Sinem Kiyici, Nizameddin Koca, Zehra Yagmur Sahin Alak, Pinar Uzgec Guller, Deniz Sigirli, Özgen Çeler, Hamiyet Yılmaz Yaşar, Arzu Or Koca, Hakan Buluş, Semin Melahat Fenkci, Kader Ugur, Erhan Aygen, Mehmet Fatih Ebiloglu, Soner Cander, Canan Ersoy, Saliha Yıldız, Remzi Kızıltan, Dilek Gogas Yavuz, Demet Yalcin Kehribar, Ayşen Akkurt Kocaeli, Gamze Gelir Çavdar, Hilmi Erdem Sumbul, Filiz Mercantepe, Süleyman Kalcan, Serhat Uysal, Baris Sariakcali, Ramazan Sari, Faruk Kutluturk, Gülşah Elbüken, Gamze Akkuş, Orcun Yalav, Seyit Uyar, Süleyman Baldane, Gonca Tamer, Ilkay Cakir, Meral Mert, Hakan Seyit, Turkan Mete, Fulya Calikoglu, Ozlem Soyluk Selcukbiricik, Ayşe Kubat Üzüm, Ayşe Nur İzol Torun, Zafer Pekkolay, Cem Haymana, Bagdagul Yuksel Guler, Taner Bayraktaroglu, Ömercan Topaloglu, İbrahim Şahin, Özlem Turhan İyidir, Serpil Çiftel, Pınar Akhanlı, Emine Kartal Baykan, Ilgın Yıldırım Şimşir, Mehmet Muhittin Yalcin, Dilek Yazici, Mithat Mızrak, Filiz Mercan Sarıdaş, Coşkun Ateş, Banu Betül Kocaman, Emre Capar, Merve Çatak, Ulcaz Perihan Aksoydan Zubaroglu, Murat Çelik, Neslihan Uslu, Seda Karslı, Fuat Mısıroglu, Mehmet Yigit, Eldeniz Yunusov, Canan Sehit Kara, Volkan Demirhan Yumuk, Fahri Bayram, Alper Sönmez
In this Turkish multicenter retrospective cohort with long-term follow-up, OAGB was associated with greater current %TWL and lower RWG compared with SG, while RYGB showed intermediate weight outcomes. Given the small OAGB subgroup, confirmation in larger prospective studies is warranted.
INTRODUCTION: Metabolic and bariatric surgery (MBS) achieves effective weight loss, but long-term outcomes vary by procedure. We compared procedure-specific total weight loss (%TWL), recurrent weight gain (RWG), and metabolic outcomes across three MBS procedures.
METHODS: This nationwide, multicenter, retrospective cohort study (n = 1,498; 78.8% women; 37 centers) used stratified random sampling. Primary outcomes were %TWL and RWG (≥ 10% of total weight lost from nadir and sensitivity analysis used the IFSO 2024 threshold of > 30%). Multivariable regression and propensity score matching (PSM) addressed baseline imbalances.
RESULTS: Procedures included Sleeve Gastrectomy (SG, n = 1,321), Roux-en-Y Gastric Bypass (RYGB, n = 124), and One Anastomosis Gastric Bypass (OAGB, n = 53). Median follow-up: SG 66 [IQR 35-91], RYGB 55 [34-98], OAGB 53 [25-100] months (p = 0.704). Nadir %TWL was comparable (~ 38%, p = 0.683). At last follow-up, median %TWL differed significantly (OAGB 33.6%, RYGB 31.7%, SG 29.6%; p = 0.010). OAGB was independently associated with lower RWG than SG (OR 0.34, 95% CI 0.18-0.64; p < 0.001), and this association was confirmed in the PSM cohort (OAGB vs SG: RWG, 37.7% vs 61.6%; p = 0.004; %TWL, 33.8% vs 30.2%; p = 0.046). Metabolic and renal parameters differed across procedure groups, but standardized remission or relapse endpoints were not assessed.
CONCLUSION: In this Turkish multicenter retrospective cohort with long-term follow-up, OAGB was associated with greater current %TWL and lower RWG compared with SG, while RYGB showed intermediate weight outcomes. Given the small OAGB subgroup, confirmation in larger prospective studies is warranted.
KEY POINTS: Short-term weight loss was similar across SG, RYGB, and OAGB. RYGB and OAGB were associated with more favorable long-term weight loss than SG. OAGB was associated with a lower RWG than SG in this cohort (absolute risk difference -20.1%; NNT=4.9), but larger prospective studies with standardized follow-up are needed.