Beyond 5 years: a matched cohort of sleeve gastrectomy versus gastric bypass |
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| Institution: | 1. Department of Surgery and Cancer, Imperial College, London, United Kingdom;2. Imperial College NHS Healthcare Trust, London, United Kingdom;1. Department of Surgery, Mayo Clinic, Jacksonville, Florida;2. Georgia Institute of Technology, Atlanta, Georgia;3. Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, Florida;1. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan;2. Center for Obesity, Life Style, and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan;3. Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan;4. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;5. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;6. Metabolic and Weight Management Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan;7. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan;8. Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan |
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| Abstract: | BackgroundLaparoscopic sleeve gastrectomy (LSG) has demonstrated excellent short-term outcomes. However, existing studies suffer from loss to follow-up, and most long-term data focus on laparoscopic Roux-en-Y gastric bypass (LRYGB). This study compares weight loss in patients ≥5 years from LSG with that in matched patients who underwent LRYGB.ObjectivesThe purpose of this study was to compare long-term weight loss in patients undergoing LRYGB and LSG.SettingUniversity hospital, United States.MethodsWe retrospectively evaluated patients who underwent LSG before August 2012 with follow-up data ≥5 years. LSG patients were matched 1:1 with LRYGB patients by sex, age at surgery, and preoperative body mass index. Univariate and multivariate analyses were performed with weight loss at the longest duration the primary outcome.ResultsOne-hundred and sixty-five patients underwent LSG during the study period. Long-term follow-up data (≥5 years) were available for 85 patients (52%). There were no preoperative differences between those with and without follow-up data. Six LSG patients (7%) were excluded because they underwent reoperation that altered intestinal anatomy. Of the 79 patients remaining, 75 were matched with post-LRYGB patients. The average follow-up period was 6.4 years for LSG patients and 6.5 years for LRYGB patients (P = .08, not significant). Change in body mass index was 6.81 kg/m2 for LSG patients and 13.11 kg/m2 for LRYGB patients. Percentage of total body weight loss was 15.25% for LSG patients and 28.73% for LRYGB patients. Percentage of excess body weight loss was 37% for LSG patients and 67% for LRYGB patients (P < .0001). Weight loss for LSG patient follow-up in clinic versus outside the clinic was 46% versus 34% (P = .18, not significant).ConclusionsLSG is now the most common bariatric surgery in the United States. Long-term data are needed to confirm that observed short-term favorable outcomes are maintained. Recent studies have produced divergent results. We observed significantly less weight loss at ≥5 years in LSG patients compared with matched LRYGB patients. |
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| Keywords: | Sleeve gastrectomy Gastric bypass Long-term outcomes |
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