight Loss Induced by One-Anastomosis Gastric Bypass in Patients with Vitamin D Supplementation. Obes Surg. 2018; 28 (11): 3454-65. https://doi.org/10.1007/s11695-018-3353-2.
[37] Saif T, Strain GW, Dakin G, Gagner M, Costa R, Pomp A. Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis. 2012; 8 (5): 542-7. https://doi.org/10.1016/j.soard.2012.01.013.
[38] Switzer NJ, Marcil G, Prasad S, Debru E, Church N, Mitchell P, et al. Long-term hypovitaminosis D and secondary hyperparathyroidism outcomes of the Roux-en-Y gastric bypass: a systematic review. Obes Rev. 2017; 18 (5): 560-6. https://doi.org/10.1111/obr.12525.
[39] Compher CW, Badellino KO, Boullata JI. Vitamin D and the bariatric surgical patient: a review. Obes Surg. 2008; 18 (2): 220-4. https://doi.org/10.1007/s11695-007-9289-6.
[40] Bourbour F, Kabir A, Pazouki A, Mokhber S, Kord-Varkaneh H, Găman MA, et al. Trends in Serum Vitamin D Levels within 12 Months after One Anastomosis Gastric Bypass (OAGB). Obes Surg. 2021. https://doi.org/10.1007/s11695-021-05434-6.
[41] Mahdy T, Gado W, Alwahidi A, Schou C, Emile SH. Sleeve Gastrectomy, One-Anastomosis Gastric Bypass (OAGB), and Single Anastomosis Sleeve Ileal (SASI) Bypass in Treatment of Morbid Obesity: a Retrospective Cohort Study. Obes Surg. 2021 Apr; 31 (4): 1579-1589. http://doi: 10.1007/s11695-020-05159-y
[42] Pellitero S, Martínez E, Puig R, Leis A, Zavala R, Granada ML, et al. Erratum to: Evaluation of Vitamin and Trace Element Requirements after Sleeve Gastrectomy at Long Term. Obes Surg. 2017; 27 (7): 1683. https://doi.org/10.1007/s11695-017-2654-1.
[43] Ben-Porat T, Elazary R, Yuval JB, Wieder A, Khalaileh A, Weiss R. Nutritional deficiencies after sleeve gastrectomy: can they be predicted preoperatively? Surg Obes Relat Dis. 2015; 11 (5): 1029-36. https://doi.org/10.1016/j.soard.2015.02.018.
[44] Musella M, Apers J, Rheinwalt K, Ribeiro R, Manno E, Greco F, et al. Efficacy of Bariatric Surgery in Type 2 Diabetes Mellitus Remission: the Role of Mini Gastric Bypass/One Anastomosis Gastric Bypass and Sleeve Gastrectomy at 1 Year of Follow-up. A European survey. Obes Surg. 2016; 26 (5): 933-40. https://doi.org/10.1007/s11695-015-1865-6.
[45] Madhok B, Mahawar KK, Boyle M, Carr WR, Jennings N, Schroeder N, et al. Management of Super-super Obese Patients: Comparison Between Mini (One Anastomosis) Gastric Bypass and Sleeve Gastrectomy. Obes Surg. 2016; 26 (7): 1646-9. https://doi.org/10.1007/s11695-016-2181-5.
[46] Liagre A, Queralto M, Juglard G, Anduze Y, Iannelli A, Martini F. Multidisciplinary Management of Leaks After One-Anastomosis Gastric Bypass in a Single-Center Series of 2780 Consecutive Patients. Obes Surg. 2019; 29 (5): 1452-61. https://doi.org/10.1007/s11695-019-03754-2.
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    Mohamed Fikry, Hesham Saad Noor, Waleed Thabet, Hosam Ghazy, Sabry Ahmed Mahmoud. (2021). A Prospective Study on Short-Term Changes in Serum Nutrient Levels After Sleeve Gastrectomy and One Anastomosis Gastric Bypass (OAGB). Journal of Surgery, 9(6), 264-270. https://doi.org/10.11648/j.js.20210906.13

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    ACS Style

    Mohamed Fikry; Hesham Saad Noor; Waleed Thabet; Hosam Ghazy; Sabry Ahmed Mahmoud. A Prospective Study on Short-Term Changes in Serum Nutrient Levels After Sleeve Gastrectomy and One Anastomosis Gastric Bypass (OAGB). J. Surg. 2021, 9(6), 264-270. doi: 10.11648/j.js.20210906.13

