BACKGROUND The aim of this study was to assess the learning curve of one anastomosis gastric bypass (OAGB-MGB) at the start of a low volume bariatric unit and analyze its impact as a preceding procedure to Roux-en Y gastric bypass (RYGB). METHODS From January 2014 to December 2017, all patients who underwent bariatric surgeries in our teaching hospital that were performed by the same surgeon were enrolled. The first 47 patients who underwent OAGB-MGB were assigned to group A. RYGB has been offered as a treatment option since July 2016; thereafter, 26 patients who underwent OAGB-MGB and 32 patients who underwent RYGB at the same time interval were assigned to group B and group C, respectively. Baseline characteristics, perioperative outcomes and percentage of total weight loss (%TWL) up to 12 months postoperatively were collected and analyzed between groups. RESULTS Compared to the patients in group C, those in groups A and B were older (39.4 yrs. and 42.2 yrs., respectively, vs. 34.2 yrs.; p = 0.021) and predominantly male (48.9 and 73.1%, respectively vs. 40.6%; p = 0.04), and they had a higher body mass index (41.8 kg/m2 and 43.3 kg/m2, respectively vs. 37.7 kg/m2; p = 0.002) and a higher incidence of hypertension (44.7 and 61.5%, respectively vs. 21.9%; p = 0.008). In addition, the operation time was significantly reduced (118.2 min and 115.8 min, respectively vs. 153.1 min; p <  0.001), and the length of stay was shortened (3.0 days and 2.9 days, respectively vs. 3.4 days; p = 0.002) in groups B and C compared to group A. No mortality, conversion or leakage was reported throughout the study period. The 30-day complication rate was decreased in group C compared to groups A and B (0% vs. 6.4 and 7.7%, respectively; p = 0.307). The %TWL at the 12-month follow-up was 36.3, 30.9 and 28.3% for groups A, B and C, respectively (p <  0.001). CONCLUSION Our study verified the early emergence of a learning curve effect for OAGB-MGB, and the proficiency acquired can be transferred to subsequent practice for RYGB in terms of acceptable operation time and length of stay without an increase in complications.

中文翻译：

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一项吻合术胃旁路术的学习曲线及其对Roux-en Y胃旁路术的影响：连续一百零五例的初步经验。

背景技术这项研究的目的是评估低容量减肥单位开始时一个吻合术胃旁路术（OAGB-MGB）的学习曲线，并分析其对Roux-en Y胃旁路术（RYGB）的影响。方法选择2014年1月至2017年12月在我校教学医院接受过减肥手术并由同一位外科医生进行手术的所有患者。自2016年7月起，将RYGB作为治疗选择，最初的47位接受OAGB-MGB的患者被分配到A组。此后，分别将26例行OAGB-MGB的患者和32例同时进行RYGB的患者分为B组和C组。基线特征 在各组之间收集围手术期结局和术后直至12个月的总体重减轻百分比（％TWL）。结果与C组患者相比，A和B组的患者年龄较大（分别为39.4岁和42.2岁，而34.2岁； p = 0.021），且主要是男性（分别为48.9％和73.1％vs.。 40.6％； p = 0.04），他们的体重指数较高（分别为41.8 kg / m2和43.3 kg / m2与37.7 kg / m2； p = 0.002），高血压的发生率较高（44.7和61.5％） ，分别为21.9％； p = 0.008）。此外，手术时间显着减少（分别为118.2分钟和115.8分钟与153.1分钟； p <0.001； p <0.001），住院时间缩短了（分别为3.0天和2.9天与3.4天； p = 0.002）。 ）与B组相比）。在整个研究期间都报告了转化或泄漏。与A组和B组相比，C组的30天并发症发生率降低了（分别为0％，6.4和7.7％； p = 0.307）。A，B和C组在12个月随访中的％TWL分别为36.3％，30.9％和28.3％（p <0.001）。结论我们的研究证实了OAGB-MGB的学习曲线效应的早期出现，并且所获得的熟练程度可以在可接受的手术时间和住院时间方面转移到RYGB的后续实践中，而不会增加并发症。001）。结论我们的研究证实了OAGB-MGB的学习曲线效应的早期出现，并且所获得的熟练程度可以在可接受的手术时间和住院时间方面转移到RYGB的后续实践中，而不会增加并发症。001）。结论我们的研究证实了OAGB-MGB的学习曲线效应的早期出现，并且所获得的熟练程度可以在可接受的手术时间和住院时间方面转移到RYGB的后续实践中，而不会增加并发症。