SynthesisObesity surgery2026
Minimally Invasive Hypoabsorptive Bariatric Surgery - A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials.
Synthesis in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
backgroundThe optimal hypoabsorptive surgical approach for management of severe obesity remains unclear.
aimTo perform a network meta-analysis (NMA) of randomized clinical trials (RCTs) comparing Roux-en-y gastric bypass (RYGB), SADI-S (single anastomosis duodeno-ileal bypass with sleeve gastrectomy), one anastomosis gastric bypass (OAGB) and duodenal switch (DS).
methodsA systematic review was performed as per PRISMA-NMA guidelines. Statistical analyses were performed using R and shiny.
results12 RCTs (with 5 sequential analyses) were included, involving 986 patients [471 RYGB (47.8%), 341 OAGB (34.6%), 145 DS (14.7%), and 29 SADI-S (2.9%)]. Patient age, gender, BMI, and ASA grade were similar (all P > 0.050). Patient follow-up ranged from 1.0-15.4 years. Compared to RYGB, DS [mean difference (MD): -13.9, 95% confidence interval (CI): -18.7; -9.1) and SADI-S (MD: -12.4, 95% CI: 19.8; 5.0) significantly increased total body weight loss, while DS (MD: -10.5, 95% CI: -13.1; -7.9), OAGB (MD: -3.1, 95% CI: -5.1; -1.2) and SADI-S (MD: -8.1, 95% CI: -16.1; -0.1) significantly increased excess body weight loss. Relative to RYGB, DS (MD: -24.9, 95% CI: -28.3; -21.5) and OAGB (MD: -1.8, 95% CI: -3.4; -0.3) significantly increased weight loss, while DS (MD: -13.6, 95% CI: -16.0; -11.2) and SADI-S (MD: -16.0, 95% CI: -23.62; -8.38) significantly increased excess weight loss. Importantly, DS (MD: 2.1, 95% CI: 0.1; 4.0) significantly increased length of stay while OAGB was associated with long-term severe malabsorption rates.
conclusionDS, SADI-S and OAGB all serve in significantly inducing weight loss, albeit results in support of SADI-S are limited due to a small sample size. Nevertheless, based on the data presented in this study, there is no consensus as to the optimal hypoabsorptive bariatric surgical approach.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.