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Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity. A Prospective Study with 5 Years of Follow-Up

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Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) is becoming increasingly popular. The aim of this study was to compare mid-term results of both procedures.

Methods

From January 2008 to December 2008, 117 obese patients were assigned by patient choice after informed consent to either a LRYGB procedure (n = 75) or a LSG procedure (n = 42). We determined operative time, length of stay, morbidity, comorbidity outcomes, failures, and excess weight loss at 5 years.

Results

Both groups were comparable in demographic characteristics and comorbidities at baseline. No significant statistical differences were found in length of stay and early major morbidity, but mean operative time was shorter in LSG group, p < 0.05. Follow-up was achieved in 74 patients (63.2 %) at 5 years, and major complications (early and late) were 10 (21.2 %) for the LRYGB group and 3 (11.1 %) for the LSG group, p > 0.05. Five years after surgery, the percentage of excess weight loss was similar in both groups (69.8 % for LRYGB and 67.3 % for LSG, p > 0.05). Failures were more common for LSG group, 22.2 versus 12.7 % for LRYGB group, but this difference was not significant, p > 0.05.

Conclusions

Both techniques are comparable regarding safety and effectiveness after 5 years of follow-up, so not one procedure is clearly superior to the other.

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References

  1. Perez RC. Current mapping of obesity. Nutr Hosp. 2013;5:21–31.

    Google Scholar 

  2. Deitel M. The obesity epidemic. Obes Surg. 2006;16:377–8.

    Article  PubMed  Google Scholar 

  3. Picot J, Jones J, Colquit JL, et al. The clinical effectiveness and cost effectiveness of bariatric (weight loss) surgery for morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190.

    CAS  Google Scholar 

  4. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23:427–36.

    Article  PubMed  Google Scholar 

  5. Leyba JL, Sanchez N, Navarrete S. Estado de la cirugía bariátrica en Venezuela: encuesta “en línea” a los miembros de la Sociedad Venezolana de Cirugía Bariátrica y Metabólica. Rev Venez Cir. 2011;64:130–4.

    Google Scholar 

  6. Kehagias I, Karamanakos SN, Argentou M, et al. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obes Surg. 2011;21:1650–6.

    Article  PubMed  Google Scholar 

  7. Boza C, Gamboa C, Salinas J, et al. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: a case-control study and 3 years of follow-up. Surg Obes Relat Dis. 2012;8:243–9.

    Article  PubMed  Google Scholar 

  8. Leyba JL, Aulestia SN, Llopis SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg. 2011;21:212–6.

    Article  PubMed  Google Scholar 

  9. Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.

    Article  PubMed  Google Scholar 

  10. Diamantis T, Apostolou KG, Griniastos J, et al. Review of long-term weight loss after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10:177–83.

    Article  PubMed  Google Scholar 

  11. Albeladi B, Bourbao-Tournois C, Hutan N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653. doi:10.1155/2013/934653.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Vidal P, Ramon JM, Godat A, et al. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results. Obes Surg. 2013;23:292–9.

    Article  PubMed  Google Scholar 

  13. Peterli R, Borbely Y, Kern B, et al. Early results of the swiss multicentre bypass or sleeve study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258:690–4.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Li JF, Lai DD, Lin Z, et al. Comparison of the long-term results of Roux-en-Y gastric bypass and sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis of randomized and nonrandomized trials. Surg Laparosc Endosc Percutan Tech. 2014;24:1–11.

    Article  CAS  PubMed  Google Scholar 

  15. Higa KD, Ho T, Boone KB. Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention. Obes Surg. 2003;13:350–4.

    Article  PubMed  Google Scholar 

  16. Rodriguez A, Mosti M, Sierra M, et al. Small bowel obstruction after antecolic antegastric laparoscopic Roux-en-Y gastric bypass: could the incidence be reduced. Obes Surg. 2010;20:1380–4.

    Article  PubMed  Google Scholar 

  17. de la Cruz-Muñoz N, Cabrera JC, Cuesta M, et al. Closure of mesenteric defect can lead to decrease in internal hernias after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2011;7:176–80.

    Article  PubMed  Google Scholar 

  18. Leyba JL, Navarrete S, Navarrete Llopis S, et al. Laparoscopic technique for hernia reduction and mesenteric defect closure in patients with internal hernia as a postoperative complication of laparoscopic Roux-en-Y gastric bypass. Surg Laparosc Endosc Percutan Tech. 2012;22:e182–5.

    Article  PubMed  Google Scholar 

  19. Choullard EK, Karaa A, Elkhoury M, et al. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for morbid obesity: case-control study. Surg Obes Relat Dis. 2011;7:500–5.

    Article  Google Scholar 

  20. Yaghoubian A, Tolan A, Stabile BE, et al. Laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy achieve comparable weight loss at 1 year. Am Surg. 2012;78:1325–8.

    PubMed  Google Scholar 

  21. Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.

    Article  PubMed  Google Scholar 

  22. Campos JM, Lins DC, Silva LB, et al. Metabolic surgery, weight regain and diabetes re-emergence. Arq Bras Cir Dig. 2013;26(Supp1):57–62.

    Article  PubMed  Google Scholar 

  23. Lim DM, Taller J, Bertucci W, et al. Comparison of laparoscopic sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass for morbid obesity in a military institution. Surg Obes Relat Dis. 2014;10:269–76.

    Article  PubMed  Google Scholar 

  24. D’Hondt M, Vanneste S, Pottel H, et al. Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss. Surg Endosc. 2011;25:2498–504.

    Article  PubMed  Google Scholar 

  25. Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.

    Article  PubMed  Google Scholar 

  26. Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7:516–25.

    Article  PubMed  Google Scholar 

  27. Sarela AI, Dexter SP, O’Kane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8-9-year results. Surg Obes Relat Dis. 2012;8:679–84.

    Article  PubMed  Google Scholar 

  28. Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg. 2010;20:447–53.

    Article  PubMed  Google Scholar 

  29. Davies DJ, Baxter JM, Baxter JN. Nutritional deficiencies after bariatric surgery. Obes Surg. 2007;17:1150–8.

    Article  CAS  PubMed  Google Scholar 

  30. Chapman AE et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. 2004;135:326–51.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

This study has been performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela

    Jose Luis Leyba, Salvador Navarrete Llopis & Salvador Navarrete Aulestia

Authors
  1. Jose Luis Leyba
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  2. Salvador Navarrete Llopis
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  3. Salvador Navarrete Aulestia
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Correspondence to Jose Luis Leyba.

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Leyba, J.L., Llopis, S.N. & Aulestia, S.N. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity. A Prospective Study with 5 Years of Follow-Up. OBES SURG 24, 2094–2098 (2014). https://doi.org/10.1007/s11695-014-1365-0

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  • DOI: https://doi.org/10.1007/s11695-014-1365-0

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