Evaluation of long-term effectiveness of modified laparoscopic one-anastomosis gastric bypass in patients with morbid obesity
DOI:
https://doi.org/10.14739/2310-1210.2025.2.321464Keywords:
morbid obesity, gastric bypass, anastomosis Roux-en-Y, one-anastomosis gastric bypass, bariatric surgery, laparoscopy, metabolic syndrome, diabetes mellitusAbstract
Aim. To determine the long-term effectiveness of modified laparoscopic one-anastomosis gastric bypass in patients with morbid obesity.
Materials and methods. A total of 36 patients with morbid obesity who underwent a surgery from 2010 to 2019 were divided into two groups according to the surgical intervention type. Group 1 – 20 (55.6 %) patients who underwent laparoscopic one-anastomosis gastric bypass in the modification of the clinic, group 2 – 16 (44.4 %) patients who underwent the Roux-en-Y gastric bypass. The study included patients of both sexes, aged 18 to 60 years with a body mass index (BMI) of ≥40 kg/m2. Patients with severe decompensated comorbidities, oncological diseases, and contraindications to laparoscopic interventions were excluded from the study. The results were evaluated at 1, 3, and 5 years. Anthropometric parameters were monitored dynamically; quality of life was assessed according to the Short Form 36 questionnaire, esophagoduodenoscopy with chromography and biopsy were performed to detect bile reflux. Statistical data were processed using the Statistica for Windows 13.0 software package.
Results. When analyzing the findings obtained, higher rates of weight loss in kilograms and percentage of excess and total body weight reduction during the entire follow-up period (p < 0.05) have been noted in group 1 patients. At the same time, the mean BMI had a statistical difference between the groups only 5 years after the surgery (p = 0.0487). The quality of patients’ life has been found to be significantly improved in both groups compared to that in the preoperative period, but without statistical significance in the long-term follow-up period. Bile reflux occurred in only 10 % of group 1 patients during the entire follow-up period (p > 0.05) with no signs of malignancies.
Conclusions. Laparoscopic one-anastomosis gastric bypass surgery modified in the clinic results in quick weight loss and significant improvements in quality of life in morbidity obese patients within 12 months after the surgery. Furthermore, the anti-reflux mechanism we developed is effective enough to prevent bile reflux.
References
Mahmoudieh M, Keleidari B, Afshin N, Sayadi Shahraki M, Shahabi Shahmiri S, Sheikhbahaei E, et al. The early results of the laparoscopic mini-gastric bypass/one anastomosis gastric bypass on patients with different body mass index. J Obes. 2020;2020:7572153. doi: https://doi.org/10.1155/2020/7572153
Biter LU, 't Hart JW, Noordman BJ, Smulders JF, Nienhuijs S, Dunkelgrün M, et al. Long-term effect of sleeve gastrectomy vs Roux-en-Y gastric bypass in people living with severe obesity: a phase III multicentre randomised controlled trial (SleeveBypass). Lancet Reg Health Eur. 2024;38:100836. doi: https://doi.org/10.1016/j.lanepe.2024.100836
Obesity and overweight [Internet]. Who.int. [cited 2025 Jan 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Albaugh VL, He Y, Münzberg H, Morrison CD, Yu S, Berthoud HR. Regulation of body weight: Lessons learned from bariatric surgery. Mol Metab. 2023;68:101517. doi: https://doi.org/10.1016/j.molmet.2022.101517
Anam M, Maharjan S, Amjad Z, Abaza A, Vasavada AM, Sadhu A, et al. Efficacy of Semaglutide in Treating Obesity: A Systematic Review of Randomized Controlled Trials (RCTs). Cureus. 2022;14(12):e32610. doi: https://doi.org/10.7759/cureus.32610
King WC, Belle SH, Hinerman AS, Mitchell JE, Steffen KJ, Courcoulas AP. Patient Behaviors and Characteristics Related to Weight Regain After Roux-en-Y Gastric Bypass: A Multicenter Prospective Cohort Study. Ann Surg. 2020;272(6):1044-52. doi: https://doi.org/10.1097/SLA.0000000000003281
