30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data
Authors: Singhal Rishi , Cardoso Victor Roth , Wiggins Tom , Super Jonathan , Ludwig Christian , Gkoutos Georgios V. , Mahawar Kamal ,   GENEVA Collaborators, Pędziwiatr Michał , Major Piotr , Zarzycki Piotr , Pantelis Athanasios , Lapatsanis Dimitris P. , Stravodimos Georgios , Matthys Chris , Focquet Marc , Vleeschouwers Wouter , Spaventa Antonio G. , Zerrweck Carlos , Vitiello Antonio , Berardi Giovanna , Musella Mario , Sanchez-Meza Alberto , Cantu Felipe J. , Mora Fernando , Cantu Marco A. , Katakwar Abhishek , Reddy D. Nageshwar , Elmaleh Haitham , Hassan Mohammad , Elghandour Abdelrahman , Elbanna Mohey , Osman Ahmed , Khan Athar , layani Laurent , Kiran Nalini , Velikorechin Andrey , Solovyeva Maria , Melali Hamid , Shahabi Shahab , Agrawal Ashish , Shrivastava Apoorv , Sharma Ankur , Narwaria Bhavya , Narwaria Mahendra , Raziel Asnat , Sakran Nasser , Susmallian Sergio , Karagöz Levent , Akbaba Murat , Pişkin Salih Zeki , Balta Ahmet Ziya , Senol Zafer , Manno Emilio , Iovino Michele Giuseppe , Osman Ahmed , Qassem Mohamed , Arana-Garza Sebastián , Povoas Heitor P. , Vilas-Boas Marcos Leão , Naumann David , Li Alan , Ammori Basil J. , Balamoun Hany , Salman Mohammed , Nasta Amrit Manik , Goel Ramen , Sánchez-Aguilar Hugo , Herrera Miguel F. , Abou-mrad Adel , Cloix Lucie , Mazzini Guilherme Silva , Kristem Leonardo , Lazaro Andre , Campos Jose , Bernardo Joaquín , González Jesús , Trindade Carlos , Viveiros Octávio , Ribeiro Rui , Goitein David , Hazzan David , Segev Lior , Beck Tamar , Reyes Hernán , Monterrubio Jerónimo , García Paulina , Benois Marine , Kassir Radwan , Contine Alessandro , Elshafei Moustafa , Aktas Sueleyman , Weiner Sylvia , Heidsieck Till , Level Luis , Pinango Silvia , Ortega Patricia Martinez , Moncada Rafael , Valenti Victor , Vlahović Ivan , Boras Zdenko , Liagre Arnaud , Martini Francesco , Juglard Gildas , Motwani Manish , Saggu Sukhvinder Singh , Momani Hazem Al , López Luis Adolfo Aceves , Cortez María Angelina Contreras , Zavala Rodrigo Aceves , D’Haese RN Christine , Kempeneers Ivo , Himpens Jacques , Lazzati Andrea , Paolino Luca , Bathaei Sarah , Bedirli Abdulkadir , Yavuz Aydın , Büyükkasap Çağr , Özaydın Safa , Kwiatkowski Andrzej , Bartosiak Katarzyna , Walędziak Maciej , Santonicola Antonella , Angrisani Luigi , Iovino Paola , Palma Rossella , Iossa Angelo , Boru Cristian Eugeniu , De Angelis Francesco , Silecchia Gianfranco , Hussain Abdulzahra , Balchandra Srivinasan , Coltell Izaskun Balciscueta , Pérez Javier Lorenzo , Bohra Ashok , Awan Altaf K. , Madhok Brijesh , Leeder Paul C. , Awad Sherif , Al-Khyatt Waleed , Shoma Ashraf , Elghadban Hosam , Ghareeb Sameh , Mathews Bryan , Kurian Marina , Larentzakis Andreas , Vrakopoulou Gavriella Zoi , Albanopoulos Konstantinos , Bozdag Ahemt , Lale