3-Three Year BAROS Score Outcomes for One anastomosis Gastric Bypass and FundoRing One anastomosis Gastric Bypass

Objective: To compare the 3-year quality of life, weight loss, comorbidity remission, and complication rates between FundoRing One-Anastomosis Gastric Bypass (f-OAGB) and standard OAGB (s-OAGB) in patients with obesity.
Background: While OAGB is an effective metabolic procedure, it is associated with specific complications like bile reflux and marginal ulcers. The FundoRing modification, involving total fundoplication of the excluded stomach, may mitigate these risks. Long-term, patient-centered outcomes measured by the Bariatric Analysis and Reporting Outcome System (BAROS) are crucial.
Methods: In this single-center, prospective randomized trial, 1000 patients (BMI 30-50 kg/m²) were assigned 1:1 to f-OAGB (n=500) or s-OAGB (n=500) between January 2021 and December 2024. A detailed CONSORT flow diagram guided the study. Randomization was performed by a statistician using sequentially numbered opaque envelopes. Outcome assessors were blinded. The primary outcome was the total BAROS score at 3 years. Safety was assessed using structured criteria, including 30-day and late complications (Clavien-Dindo classification).
Results: At 3 years, follow-up was 83.0% (415/500) for f-OAGB and 87.0% (435/500) for s-OAGB (reasons for attrition: lost to follow-up, protocol violations, withdrawal of consent). The f-OAGB group demonstrated a significantly higher total BAROS score (5.59±1.13 vs. 4.57±1.09; mean difference 1.02, 95% CI 0.87–1.17; p<0.001), indicating a "very good" vs. "good" outcome. f-OAGB resulted in superior %EWL (84.3±12.1% vs. 76.8±14.3%; p<0.001), greater improvement in medical conditions, and better quality of life. No intraoperative, 30-day, or late mortality occurred in either group during the 3-year follow-up period (overall mortality 0%). f-OAGB was associated with significantly lower rates of bile reflux (0.2% vs. 9.4% at 3 years, p<0.001), marginal ulcers (0.2% vs. 3.4% at 3 years, p<0.001), and dumping syndrome (13.7% vs. 36.5% at 3 years, p<0.001).
Conclusions: At 3 years post-surgery, FundoRing OAGB is superior to standard OAGB in achieving better overall health outcomes as measured by the BAROS score. It provides enhanced weight loss, greater comorbidity resolution, and superior quality of life, while significantly reducing the risk of bile reflux, marginal ulceration, and dumping syndrome. F-OAGB represents a safe and effective technical advancement in metabolic surgery.