Is single anastomosis gastric bypass with fixed common channel length is effective and safe as standard minigastric bypass?

Background
Although minigastric bypass (MGB) leads to a safe and considerable weight loss in most patients, there is still weight regain or unsatisfied weight loss, which occurs in ∼13% of patients; moreover, 0.5% of the patients develop malnutrition, requiring surgical correction. The main cause behind is that the small intestinal length is very variable, and in standard MGB, the common channel length is not measured, and there is a strong evidence to support that the degree of malabsorption after gastric bypass surgery is influenced mainly by the length of common channel.
Aim
The aim was to study the effects of fixed common channel length on the outcome of MGB regarding the weight loss and the incidence of nutritional deficiencies.
Patients and methods
This prospective randomized study included 60 obese patients who underwent laparoscopic MGB surgery between March 2016 and March 2018. They were assigned into two groups: group I underwent standard MGB, and group II underwent single anastomosis gastric bypass with fixed common channel length of 300 cm.
Results
Both groups had satisfactory excess weight loss (EWL); however, EWL was steadier in group II. Mean percentage of EWL reported after 1 year was 67±6% in group I, whereas in group II was 70±1.47%, with value of 0.453. There was less incidence of nutritional deficiencies in group II. Both groups had significant improvement of preoperative comorbidities, for instance, 36.7% of group I and 50% of group II showed improvement of their diabetes status (=0.297), and ∼33.3% of both groups I and II showed improvement of their blood pressure. In addition, malodorous flatus affecting social life was more frequent in group II than in group I, with value of 0.001; however, this did not affect their quality of life, estimated by bariatric analysis and reporting outcome system (BAROS).
Conclusion
Performing single anastomosis gastric bypass with fixed common channel length achieves satisfactory maintained EWL, with less possible metabolic complications.