Comparison of Morbidity in Laparoscopic Sleeve Gastrectomy and One Anastomosis Gastric Bypass in Morbid Obesity Patients

Abstract

Background: Bariatric surgery is the best way to cure obesity and other health problems that come with it. One Anastomosis Gastric Bypass (OAGB) and Laparoscopic Sleeve Gastrectomy (LSG) are the two most common types of surgery.  The surgeon initially makes the functioning stomach smaller by cutting off a tube-like pouch from the remainder of the stomach in a procedure called One Anastomosis Gastric Bypass (OAGB), which is also called mini-gastric bypass. Objective: The goal of this study was to look at how often early and late problems happen in people who have OAGB and LSG. Study Design: This randomized controlled study (RCT). Settings: Allied Hospital Faisalabad Pakistan. Duration: One year from July 01, 2021 to June 30, 2022. Methods: All 240 patients who had a Body Mass Index (BMI) of more than 37.5 kg/m² or 32.5 kg/m² and other health problems including diabetes or high blood pressure. Patients with significant cardiac, respiratory, renal, or hepatic conditions that could affect anesthesia were excluded. Using the lottery method, participants were randomly assigned to two groups: Group 1 underwent OAGB, while Group 2 underwent LSG. Perioperative outcomes, including operative time and hospital stay, as well as early (<30 days) and late (>1 month) complications, were assessed. All surgeries were performed under general anesthesia, and patients were monitored for complications during an 8-month follow-up period. Results: The study compared postoperative complications between patients undergoing OAGB and LSG. No cases of leakage (0.0%) occurred in the OAGB group, whereas 3 patients (2.50%) in the LSG group experienced this complication, with a statistically significant difference (p-value = 0.0001). Bleeding was observed in 6 patients (5.0%) after OAGB and 12 patients (10.0%) after LSG. Postoperative vomiting affected 17 patients (14.17%) in the OAGB group and 22 patients (18.33%) in the LSG group. Additionally, ulcers were reported in 10.0% of OAGB patients compared to 15.0% of LSG patients. Anemia was present in 10.83% of OAGB cases and 15.83% of LSG cases. Notably, gastroesophageal reflux disease (GERD) occurred at a much lower rate in the OAGB group (2.50%) than in the LSG group (15.83%), highlighting a substantial difference between the two surgical approaches. Conclusion: This study concluded that the early and late complications are less after OAGB in morbid obesity patients as compared to LSG.