Modified antireflux monoanastomotic laparoscopic gastric bypass in morbid obesity surgery

Authors

  • A. V. Klymenko Zaporizhzhia State Medical University, Ukraine,
  • V. M. Klymenko Zaporizhzhia State Medical University, Ukraine,
  • A. I. Bilai Zaporizhzhia State Medical University, Ukraine,
  • M. V. Nikolaiev Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2020.5.214741

Keywords:

morbid obesity, gastric bypass, Roux-en-Y gastric bypass, dumping syndrome

Abstract

 

Aim: to analyze the results of a modified monoanastomotic gastric bypass technique in patients with morbid obesity.

Materials and methods. The results of 30 morbidly obese patients who underwent gastric bypass surgery were studied. The patients were divided into two groups. Modified in our clinic laparoscopic monoanastomotic gastric bypass was performed in 19 patients (the main group). The control group included 11 patients after standard Roux-en-Y laparoscopic gastric bypass technique. Inclusion criteria were: patients of both sexes aged 18–60 years old with morbid obesity and body mass index (BMI) of 40 kg/m2 or more, and 35 kg/m2 or more in case of additional comorbidities (type 2 diabetes mellitus, hypertension, dyslipidemia, sleep apnea syndrome).

Statistics were performed using the Statistica 13.0 software package by parametric and nonparametric statistical methods.

Results. The postoperative period was 5 (4; 6) days in the main group and 7 (5; 8) days in the control group (P = 0.13). In both groups, the decrease in body weight ranged from 12 to 52 kg in 6 months. In the main group, the average weight loss was 29 kg in 6-month and 38 kg in 12-month period. BMI in 6 months was 31.28 kg/m2, in 12 months – 27.70 kg/m2. In the control group, this indicator was 27 kg/m2 and 44 kg/m2 in 6 months and 12 months, respectively. The average BMI in 6 months was 31.64 kg/m2, in 12 months – 26.03 kg/m2, respectively.

Conclusions. Monoanastomotic gastric bypass in the modification by the clinic is an effective and safe operation for morbid obesity patients that can effectively and systematically reduce body weight. Monoanastomotic gastric bypass in modification by the clinic has the same strengths as the Roux-en-Y technique but avoids the risks associated with the second anastomosis and pathological bile reflux into the esophagus. Further studies are needed to evaluate the long-term results after modified monoanastomotic gastric bypass technique.

 

References

Fried, M., Yumuk, V., Oppert, J. M., Scopinaro, N., Torres, A. J., Weiner, R., Yashkov, Y., & Frühbeck, G. (2013). Interdisciplinary European Guidelines on metabolic and bariatric surgery. Obesity Facts, 6(5), 449-468. https://doi.org/10.1159/000355480

Altieri, M. S., Pryor, A., Bates, A., Docimo, S., Talamini, M., & Spaniolas, K. (2018). Bariatric procedures in adolescents are safe in accredited centers. Surgery for Obesity and Related Diseases, 14(9), 1368-1372. https://doi.org/10.1016/j.soard.2018.04.004

Іoffe, O. Yu., Tsiura, Yu. P., Kryvopustov, M. S., Stetsenko, O. P., Tarasiuk, T. V., & Parahuz, O. Ya. (2015). Shlunkove shuntuvannia yak kliuchova lanka v kompleksnomu likuvanni komorbidnykh staniv u khvorykh na morbidne ozhyrinnia [Gastric bypass as the key link in complex treatment of comorbid conditions in patients with morbid obesity]. Ukrainskyi terapevtychnyi zhurnal, (2), 62-66. [in Ukrainian].

Rutledge, R. (2001). The mini-gastric bypass: experience with the first 1,274 cases. Obesity Surgery, 11(3), 276-280. https://doi.org/10.1381/096089201321336584

Deitel, M., Hargroder, D., & Peraglie, C. (2016). Mini-Gastric Bypass for Bariatric Surgery Increasing Worldwide. Austin Journal of Surgery, 3(3), Article 1092. https://doi.org/10.26420/austinjsurg.2016.1092

Lee, W. J., Ser, K. H., Lee, Y. C., Tsou, J. J., Chen, S. C., & Chen, J. C. (2012). Laparoscopic Roux-en-Y Vs. Mini-gastric Bypass for the Treatment of Morbid Obesity: a 10-Year Experience. Obesity Surgery, 22(12), 1827-1834. https://doi.org/10.1007/s11695-012-0726-9

Carbajo, M. A., Luque-de-León, E., Jiménez, J. M., Ortiz-de-Solórzano, J., Pérez-Miranda, M., & Castro-Alija, M. J. (2017). Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obesity Surgery, 27(5), 1153-1167. https://doi.org/10.1007/s11695-016-2428-1

Kular, K. S., Manchanda, N., & Rutledge, R. (2014). A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obesity Surgery, 24(9), 1430-1435. https://doi.org/10.1007/s11695-014-1220-3

Lavryk, A. S., Zgonnyk, A. Yu., & Lavryk, O. A. (2015). Nebezpeky y uskladnennia maloinvazyvnoho likuvannia ozhyrinnia [Dangers and complications of mini-invasive obesity treatment]. Odeskyi medychnyi zhurnal, (2), 31-33. [in Ukrainian].