Istfan NW, Lipartia M, Anderson WA, Hess DT, Apovian CM. Approach to the Patient: Management of the Post-Bariatric Surgery Patient With Weight Regain. J Clin Endocrinol Metab. 2021;106(1):251-63. doi: https://doi.org/10.1210/clinem/dgaa702
Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, et al. Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med. 2017;376(7):641-51. doi: https://doi.org/10.1056/NEJMoa1600869
Fink J, Seifert G, Blüher M, Fichtner-Feigl S, Marjanovic G. Obesity Surgery. Dtsch Arztebl Int. 2022;119(5):70-80. doi: https://doi.org/10.3238/arztebl.m2021.0359
Di Lorenzo N, Antoniou SA, Batterham RL, Busetto L, Godoroja D, Iossa A, et al. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surg Endosc. 2020;34(6):2332-58. doi: https://doi.org/10.1007/s00464-020-07555-y
Barzin M, Ebadinejad A, Aminian A, Khalaj A, Ghazy F, Koohi F, et al. Does One-anastomosis gastric bypass provide better outcomes than sleeve gastrectomy in patients with BMI greater than 50? A systematic review and meta-analysis. Int J Surg. 2023;109(3):277-86. doi: https://doi.org/10.1097/js9.0000000000000203
Kraljević M, Delko T, Köstler T, Osto E, Lutz T, Thommen S, et al. Laparoscopic roux-en-Y gastric bypass versus laparoscopic mini gastric bypass in the treatment of obesity: Study protocol for a randomized controlled trial. Trials. 2017;18(1):226. doi: https://doi.org/10.1186/s13063-017-1957-9
Chaim EA, Ramos AC, Cazzo E. Mini-gastric bypass: Description of the technique and preliminary results. Arq Bras Cir Dig. 2017;30(4):264-6. doi: https://doi.org/10.1590/0102-6720201700040009
Mocanu V, Verhoeff K, Forbes H, Birch DW, Karmali S, Switzer NJ. Comparing patient selection and 30-day outcomes between single anastomosis gastric bypass and roux-en-Y gastric bypass: A retrospective cohort study of 47,384 patients. Obes Surg. 2022;33(1):188-94. doi: https://doi.org/10.1007/s11695-022-06353-w
Ruiz-Mar G, Ruelas-Ayala A, Ornelas-Oñate LA, Ramirez-Velasquez JE. The one anastomosis gastric bypass technique: Results after one year of follow-up. Arq Bras Cir Dig. 2019;32(4):e1476. doi: https://doi.org/10.1590/0102-672020190001e1476
Karagul S, Senol S, Karakose O, Uzunoglu K, Kayaalp C. One Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass: A Randomized Prospective Trial. Medicina (Kaunas). 2024;60(2):256. doi: https://doi.org/10.3390/medicina60020256
Saarinen T, Meriläinen S, Koivukangas V, Pietiläinen KH, Juuti A. Prospective randomized controlled trial comparing the efficacy and safety of Roux-en-Y gastric bypass and one-anastomosis gastric bypass (the RYSA trial): trial protocol and interim analysis. Trials. 2019;20(1):803. doi: https://doi.org/10.1186/s13063-019-3898-y
Howard R, Chao GF, Yang J, Thumma JR, Arterburn DE, Telem DA, et al. Medication use for obesity-related comorbidities after sleeve gastrectomy or Gastric Bypass. JAMA Surg. 2022;157(3):248. doi: https://doi.org/10.1001/jamasurg.2021
Tourky M, Issa M, Salman MA, Salman A, Shaaban HE, Safina A, et al. Nutritional Complications After Laparoscopic Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass: A Comparative Systematic Review and Meta-Analysis. Cureus. 2022;14(1):e21114. doi: https://doi.org/10.7759/cureus.21114
Keleidari B, Dehkordi MM, Shahraki MS, Ahmadi ZS, Heidari M, Hajian A, et al. Bile reflux after one anastomosis gastric bypass surgery: A review study. Ann Med Surg (Lond). 2021;64:102248. doi: https://doi.org/10.1016/j.amsu.2021.102248
Eldredge TA, Bills M, Ting YY, Dimitri M, Watson MM, Harris MC, et al. Once in a Bile - the Incidence of Bile Reflux Post-Bariatric Surgery. Obes Surg. 2022;32(5):1428-1438. doi: https://doi.org/10.1007/s11695-022-05977-2
Zarshenas N, Tapsell LC, Batterham M, Neale EP, Talbot ML. Changes in anthropometric measures, nutritional indices and gastrointestinal symptoms following one anastomosis gastric bypass (OAGB) compared with roux-en-Y gastric bypass (RYGB). Obes Surg. 2021;31(6):2619-31. doi: https://doi.org/10.1007/s11695-021-05284-2
