HAND-SEWN VS. MECHANICAL GASTROJEJUNAL ANASTOMOSIS IN MINI-GASTRIC BYPASS: SHORT-AND LONG-TERM OUTCOMES FROM A NATIONAL BARIATRIC REGISTRY ruslan.menzulin@gmail.com

 

HAND-SEWN VS. MECHANICAL GASTROJEJUNAL ANASTOMOSIS IN MINI-GASTRIC BYPASS: SHORT-AND LONG-TERM OUTCOMES FROM A NATIONAL BARIATRIC REGISTRY

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Russia

Oral or Poster

Gastrojejunal anastomosis in mini-gastric bypass/one-anastomosis gastric bypass (MGB-OAGB) can be hand-sewn (HSA) or mechanical (MA). We evaluated how anastomotic technique affects short-term (surgical complications) and long-term (excess weight loss [EWL]) outcomes of MGB-OAGB.

A retrospective cohort study was performed using data from the Russian National Bariatric Registry (2013-2024). Adults with morbid obesity, treated with primary MGB-OAGB, were included and categorized as HSA or MA. Analyses included descriptive statistics and logistic regression.

Overall, 10,701 patients were included: 5,422 HSA and 5,279 MA (Table 1). The HSA cohort had more patients with hypertension (52.6% vs. 46.1%, p<0.001) and worse functional status (<3 stairs without limitations – 31.4% vs. 25.6%, p<0.001). However, HSA patients had lower rates of diabetes (15.7% vs. 23.0%, p<0.001) and sleep apnea (16.5% vs. 19.6%, p<0.001). Median operative time was shorter in HSA patients: 100 (IQR: 80-120) vs. 110 (IQR: 80-125) minutes (p<0.001). Both surgical (1.7% vs. 2.6%, p=0.001) and all in-hospital complication rates (1.8% vs. 3.0%, p<0.001) were significantly lower in HSA patients. Anastomotic leak, stenosis, and bleeding rates were comparable between the cohorts. Multivariate logistic regression analysis revealed that MA technique was associated with higher odds of surgical complications (OR 1.53; 95%CI: 1.16-2.03) and lower odds of achieving >50%EWL at 6 months (OR 0.68; 95%CI: 0.56-0.84) and 12 months (OR 0.65; 95%CI: 0.52-0.80) postoperatively (Table 2).

The hand-sewn gastrojejunal anastomosis in MGB-OAGB appears to be safer than mechanical, without prolonging operative time. HSA can also lead to improved 1-year EWL.