Azmi , Kirkil Cuneyt , Dincer Mursid , Bashir Ahmad , Haddad Ashraf , Hijleh Leen Abu , Zilberstein Bruno , de Marchi Danilo Dallago , Souza Willy Petrini , Brodén Carl Magnus , Gislason Hjörtur , Shah Kamran , Ambrosi Antonio , Pavone Giovanna , Tartaglia Nicola , Kona S. Lakshmi Kumari , Kalyan K. , Perez Cesar Ernesto Guevara , Botero Miguel Alberto Forero , Covic Adrian , Timofte Daniel , Maxim Madalina , Faraj Dashti , Tseng Larissa , Liem Ronald , Ören Gürdal , Dilektasli Evren , Yalcin Ilker , AlMukhtar Hudhaifa , Hadad Mohammed Al , Mohan Rasmi , Arora Naresh , Bedi Digvijaysingh , Rives-Lange Claire , Chevallier Jean-Marc , Poghosyan Tigran , Sebbag Hugues , Zinaï Lamia , Khaldi Saadi , Mauchien Charles , Mazza Davide , Dinescu Georgiana , Rea Bernardo , Pérez-Galaz Fernando , Zavala Luis , Besa Anais , Curell Anna , Balibrea Jose M. , Vaz Carlos , Galindo Luis , Silva Nelson , Caballero José Luis Estrada , Sebastian Sergio Ortiz , Marchesini João Caetano Dallegrave , da Fonseca Pereira Ricardo Arcanjo , Sobottka Wagner Herbert , Fiolo Felipe Eduardo , Turchi Matias , Coelho Antonio Claudio Jamel , Zacaron Andre Luis , Barbosa André , Quinino Reynaldo , Menaldi Gabriel , Paleari Nicolás , Martinez-Duartez Pedro , de Esparza Gabriel Martínez de Aragon Ramírez , Esteban Valentin Sierra , Torres Antonio , Garcia-Galocha Jose Luis , Josa Miguel , Pacheco-Garcia Jose Manuel , Mayo-Ossorio Maria Angeles , Chowbey Pradeep , Soni Vandana , de Vasconcelos Cunha Hercio Azevedo , Castilho Michel Victor , Ferreira Rafael Meneguzzi Alves , Barreiro Thiago Alvim , Charalabopoulos Alexandros , Sdralis Elias , Davakis Spyridon , Bomans Benoit , Dapri Giovanni , Van Belle Koenraad , Takieddine Mazen , Vaneukem Pol , Karaca Esma Seda Akalın , Karaca Fatih Can , Sumer Aziz , Peksen Caghan , Savas Osman Anil , Chousleb Elias , Elmokayed Fahad , Fakhereldin Islam , Aboshanab Hany Mohamed , Swelium Talal , Gudal Ahmad , Gamloo Lamees , Ugale Ayushka , Ugale Surendra , Boeker Clara , Reetz Christian , Hakami Ibrahim Ali , Mall Julian , Alexandrou Andreas , Baili Efstratia , Bodnar Zsolt , Maleckas Almantas , Gudaityte Rita , Guldogan Cem Emir , Gundogdu Emre , Ozmen Mehmet Mahir , Thakkar Deepti , Dukkipati Nandakishore , Shah Poonam Shashank , Shah Shashank Subhashchandra , Shah Simran Shashank , Adil Md Tanveer , Jambulingam Periyathambi , Mamidanna Ravikrishna , Whitelaw Douglas , Adil Md Tanveer , Jain Vigyan , Veetil Deepa Kizhakke , Wadhawan Randeep , Torres Antonio , Torres Max , Tinoco Tabata , Leclercq Wouter , Romeijn Marleen , van de Pas Kelly , Alkhazraji Ali K. , Taha Safwan A. , Ustun Murat , Yigit Taner , Inam Aatif , Burhanulhaq Muhammad , Pazouki Abdolreza , Eghbali Foolad , Kermansaravi Mohammad , Jazi Amir Hosein Davarpanah , Mahmoudieh Mohsen , Mogharehabed Neda , Tsiotos Gregory , Stamou