Background

Roux-en-Y Gastric Bypass (RYGB) is considered the gold standard for weight-loss surgery. The Single-Anastomosis Gastric Bypass (SAGB), initially described at the beginning of the century as an alternative to RYGB, has only recently been approved by the American Society for Metabolic and Bariatric Surgery. SAGB simplifies the RYGB through creation of a single anastomosis. Our goal was to compare the initial outcomes of SAGB with RYGB.

Methods

Patients who underwent laparoscopic SAGB or RYGB in 2020 and 2021 were identified in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. We used a coarsened exact matching strategy to match patients who underwent SAGB to patients who underwent RYGB based on age, BMI, sex, operation length, race, and ASA classification.

Results

Of the 85,426 patients included in the study, 2,282 (2.7%) underwent SAGB and 83,144 (97.3%) underwent RYGB. Between 2020 to 2021, when compared with RYGB, SAGB was associated with fewer superficial surgical site infections (IRR 0.30, 95%CI [0.11, 0.81]), transfusions (IRR 0.25, 95%CI [0.11, 0.57]), ICU admissions (IRR 0.30, 95%CI [0.12, 0.71]), GI bleeding (IRR 0.29, 95%CI [0.12, 0.70]), and re-operations (IRR 0.67, 95%CI [0.47, 0.97]). There were no significant differences in rates of anastomotic leaks, deep organ/space infections, and venous thromboembolism.

Conclusions

While limited by the number of cases currently available in the MBSAQIP, the data from 2020 and 2021 suggests that SAGB may be a safe option for patients. Additional review of clinical outcomes will help to establish its place in the surgical armamentarium.