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    AMA Style

    Mohamed Fikry, Hesham Saad Noor, Waleed Thabet, Hosam Ghazy, Sabry Ahmed Mahmoud. A Prospective Study on Short-Term Changes in Serum Nutrient Levels After Sleeve Gastrectomy and One Anastomosis Gastric Bypass (OAGB). J Surg. 2021;9(6):264-270. doi: 10.11648/j.js.20210906.13

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  • @article{10.11648/j.js.20210906.13,
      author = {Mohamed Fikry and Hesham Saad Noor and Waleed Thabet and Hosam Ghazy and Sabry Ahmed Mahmoud},
      title = {A Prospective Study on Short-Term Changes in Serum Nutrient Levels After Sleeve Gastrectomy and One Anastomosis Gastric Bypass (OAGB)},
      journal = {Journal of Surgery},
      volume = {9},
      number = {6},
      pages = {264-270},
      doi = {10.11648/j.js.20210906.13},
      url = {https://doi.org/10.11648/j.js.20210906.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210906.13},
      abstract = {In Egypt, sleeve gastrectomy and one anastomosis gastric bypass (OAGB) are popular bariatric procedures. The current study was conducted to compare between these two procedures regarding short-term weight loss, comorbidity improvement, vitamin and micronutrient changes. This prospective study included 40 cases who were divided into two equal groups; sleeve gastrectomy and OAGB groups. All cases received the standard perioperative care. Our primary outcome was serum nutrient changes (hemoglobin, iron, calcium, vitamin D, and vitamin B 12), while secondary outcomes included weight loss parameters along with the improvement of obesity related comorbidities. These data were recorded 3, 6, and 12 months after operation, and then compared to the corresponding baseline values. Demographic criteria were comparable between the two groups, apart from diabetes which was more prevalent in the OAGB group. Both groups were followed by a significant and comparable weight loss at the short-term after operation. Both groups were associated with significant improvement in DM and hypertension at 12 months. Most evaluated vitamin and nutrient levels were comparable between the two groups except for hemoglobin, iron and vitamin B 12 levels, which were significantly higher with sleeve gastrectomy at 6- and 12-month follow up. Both sleeve gastrectomy and OAGB are effective bariatric procedures that could achieve satisfactory weight loss and improvement of comorbidities. However, OAGB carries higher risk of iron, hemoglobin and vitamin B 12 deficiency.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - A Prospective Study on Short-Term Changes in Serum Nutrient Levels After Sleeve Gastrectomy and One Anastomosis Gastric Bypass (OAGB)
    AU  - Mohamed Fikry
    AU  - Hesham Saad Noor
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    AU  - Sabry Ahmed Mahmoud
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    N1  - https://doi.org/10.11648/j.js.20210906.13
    DO  - 10.11648/j.js.20210906.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 264
    EP  - 270
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20210906.13
    AB  - In Egypt, sleeve gastrectomy and one anastomosis gastric bypass (OAGB) are popular bariatric procedures. The current study was conducted to compare between these two procedures regarding short-term weight loss, comorbidity improvement, vitamin and micronutrient changes. This prospective study included 40 cases who were divided into two equal groups; sleeve gastrectomy and OAGB groups. All cases received the standard perioperative care. Our primary outcome was serum nutrient changes (hemoglobin, iron, calcium, vitamin D, and vitamin B 12), while secondary outcomes included weight loss parameters along with the improvement of obesity related comorbidities. These data were recorded 3, 6, and 12 months after operation, and then compared to the corresponding baseline values. Demographic criteria were comparable between the two groups, apart from diabetes which was more prevalent in the OAGB group. Both groups were followed by a significant and comparable weight loss at the short-term after operation. Both groups were associated with significant improvement in DM and hypertension at 12 months. Most evaluated vitamin and nutrient levels were comparable between the two groups except for hemoglobin, iron and vitamin B 12 levels, which were significantly higher with sleeve gastrectomy at 6- and 12-month follow up. Both sleeve gastrectomy and OAGB are effective bariatric procedures that could achieve satisfactory weight loss and improvement of comorbidities. However, OAGB carries higher risk of iron, hemoglobin and vitamin B 12 deficiency.
    VL  - 9
    IS  - 6
    ER  - 

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Author Information
  • Department of General Surgery, Faculty of Medicine, Mansoura University Hospitals, Mansoura, Egypt

  • Department of General Surgery, Faculty of Medicine, Mansoura University Hospitals, Mansoura, Egypt

  • Department of General Surgery, Faculty of Medicine, Mansoura University Hospitals, Mansoura, Egypt

  • Department of General Surgery, Faculty of Medicine, Mansoura University Hospitals, Mansoura, Egypt

  • Department of General Surgery, Faculty of Medicine, Mansoura University Hospitals, Mansoura, Egypt

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