Felsenreich DM, Langer FB, Eichelter J, Jedamzik J, Gensthaler L, Nixdorf L, et al. Bariatric Surgery-How Much Malabsorption Do We Need?-A Review of Various Limb Lengths in Different Gastric Bypass Procedures. J Clin Med. 2021;10(4):674. doi: https://doi.org/10.3390/jcm10040674
Klymenko AV, Klymenko VM, Bilai AI, Nikolaiev MV. [Modified antireflux monoanastomotic laparoscopic gastric bypass in morbid obesity surgery]. Zaporozhye medical journal. 2020;22(5):676-81. Russian. doi: https://doi.org/10.14739/2310-1210.2020.5.214741
American Society for Bariatric Surgery Standards Committee, 2004-2005; Oria HE, Carrasquilla C, Cunningham P, Hess DS, Johnell P, Kligman MD, et al. Guidelines for weight calculations and follow-up in bariatric surgery. Surg Obes Relat Dis. 2005;1(1):67-8. doi: https://doi.org/10.1016/j.soard.2004.12.005
Mohajan D, Mohajan HK. Broca Index: A simple tool to measure ideal body weight. Innovation in Science and Technology. 2023;2(2):21-4. doi: https://doi.org/10.56397/ist.2023.03.04
McHorney CA, Ware JE Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994;32(1):40-66. doi: https://doi.org/10.1097/00005650-199401000-00004
IFSO 8th global registry report [Internet]. International Federation for Surgery for Obesity and Metabolic Disorders; 2024 [cited 2025 Jan 10]. Available from: https://www.ifso.com/pdf/8th-ifso-registry-report-2023.pdf
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. doi: https://doi.org/10.1016/s0140-6736(19)30475-1
Jamal W, Zagzoog MM, Sait SH, Alamoudi AO, Abo'ouf S, Alghamdi AA, et al. Initial outcomes of one anastomosis gastric bypass at a single institution. Diabetes Metab Syndr Obes. 2018;12:35-41. doi: https://doi.org/10.2147/DMSO.S180111
Uhe I, Douissard J, Podetta M, Chevallay M, Toso C, Jung MK, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials. Obesity (Silver Spring). 2022;30(3):614-27. doi: https://doi.org/10.1002/oby.23338
Magouliotis DE, Tasiopoulou VS, Tzovaras G. One Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass for Morbid Obesity: an Updated Meta-Analysis. Obes Surg. 2019;29(9):2721-30. doi: https://doi.org/10.1007/s11695-019-04005-0
Singh B, Saikaustubh Y, Singla V, Kumar A, Ahuja V, Gupta Y, et al. One Anastomosis Gastric Bypass (OAGB) vs Roux en Y Gastric Bypass (RYGB) for Remission of T2DM in Patients with Morbid Obesity: a Randomized Controlled Trial. Obes Surg. 2023;33(4):1218-27. doi: https://doi.org/10.1007/s11695-023-06515-4
Oria HE, Moorehead MK. Updated Bariatric Analysis and Reporting Outcome System (BAROS). Surg Obes Relat Dis. 2009;5(1):60-6. doi: https://doi.org/10.1016/j.soard.2008.10.004
Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM, Schmülling C, Neugebauer E, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg. 1995;82(2):216-22. doi: https://doi.org/10.1002/bjs.1800820229
Moorehead MK, Ardelt-Gattinger E, Lechner H, Oria HE. The validation of the Moorehead-Ardelt Quality of Life Questionnaire II. Obes Surg. 2003;13(5):684-92. doi: https://doi.org/10.1381/096089203322509237
Katayama RC, Arasaki CH, Herbella FAM, Neto RA, Lopes Filho GJ. One-Anastomosis and Roux-en-Y Gastric Bypass Promote Similar Weight Loss, Patient Satisfaction, Quality of Life, Inflammation Grade, and Cellular Damage in the Esophagus and Gastric Pouch in a Short-term Follow-up. J Obes Metab Syndr. 2021;30(4):396-402. doi: https://doi.org/10.7570/jomes21040
Lee WJ, Ser KH, Lee YC, Tsou JJ, Chen SC, Chen JC. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827-34. doi: https://doi.org/10.1007/s11695-012-0726-9
Mahawar KK, Himpens J, Shikora SA, Chevallier JM, Lakdawala M, De Luca M, et al. The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified Delphi approach. Obes Surg. 2017;28(2):303-12. doi: https://doi.org/10.1007/s11695-017-3070-2
Bernstein H, Bernstein C, Payne CM, Dvorak K. Bile acids as endogenous etiologic agents in gastrointestinal cancer. World J Gastroenterol. 2009;15(27):3329. doi: 10.3748/wjg.15.3329
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 A. V. Klymenko, V. M. Klymenko, B. S. Kravchenko, K. P. Polishchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
