BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS
RESULTS: Patient Characteristics (July 2002 to July 2016) BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS RESULTS: Patient Characteristics (July 2002 to July 2016) Age 43 (12 - 74) Gender Female 1691 (61.5%) Male 1059 (38.5%) BMI 46 (31 - 86) EBW (kg) 65 (28 - 220) The results of the first 209 patients operated on with the technique have confirmed our hypothesis. Our patients have no clinical symptoms as well as no objective evidence of GERD (measured in the 20 first patients by endoscopy and pHmetry) and margin ulcers.
RESULTS: Patient Characteristics (July 2002 to July 2016) BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS RESULTS: Patient Characteristics (July 2002 to July 2016) Primary Surgery 1601 (56.1%) Other Previous Open Surgery 663 (24.1%) Other Associated Procedures 432 (15.7 %) Revisional Surgery 154 (5.4%) The results of the first 209 patients operated on with the technique have confirmed our hypothesis. Our patients have no clinical symptoms as well as no objective evidence of GERD (measured in the 20 first patients by endoscopy and pHmetry) and margin ulcers.
Length of Hospital Stay BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS RESULTS: Patient Characteristics (July 2002 to July 2016) Length of Hospital Stay Uncomplicated Patients 2,715 (98.8%) 1 day (15-120 h.) Patients with Major Complications 35 (1.2%) 9 days (4-32 d.) The results of the first 209 patients operated on with the technique have confirmed our hypothesis. Our patients have no clinical symptoms as well as no objective evidence of GERD (measured in the 20 first patients by endoscopy and pHmetry) and margin ulcers.
Surgical Early Major Complications BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS Surgical Early Major Complications Intraoperative Complications (resolved by Open Surgery) 4 (0.14%) Bleeding 2 (0.072 %) Gastro-esophageal Perforation 1 (0.036 %) Incorrect Gastric Transection Immediate Postoperative Complications (resolved by Open Surgery) 6 (0.21%) Leaks Intestinal Obstruction Partial Necrosis of Excluded Stomach Immediate Postoperative Complications (resolved by Lap. Surgery) 17 (0.61%) 10 (0.36%) 3 (0.109 %) Acute Gastric Distension The results of the first 209 patients operated on with the technique have confirmed our hypothesis. Our patients have no clinical symptoms as well as no objective evidence of GERD (measured in the 20 first patients by endoscopy and pHmetry) and margin ulcers. TOTAL 25 (0.909%)
Mortality Non Surgical Early Major Complications Mortality Total BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS Non Surgical Early Major Complications Mortality Complications Treated Conservatively Mortality Leaks 8 (0.29 %) Acute Pancreatitis 1 (0.036 %) Infected Hematoma Total 10 (0.36%) Massive Pulmonary Embolism 1 (0.036 %) Nosocomial Pneumonia (Post-reintervention) DIC-Post Band reversion Total 3 (0.109%)
Gastro-intestinal stenosis BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS Late Complications Gastro-intestinal stenosis 9 (0.3%) Pneumatic Dilatation 7 (0.25%) Prosthesis 2 (0.072%) Anastomotic Ulcer Medical treatment 29 (0.9%) Malnutrition 28 (0.9%) B1-B6 Vitamin (severe deficit) 3 (0.1%) Weight regain Revisional surgery 1 (0.03%) Chronic reflux 12 (0.4%) TOTAL 82 (2.82 %)
Percent of mean (and range) BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS Weight Loss Percent of mean (and range) EWL at: 1 year 84% (55 –112%) 2 year 88% (58 –115%) 3 year 81% (55 –103%) 4 year 79% (51 –102%) 5 year 77% (48 –100%) 10 year 14 year 70% (45–98%) 70% (40–98%)
Arterial Hypertension Gastroesophageal reflux disease BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS Severe Comorbidities - Resolution Index at 2-years at 14-years Dyslipidemia 98% 86% Type II Diabetes 94% 90% Arterial Hypertension 87% Sleep apnea 100% Gastroesophageal reflux disease 92% Fatty liver
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) BMI Distribution TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control Co-morbidities Prevalence COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) Co-morbidities Prevalence TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) Hospital Stay TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control Intra-operative Complications COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) Intra-operative Complications Bleeding Liver Failure Injury splenic Other Gastrointestinal perforation vascular Deaths % TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control Post-operative Complications COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) Post-operative Complications
IFSO- European Database Control General Complications COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) General Complications 0.56% 4.06% TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB 3.96% 4.29% TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) General Complications: “Esophageal” 0.54% 0% TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 RYGB OAGB 1.4% 2.42% TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) General Complications: “Gastric” 0.22% 1.32% TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB 0.17% 0.16% TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) General Complications: “Metabolic” 0.63% 0.34% TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB 0.04% 0.67% TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) General Complications: “Hepatobillary” 1.02% 0% TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB 0.20% 0.98% TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control (Since January 2010) General Complications: “Non - specific” 0.55% 0% TOTAL OPERATIONS 938 TOTAL OPERATIONS 14161 OAGB RYGB 0.16% 0.13% TOTAL OPERATIONS 2542 TOTAL OPERATIONS 16225 GB SG
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control Evolution of % EWL
IFSO- European Database Control COMPARATIVE: OAGB vs. RYGB vs. GB vs. SG IFSO- European Database Control Evolution of % EBMIL
BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS CONCLUSIONS The OAGB (BAGUA) technique in our experience does not reduce the “complexity” of the surgical procedure, but significantly reduces operative time and lenght of hospital stay compared to other complex techniques; it also substantially decreases both early and late complication rates. In conclusion
BYPASS GASTRICO DE UNA ANASTOMOSIS (OAGB-BAGUA): RESULTADOS EN UNA SERIE DE 2850 PACIENTES DURANTE 14 AÑOS CONCLUSIONS Excellent results in our long-term follow-up in regards to EWL, EBMIL, resolution of co- morbidities and quality of life make OAGB a safe and effective technique, and a powerful alternative for the treatment of morbid and super-morbid obesity after a 14-year experience. In conclusion
CENTER OF EXCELLENCE FOR THE STUDY AND OBESITY SURGERY TREATMENT