Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: Results from a meta-analysis of randomized controlled trials |
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| Institution: | 1. Department of Gastrointestinal Surgery, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People''s Hospital, Affiliated Hospital of the University of Electronic Science and Technology, Chengdu, China;2. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China;3. Department of Endocrinology and Metabolism, Eastern hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People''s Hospital, Affiliated Hospital of the University of Electronic Science and Technology, Chengdu, China;1. General and Bariatric Surgery Unit, Department of Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy;2. Advanced Biomedical sciences Department, Federico II University, Naples, Italy;3. Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy;4. Bariatric Surgery Unit, Ospedale del Mare, Naples, Italy;5. Director of MGB-OAGB Club, Toronto, Canada;1. Division of Nuclear Medicine, Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts;2. Research Division, Joslin Diabetes Center, and Harvard Medical School, Boston, Massachusetts;1. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada;2. Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada |
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| Abstract: | BackgroundLaparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass (LRYGB) are 2 widely used procedures performed in bariatric surgery. However, their long-term weight loss effects have not been well compared.ObjectivesTo evaluate the long-term outcome of 2 procedures for treating morbid obesity.SettingThe gastrointestinal surgery center, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital.MethodsThree electronic databases, PubMed, CNKI, and EMBASE, were searched ending in September 2018. Eligible studies were prospective randomized controlled trials.ResultsOf 15 randomized controlled trials studies, 1381 cases were included, 697 were randomly divided into the laparoscopic sleeve gastrectomy group and 684 to the LRYGB group. A statistically significant percent excess weight loss reduction in weighted mean difference was observed in LRYGB group at 5 years (weighted mean difference = −8.9, 95% confidence interval CI] = −13.08 to −4.73, P < .0001), and at 3 years (weighted mean difference = −11.96, 95% CI = −17.62 to −6.30, P < .0001). However, there was not any statistically difference between the 2 procedures in <3 years. The total complication of the LSC group were less than that of the LRYGB groups (odds ratio = .52, 95%CI = .35–.76, P = .0007). This meta-analysis showed that the LRYGB procedure could reduce gastrointestinal reflux disease (odds ratio = .26, 95%CI = .11–.61, P = .002); however, no statistically significant differences were found in type 2 diabetes, hypertension, dyslipidemia, and sleep apnea.ConclusionsThis meta-analysis showed that significantly greater in percent excess weight loss after 5 years of LRYGB treatment; however, it seems to have a higher incidence of total complications. |
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