Background

The prospective multicenter randomized trial YOMEGA comparing the OAGB to the RYGB confirmed the non-inferiority of OAGB in terms of weight loss at 24 months: significantly more complications were observed for OAGB with a biliopancreatic limb of 200 cm.

Methods

Data from the YOMEGA trial were analyzed at 5 years. The primary end-point was %EBL; secondary end-points: T2D remission, nutritional status, complications.

Results

121 OAGB and 127 RYGB were randomized and analyzed. At baseline, mean age was 43.3 (SD 10.9), mean BMI: 44.0 (SD 5.6), T2D:24%. At 5 years, comparing OAGB to RYGB, mean %EBL was -76% (SD 26.2) versus -72.7% (SD 29.9), p =0.46 ; 30.8% achieved T2D remission in both arms and nutritional status did not differ; 11.3% had > 4 stools/day for OAGB versus 8.2% for RYGB (p=0.57) ; 38.7% suffered from clinical GERD versus 20.8% respectively, p =0.01, with the use of > 20 mg of PPI/ day in 43.6% of OAGB versus 26.9% of RYGB, p = 0.03. 3 patients of the OAGB group were reoperated for an anastomotic ulcer, none in the RYGB group. 11 patients were converted from OAGB to RYGB (8.7%). 18.2% of OAGB required an hospitalization for a serious adverse event versus 10.4% of RYGB, p=0.16. The lost to follow-up rate was 28.6%.

Conclusions

EBL% was not significantly different between groups at 5 years. The nutritional risk and diarrhea rate seemed to improve with time for OAGB but 38.7% suffered from GERD with a conversion rate to RYGB of 8.7%.