One-Anastomosis Versus Roux-en-Y Gastric Bypass in the Resolution of Comorbidities: A Non-inferiority Meta-analysis and Meta-regression.

Bariatric surgery is effective for treating obesity and its comorbidities, but the optimal technique remains debated. This meta-analysis compared one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) in comorbidity remission and postoperative outcomes. We analyzed 12 trials, assessing T2DM, hypertension, and sleep apnea remission, as well as postoperative complications. Statistical analyses included risk differences (RD) and risk ratios (RR). OAGB was non-inferior to RYGB for T2DM remission (RD -1%; 95% CI -10% to 8%) but had higher risks of bile reflux (RR 7.62; 95% CI 1.97-29.46) and de novo GERD (RR 5.10; 95% CI 1.44-18.00). While OAGB is effective for T2DM remission, RYGB is superior in reducing bile reflux and GERD, highlighting the need for individualized surgical approaches.