Long-Term Outcomes and Predictors of Recurrent Weight Gain After Sleeve Gastrectomy, Roux-En-Y Gastric Bypass, and One Anastomosis Gastric Bypass: Turkish Metabolic and Bariatric Surgery Follow-up Study (TMBS Study)
Obesity Surgery, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11695-026-08927-4
- Dergi Adı: Obesity Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Anahtar Kelimeler: Long-term Outcomes, Metabolic and Bariatric Surgery, One Anastomosis Gastric Bypass, Recurrent Weight Gain, Roux-en-Y Gastric Bypass, Sleeve Gastrectomy
- Bursa Uludağ Üniversitesi Adresli: Evet
Özet
Introduction: Metabolic and bariatric surgery (MBS) achieves effective weight loss, but long-term outcomes vary by procedure. We compared procedure-specific total weight loss (%TWL), recurrent weight gain (RWG), and metabolic outcomes across three MBS procedures. Methods: This nationwide, multicenter, retrospective cohort study (n = 1,498; 78.8% women; 37 centers) used stratified random sampling. Primary outcomes were %TWL and RWG (≥ 10% of total weight lost from nadir and sensitivity analysis used the IFSO 2024 threshold of > 30%). Multivariable regression and propensity score matching (PSM) addressed baseline imbalances. Results: Procedures included Sleeve Gastrectomy (SG, n = 1,321), Roux-en-Y Gastric Bypass (RYGB, n = 124), and One Anastomosis Gastric Bypass (OAGB, n = 53). Median follow-up: SG 66 [IQR 35–91], RYGB 55 [34–98], OAGB 53 [25–100] months (p = 0.704). Nadir %TWL was comparable (~ 38%, p = 0.683). At last follow-up, median %TWL differed significantly (OAGB 33.6%, RYGB 31.7%, SG 29.6%; p = 0.010). OAGB was independently associated with lower RWG than SG (OR 0.34, 95% CI 0.18–0.64; p < 0.001), and this association was confirmed in the PSM cohort (OAGB vs SG: RWG, 37.7% vs 61.6%; p = 0.004; %TWL, 33.8% vs 30.2%; p = 0.046). Metabolic and renal parameters differed across procedure groups, but standardized remission or relapse endpoints were not assessed. Conclusion: In this Turkish multicenter retrospective cohort with long-term follow-up, OAGB was associated with greater current %TWL and lower RWG compared with SG, while RYGB showed intermediate weight outcomes. Given the small OAGB subgroup, confirmation in larger prospective studies is warranted. Key Points: Short-term weight loss was similar across SG, RYGB, and OAGB. RYGB and OAGB were associated with more favorable long-term weight loss than SG. OAGB was associated with a lower RWG than SG in this cohort (absolute risk difference −20.1%; NNT=4.9), but larger prospective studies with standardized follow-up are needed.