Konstantinos , Rodriguez Francisco J. Barrera , Navarro Marco A. Rojas , Torres Omar Mohamed , Martinez Sergio Lopez , Tamez Elda Rocio Maltos , Cornejo Gustavo A. Millan , Flores Jose Eduardo Garcia , Mohammed Diya Aldeen , Elfawal Mohamad Hayssam , Shabbir Asim , Guowei Kim , So Jimmy By , Kaplan Elif Tuğçe , Kaplan Mehmet , Kaplan Tuğba , Pham DangTuan , Rana Gurteshwar , Kappus Mojdeh , Gadani Riddish , Kahitan Manish , Pokharel Koshish , Osborne Alan , Pournaras Dimitri , Hewes James , Napolitano Errichetta , Chiappetta Sonja , Bottino Vincenzo , Dorado Evelyn , Schoettler Axel , Gaertner Daniel , Fedtke Katharina , Aguilar-Espinosa Francisco , Aceves-Lozano Saul , Balani Alessandro , Nagliati Carlo , Pennisi Damiano , Rizzi Andrea , Frattini Francesco , Foschi Diego , Benuzzi Laura , Parikh Chirag , Shah Harshil , Pinotti Enrico , Montuori Mauro , Borrelli Vincenzo , Dargent Jerome , Copaescu Catalin A. , Hutopila Ionut , Smeu Bogdan , Witteman Bart , Hazebroek Eric , Deden Laura , Heusschen Laura , Okkema Sietske , Aufenacker Theo , den Hengst Willem , Vening Wouter , van der Burgh Yonta , Ghazal Ahmad , Ibrahim Hamza , Niazi Mourad , Alkhaffaf Bilal , Altarawni Mohammad , Cesana Giovanni Carlo , Anselmino Marco , Uccelli Matteo , Olmi Stefano , Stier Christine , Akmanlar Tahsin , Sonnenberg Thomas , Schieferbein Uwe , Marcolini Alejandro , Awruch Diego , Vicentin Marco , de Souza Bastos Eduardo Lemos , Gregorio Samuel Azenha , Ahuja Anmol , Mittal Tarun , Bolckmans Roel , Wiggins Tom , Baratte Clément , Wisnewsky Judith Aron , Genser Laurent , Chong Lynn , Taylor Lillian , Ward Salena , Hi Michael W. , Heneghan Helen , Fearon Naomi , Plamper Andreas , Rheinwalt Karl , Heneghan Helen , Geoghegan Justin , Ng Kin Cheung , Fearon Naomi , Kaseja Krzysztof , Kotowski Maciej , Samarkandy Tarig A. , Leyva-Alvizo Adolfo , Corzo-Culebro Lourdes , Wang Cunchuan , Yang Wah , Dong Zhiyong , Riera Manel , Jain Rajesh , Hamed Hosam , Said Mohammed , Zarzar Katia , Garcia Manuel , Türkçapar Ahmet Gökhan , Şen Ozan , Baldini Edoardo , Conti Luigi , Wietzycoski Cacio , Lopes Eduardo , Pintar Tadeja , Salobir Jure , Aydin Cengiz , Atici Semra Demirli , Ergin Anıl , Ciyiltepe Huseyin , Bozkurt Mehmet Abdussamet , Kizilkaya Mehmet Celal , Onalan Nezihe Berrin Dodur , Zuber Mariana Nabila Binti Ahmad , Wong Wei Jin , Garcia Amador , Vidal Laura , Beisani Marc , Pasquier Jorge , Vilallonga Ramon , Sharma Sharad , Parmar Chetan , Lee Lyndcie , Sufi Pratik , Sinan Hüseyin , Saydam Mehmet 
Published: December 2021

Abstract
Background
There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts.

Materials and methods
This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups.

Results
In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07).

Conclusions
This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts.