Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up

Background: Laparoscopic mini-gastric bypass (LMGB) is an alternative to the laparoscopic Roux-en-Y gastric bypass (LRYGB), which is considered to be the gold standard in the treatment of morbid obesity. Objectives: Present 5-year results of 175 patients who had undergone a LMGB between October 2006 and October 2008. Setting: University public hospital, France. Methods: Complete follow-up was available in 126 of 175 patients (72%) who had LMGB. Mortality, morbidity, weight loss, co-morbidities, and quality of life were assessed. Weight loss was determined as a change in body mass index (BMI) and percent excess BMI loss (%EBMIL). Quality of life in the treatment group was analyzed using the Gastrointestinal Quality of Life Index (GIQLI) and was compared with a retrospectively case matched preoperative control group. Results: There were no deaths. Thirteen patients (10.3%) developed major complications. Marginal ulcers occurred in 4% of patients. Incapacitating biliary reflux developed in 2 (1.6%) who required conversion into RYGB. Gastric pouch dilation occurred in 4 patients (3.2%) and inadequate weight loss with severe malnutrition in 2 (1.6%). At 5 years, mean BMI was 31 +/- 6 kg/m(2) and mean %EBMIL was 71.5% +/- 26.5%. Postoperative GIQLI score of the treatment group was significantly higher than preoperative score of the control group (110.3 +/- 17.4 versus 92.5 +/- 15.9, P < .001). Social, psychological, and physical functions were increased significantly. No significant differences were found in gastroesophageal reflux or diarrhea symptoms between the 2 groups. Long-term follow-up showed an improvement in all co-morbidities. Conclusions: At 5 years, LMGB was safe, effective, and provided interesting quality of life results. (C) 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.