背景:一种胃旁路吻合术(OAGB)在减肥手术中寻求更好的结果方面获得了突出的地位。然而,与Roux-en-Y胃旁路术(RYGB)和袖状胃切除术(SG)相比,其疗效和安全性仍不明确。
目的:比较OAGB相对于RYGB和SG治疗肥胖症的疗效和安全性。
方法:我们系统地搜索了PubMed,EMBASE,科克伦图书馆,丁香花,和GoogleScholar数据库,用于比较OAGB和RYGB或SG在肥胖手术方法中的随机对照试验。我们汇总了体重指数的结果,过量体重减轻的百分比,2型糖尿病缓解期,并发症,和胃食管反流病.用R软件(4.2.3版)进行统计学分析。
结果:从11项随机对照试验中提取了854名患者的数据,其中422例(49.4%)提交OAGB,平均随访6个月至5年。荟萃分析显示,OAGB患者在1年随访时体重下降的百分比显着升高,在5年随访时体重指数显着降低。相反,2型糖尿病缓解率,并发症,和胃食管反流病两组间无显著差异。证据的总体质量被认为非常低。
结论:我们的结果证实了OAGB在治疗肥胖方面与RYGB和SG的疗效相当。维持2型糖尿病缓解没有显着差异,并发症,和胃食管反流病的发病率。
BACKGROUND: One anastomosis gastric bypass (OAGB) has gained prominence in the search for better results in bariatric surgery. However, its efficacy and safety compared to Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) remain ill-defined.
OBJECTIVE: To compare the efficacy and safety of OAGB relative to RYGB and SG in the treatment of obesity.
METHODS: We systematically searched PubMed, EMBASE, Cochrane Library, Lilacs, and Google Scholar databases for randomized controlled trials comparing OAGB with RYGB or SG in the surgical approach to obesity. We pooled outcomes for body mass index, percentage of excess weight loss, type-2 diabetes mellitus remission, complications, and gastroesophageal reflux disease. Statistical analyses were performed with R software (version 4.2.3).
RESULTS: Data on 854 patients were extracted from 11 randomized controlled trials, of which 422 (49.4%) were submitted to OAGB with mean follow-up ranging from six months to five years. The meta-analysis revealed a significantly higher percentage of excess weight loss at 1-year follow-up and a significantly lower body mass index at 5-year follow-up in OAGB patients. Conversely, rates of type-2 diabetes mellitus remission, complications, and gastroesophageal reflux disease were not significantly different between groups. The overall quality of evidence was considered very low.
CONCLUSIONS: Our results corroborate the comparable efficacy of OAGB in relation to RYGB and SG in the treatment of obesity, maintaining no significant differences in type-2 diabetes mellitus remission, complications, and gastroesophageal reflux disease rates.