Evidence mapPaperPMID 41968218Full record

ArticleObesity surgery2026

Ring-Augmented versus Non-Ring-Augmented One-Anastomosis Gastric Bypass as Revisional Surgery after Sleeve Gastrectomy: a Comparative Cohort Study.

Ahmed Elmasry, Mohamed Sallam, Mahmoud F Abdelaziz, Amr Abdelatyy, Mohamed Abdelgawad, Muhammad S Sahali, Eslam E Mohamed, Hashem Altabbaa, Ahmed El Shamarka, Mohamed H Zidan

Erratum issuedAbstract readComparative Study
In one paragraph

Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Ahmed ElmasryArab Contractors Medical Centre, Cairo, Egypt. dr_Ahmedmasry@yahoo.com.
Mohamed SallamIndependent Surgeon, Ministry of Health and Population, Cairo, Egypt.
Mahmoud F AbdelazizIndependent Surgeon, Ministry of Health and Population, Cairo, Egypt.
Amr AbdelatyyMatareya Teaching Hospital, Cairo, Egypt.
Mohamed AbdelgawadIndependent Surgeon, Ministry of Health and Population, Cairo, Egypt.
Muhammad S SahaliIndependent Surgeon, Ministry of Health and Population, Cairo, Egypt.
Eslam E MohamedIndependent Surgeon, Ministry of Health and Population, Cairo, Egypt.
Hashem AltabbaaAl-Basheer-Hospital, Amman, Jordan.ORCID http://orcid.org/0000-0002-8031-838X
Ahmed El ShamarkaThe Research Papyrus Lab, Alexandria, Egypt. A.shamarka1995@gmail.com.ORCID http://orcid.org/0000-0002-7257-9969
Mohamed H ZidanThe Research Papyrus Lab, Alexandria, Egypt. mohamed.hessien1171@alexmed.edu.eg.ORCID http://orcid.org/0000-0001-7425-356X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleeve gastrectomy (SG) is the most frequently performed metabolic and bariatric surgery (MBS) worldwide, but long-term suboptimal weight loss (SOWL) or recurrent weight gain (RWG) affects up to one third of patients and often necessitates revisional procedures. One-anastomosis gastric bypass (OAGB) is an effective revision, yet pouch dilation and late RWG remain concerns. Ring augmentation (RA) has been proposed to enhance restriction and sustain weight loss, but evidence in the revisional OAGB setting is limited.

methodsThis retrospective comparative cohort study analyzed 94 adults who underwent revisional OAGB after SG at a high-volume tertiary MBS center. Patients were grouped into two categories: Ring Augmented OAGB (RaOAGB) (n = 45) and Non-Ring Augmented OAGB (NRa-OAGB) (n = 49). The primary outcomes were percentage excess weight loss (%EWL), percentage total weight loss (%TWL), and change in body mass index (BMI) at 3, 6, and 12 months. Secondary outcomes included improvement of obesity-related conditions, metabolic parameters (lipid profile, HbA1c), nutritional markers, operative time, hospital stay, and early/late complications.

resultsBoth groups achieved significant weight reduction at 12 months (p < 0.001 within groups). RaOAGB yielded greater BMI reduction (27.6 vs. 32.2 kg/m²), %EWL (81.7% vs. 61.3%), and %TWL (31.5% vs. 24.2%) compared with NRa-OAGB (all p < 0.001). Lipid profiles improved in both groups; LDL decreased, and total cholesterol equalized by 12 months. Glycemic control changes were modest and similar between cohorts. Operative time, length of stay, and early postoperative complications were comparable. Ring-related adverse events were infrequent (food intolerance 6.7% vs. 4.1%; no erosions were observed; one patient (2.2%) required ring removal at 10 months due to persistent vomiting and food intolerance).

conclusionsRaOAGB is a safe and effective revisional option for RWG and SOWL after SG, achieving significantly greater 1-year weight loss than standard OAGB, with uncommon ring-related adverse events, including one ring removal. These findings support the role of mechanical reinforcement to enhance the durability of revisional bypass but warrant confirmation through long-term, multicenter randomized trials.

Indexed as

GastrectomyGastric BypassObesity, MorbidReoperationAdultAnastomosis, SurgicalBody Mass IndexFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeWeight LossBanded OAGBRecurrent weight gainRevisional bariatric surgeryRing-augmented one-anastomosis gastric bypassSleeve gastrectomy failure

Identifiers

PMID41968218
PMCPMC13222327

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.