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Purpose Roux-en-Y-Gastric-Bypass (RYGB) and One-Anastomosis-Gastric-Bypass (OAGB) are effective standard bariatric surgeries with comparable weight loss and remission of obesity-related comorbidities. As procedure-specific health-related quality-of-life (HrQoL) outcomes have not been directly compared thus far, we conducted this questionnaire-based study. Methods 240 patients after undergoing either RYGB or OAGB between 2011 and 2016 were contacted and asked to fill out SF36 and BAROS questionnaires. All statistical analysis was performed with Microsoft Excel and GraphPad Prism. Primary objectives were procedure-dependent differences in HrQoL. Secondary objectives were weight loss and remission of comorbidities. Results 119 of 240 contacted patients (49.6%) replied, 58 after RYGB (48.7%) and 61 after OAGB (51,3 %). Follow-up period was 24 months in 64 evaluable patients. Mean age was 46 years (range 23 to 71). Regarding the 24 months groups showed high SF36-HrQoL sum scales. Global mean BAROS results after >24 months were “very good“ in both procedures. EWL in RYGB (80.81%) and in OAGB (81.36%) were comparably excellent. Conclusion Concerning SF36 and BAROS evaluated HrQoL in early and late postoperative phases, both procedures demonstrated comparable and relevant improvements. Further (preferably randomized) studies should include evaluation of preoperative HrQoL.

Aim of this study was to improve knowledge about the best conversional bariatric procedure following sleeve gastrectomy (SG).Data of conversional Roux-en-Y gastric bypass (RYGB) and of one anastomosis gastric bypass (OAGB) after SG were collected prospectively and analyzed retrospectively. Weight loss parameters, gastroesophageal reflux disease (GERD) and comorbidities outcomes were recorded.Total of 123 patients (90 female, mean age 44 ± 0.9 years, mean body mass index (BMI) 42 ± 0.8 kg/mBoth RYGB and OAGB are effective conversional procedures after SG, leading to comparable TBWL, BMI-loss and high remission rates of comorbidities including GERD. Significantly shorter operation times were in favor of OAGB. BPL, which was longer in OAGB was significantly related to higher %TBWL and %BMI-loss compared to RYGB.

Logan Rawlins,1 Barbara H Johnson,2 Stephen S Johnston,2 Nivesh Elangovanraaj,3 Mohit Bhandari,4 Ricardo V Cohen,5 Karl Peter Rheinwalt,6 Raymond Fryrear,2 Sanjoy Roy2 1Allegheny Health Network Bariatric & Metabolic Institute, Pittsburgh, PA, USA; 2Johnson & Johnson Medical Device Company, Cincinnati, OH, USA; 3Mu Sigma, Bangalore, India; 4Mohak Bariatric and Robotic Surgery Centre, Indore, India; 5The Center for the Treatment of Obesity and Diabetes, Hospital Alemão Oswaldo Cruz, Sao Paulo, Brazil; 6St. Franziskus-Hospital, Cologne, GermanyCorrespondence: Stephen S JohnstonDirector, Real-World Data Analytics and Research, Epidemiology, Medical Devices, Johnson & Johnson, 410 George Street, New Brunswick, NJ, USTel +1-443-254-2222Email sjohn147@its.jnj.comObjective: To compare outcomes between the two latest innovations in powered stapling technology, the ECHELON FLEX™ GST system (GST) and the Signia™ Stapling System (SIG), among patients undergoing sleeve gastrectomy for obesity.Patients and Methods: Using the Premier Healthcare Database of US hospital discharge records, we selected patients undergoing inpatient sleeve gastrectomy with dates of surgical admission between March 1, 2017 (SIG launch), and December 31, 2018. Outcomes measured during the surgical admission included in-hospital hemostasis-related complications (bleeding/transfusion; primary outcome), leak, total hospital costs, length of stay (LOS), and operating room time; 30-, 60-, and 90-day all-cause inpatient readmissions were also examined. We used 1:1 cardinality matching to balance the GST and SIG groups on numerous patient and hospital/provider characteristics, allowing a maximum standardized mean difference (SMD) ≤ 0.05 for all matching covariates. Generalized estimating equations (GEE) accounting for hospital-level clustering were used to compare the study outcomes between the GST and SIG groups.Results: Of the 5573 identified cases, there were 491 patients in each group (982 total) after matching. The observed incidence proportion of hemostasis-related complications during the surgical admission was lower in the GST group as compared with the SIG group (3 events/491 [0.61%] vs 11 events/491 [2.24%]; odds ratio [SIG=reference] = 0.28, 95% CI=0.13– 0.60, P=0.0012). Differences between the GST and SIG groups were not statistically significant for leak, total hospital costs, LOS, OR time, and all-cause inpatient readmission at 30, 60, and 90 days.Conclusion: In this retrospective study of 982 matched patients undergoing sleeve gastrectomy, the ECHELON FLEX™ GST system was associated with a lower rate of hemostasis-related complications as compared with the Signia™ Stapling System. Further controlled prospective studies are needed to confirm the validity of this finding.Keywords: sleeve gastrectomy, surgical staplers, bleeding, leak, cost