Tolone, S., Cristiano, S., Savarino, E., Lucido, F. S., Fico, D. I., & Docimo, L. (2016). Effects of omega-loop bypass on esophagogastric junction function. Surgery for Obesity and Related Diseases, 12(1), 62-69. https://doi.org/10.1016/j.soard.2015.03.011

Mion, F., Tolone, S., Garros, A., Savarino, E., Pelascini, E., Robert, M., Poncet, G., Valette, P.-J., Marjoux, S., Docimo, L., & Roman, S. (2016). High-resolution Impedance Manometry after Sleeve Gastrectomy: Increased Intragastric Pressure and Reflux are Frequent Events. Obesity Surgery, 26(10), 2449-2456. https://doi.org/10.1007/s11695-016-2127-y

Bruzzi, M., Chevallier, J. M., & Czernichow, S. (2017). One-Anastomosis Gastric Bypass: Why Biliary Reflux Remains Controversial? Obesity Surgery, 27(2), 545-547. https://doi.org/10.1007/s11695-016-2480-x

Carbajo, M. A., Luque-de-León, E., Jiménez, J. M., Ortiz-de-Solórzano, J., Pérez-Miranda, M., & Castro-Alija, M. J. (2017). Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obesity Surgery, 27(5), 1153-1167. https://doi.org/10.1007/s11695-016-2428-1

Chevallier, J. M., Arman, G. A., Guenzi, M., Rau, C., Bruzzi, M., Beaupel, N., Zinzindohoué, F., & Berger, A. (2015). One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obesity Surgery, 25(6), 951-958. https://doi.org/10.1007/s11695-014-1552-z

Amor, I. B., Petrucciani, N., Kassir, R., Al Munifi, A., Piche, T., Debs, T., & Gugenheim, J. (2017). Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass. Obesity Surgery, 27(5), 1398. https://doi.org/10.1007/s11695-017-2646-1

Aurora, A. R., Khaitan, L., & Saber, A. A. (2012). Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surgical Endoscopy, 26(6), 1509-1515. https://doi.org/10.1007/s00464-011-2085-3

Musella, M., Susa, A., Manno, E., De Luca, M., Greco, F., Raffaelli, M., Cristiano, S., Milone, M., Bianco, P., Vilardi, A., Damiano, I., Segato, G., Pedretti, L., Giustacchini, P., Fico, D., Veroux, G., & Piazza, L. (2017). Complications Following the Mini/One Anastomosis Gastric Bypass (MGB/OAGB): a Multi-institutional Survey on 2678 Patients with a Mid-term (5 Years) Follow-up. Obesity Surgery, 27(11), 2956-2967. https://doi.org/10.1007/s11695-017-2726-2

Ralki, M., Cassiman, D., Van Dongen, J., Ferrante, M., & Van Overbeke, L. (2017). Liver failure after long-limb gastric bypass. Clinics and Research in Hepatology and Gastroenterology, 41(3), e32-e37. https://doi.org/10.1016/j.clinre.2016.11.004

Rutledge, R., & Walsh, T. R. (2005). Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obesity Surgery, 15(9), 1304-1308. https://doi.org/10.1381/096089205774512663

Khan, A., Kim, A., Sanossian, C., & Francois, F. (2016). Impact of obesity treatment on gastroesophageal reflux disease. World Journal of Gastroenterology, 22(4), 1627-1638. https://doi.org/10.3748/wjg.v22.i4.1627

Saarinen, T., Räsänen, J., Salo, J., Loimaala, A., Pitkonen, M., Leivonen, M., & Juuti, A. (2017). Bile Reflux Scintigraphy After Mini-Gastric Bypass. Obesity Surgery, 27(8), 2083-2089. https://doi.org/10.1007/s11695-017-2608-7

How to Cite

1.
Klymenko AV, Klymenko VM, Bilai AI, Nikolaiev MV. Modified antireflux monoanastomotic laparoscopic gastric bypass in morbid obesity surgery. Zaporozhye Medical Journal [Internet]. 2020Oct.20 [cited 2024Dec.26];22(5). Available from: http://zmj.zsmu.edu.ua/article/view/214741

Issue

Section

Original research