{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["407(8)"],"submitter":["Fadel MG"],"pubmed_abstract":["<h4>Background</h4>Laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with obesity, BMI ≥ 50 kg/m<sup>2</sup>, can be a challenging operation. Weight loss with intra-gastric balloon (IGB) insertion prior to LRYGB may improve operative outcomes.<h4>Methods</h4>Between June 2000 and June 2020, patients with a BMI ≥ 50 kg/m<sup>2</sup> underwent either IGB insertion followed by LRYGB (two-stage group), or LRYGB as the definitive bariatric procedure (single-stage group) in our institution. The two-stage procedure was adopted for high risk individuals. Primary outcome measures were percentage total weight loss (%TWL) at 24 months, length of stay and postoperative morbidity. Propensity score analysis was used to account for differences between groups.<h4>Results</h4>A total of 155 (mean age 42.9 years ± 10.60; mean BMI 54.6 kg/m<sup>2</sup> ± 4.53) underwent either the two-stage (n = 30) or single-stage procedure (n = 125) depending on preoperative fitness. At 6 months following LRYGB, there was a significant difference in %TWL between the groups in a matched analysis (11.9% vs 23.7%, p < 0.001). At 24 months, there was no difference in %TWL (32.0% vs 34.7%, p = 0.13). Median hospital stay following LRYGB was 2.0 (1-4) days with the two-stage vs 2.0 (0-14) days for the single-stage approach (p = 0.75). There was also no significant difference in complication rates (p = 0.058) between the two groups.<h4>Conclusions</h4>There was no difference in weight loss after one or two-stage procedures in the treatment of patients with a BMI ≥ 50 kg/m<sup>2 </sup>super obesity in a propensity score weighted analysis at 24 months. Length of stay and perioperative complications were similar for high risk patients; however, the two-stage approach was associated with delayed weight loss. Single-stage management is recommended for moderate risk patients, particularly with significant metabolic disorders, whilst two-stage approach is a safe and feasible pathway for high risk individuals."],"journal":["Langenbeck's archives of surgery"],"pagination":["3349-3356"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9722810"],"repository":["biostudies-literature"],"pubmed_title":["Clinical outcomes of single-stage versus two-stage laparoscopic Roux-en-y gastric bypass in the management of obesity (BMI ≥ 50 kg/m<sup>2</sup>): a retrospective cohort study."],"pmcid":["PMC9722810"],"pubmed_authors":["Lairy A","Fehervari M","Das B","Efthimiou E","Fadel MG","Alyaqout K","Ashrafian H","Khwaja H"],"additional_accession":[]},"is_claimable":false,"name":"Clinical outcomes of single-stage versus two-stage laparoscopic Roux-en-y gastric bypass in the management of obesity (BMI ≥ 50 kg/m<sup>2</sup>): a retrospective cohort study.","description":"<h4>Background</h4>Laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with obesity, BMI ≥ 50 kg/m<sup>2</sup>, can be a challenging operation. Weight loss with intra-gastric balloon (IGB) insertion prior to LRYGB may improve operative outcomes.<h4>Methods</h4>Between June 2000 and June 2020, patients with a BMI ≥ 50 kg/m<sup>2</sup> underwent either IGB insertion followed by LRYGB (two-stage group), or LRYGB as the definitive bariatric procedure (single-stage group) in our institution. The two-stage procedure was adopted for high risk individuals. Primary outcome measures were percentage total weight loss (%TWL) at 24 months, length of stay and postoperative morbidity. Propensity score analysis was used to account for differences between groups.<h4>Results</h4>A total of 155 (mean age 42.9 years ± 10.60; mean BMI 54.6 kg/m<sup>2</sup> ± 4.53) underwent either the two-stage (n = 30) or single-stage procedure (n = 125) depending on preoperative fitness. At 6 months following LRYGB, there was a significant difference in %TWL between the groups in a matched analysis (11.9% vs 23.7%, p < 0.001). At 24 months, there was no difference in %TWL (32.0% vs 34.7%, p = 0.13). Median hospital stay following LRYGB was 2.0 (1-4) days with the two-stage vs 2.0 (0-14) days for the single-stage approach (p = 0.75). There was also no significant difference in complication rates (p = 0.058) between the two groups.<h4>Conclusions</h4>There was no difference in weight loss after one or two-stage procedures in the treatment of patients with a BMI ≥ 50 kg/m<sup>2 </sup>super obesity in a propensity score weighted analysis at 24 months. Length of stay and perioperative complications were similar for high risk patients; however, the two-stage approach was associated with delayed weight loss. Single-stage management is recommended for moderate risk patients, particularly with significant metabolic disorders, whilst two-stage approach is a safe and feasible pathway for high risk individuals.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Dec","modification":"2025-04-04T23:44:30.552Z","creation":"2025-04-04T23:44:30.552Z"},"accession":"S-EPMC9722810","cross_references":{"pubmed":["36050499"],"doi":["10.1007/s00423-022-02664-9"]}}