Skip to main content
SpringerLink
Log in

Long-term effects of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for the treatment of morbid obesity: a monocentric prospective study with minimum follow-up of 5 years

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most widely used bariatric procedures nowadays. The aim of this study was to compare long-term results on weight loss and comorbidities improvement for both procedures. A cohort of 304 consecutive patients underwent surgery in 2006–2009: 162 underwent LSG and 142 underwent LRYGB. The mean follow-up time was 75.8 ± 8.4 months (range 60–96). LSG showed greater effectiveness in percentage of excess weight loss (%EWL) at 180 days and at 1 year of follow-up. Instead, at 5th year follow-up LRYGB and LSG showed similar %EWL values (72.34 versus 70.26). LSG group showed a lack of weight loss in patients from 3 to 5 years after surgery, whereas LRYGB group patients maintained an effective weight loss during the entire follow-up period. In LSG group both length of stay and operative time were found to be shorter. LRYGB showed better effectiveness in type 2 diabetes mellitus (T2DM) resolution rate. None of the two techniques has proven to be clearly better than the other on a long-term follow-up analysis, except for the LRYGB better results in T2DM healing. According to our findings, in LSG Group after 3 years the weight remains stable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Fontaine KR, Redden DT, Wang C et al (2003) Years of life lost due to obesity. J Am Med Assoc 289(2):187–193

    Article  Google Scholar 

  2. Yanovski SZ (2000) Overweight, obesity, and health risk: National Task Force on the Prevention and Treatment of Obesity. Arch Intern Med 160(7):898–904

    Article  Google Scholar 

  3. Franco JVA, Ruiz PA, Palermo M et al (2011) A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding. Obes Surg 21(9):1458–1468

    Article  PubMed  Google Scholar 

  4. Buchwald H, Avidor Y, Braunwald E et al (2004) Bariatric surgery: a systematic review and metanalysis. JAMA 292(14):1724–1737

    Article  CAS  PubMed  Google Scholar 

  5. Sjöström L, Lindroos AK, Peltonen M et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693

    Article  PubMed  Google Scholar 

  6. Mingrone G, Panunzi S, De Gaetano A et al (2012) Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med 366:1577–1585

    Article  CAS  PubMed  Google Scholar 

  7. Flum DR, Belle SH, King WC et al (2009) Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med 361:445–454

    Article  PubMed  Google Scholar 

  8. Adams TD, Davidson LE, Litwin SE et al (2012) Health benefits of gastric bypass surgery after 6 years. JAMA 308:1122–1131

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Daskalakis M, Weiner RA (2009) Sleeve gastrectomy as a single stage bariatric operation: indications and limitations. Obes Facts 2(1):8–10

    Article  PubMed  Google Scholar 

  10. Buchwald H, Avidor Y, Braunwald E et al (2004) Bariatric surgery: a systematic review and meta-analysis. J Am Med Assoc 292(14):1724–1737

    Article  CAS  Google Scholar 

  11. Aggarwal S, Kini SU, Herron DM (2007) Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis 3(2):189–194

    Article  PubMed  Google Scholar 

  12. Felberbauer FX, Langer F, Shakeri-Manesch S et al (2008) Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obes Surg 18(7):814–818

    Article  PubMed  Google Scholar 

  13. Topart P, Becouarn G, Ritz P (2012) Comparative early outcomes of three laparoscopic bariatric procedures: sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis 8(3):250–254

    Article  PubMed  Google Scholar 

  14. Nguyen NT, Nguyen B, Gebhart A et al (2013) Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg 216(2):252–257

    Article  PubMed  Google Scholar 

  15. Nguyen NT, Root J, Zainabadi K et al (2005) Accelerated growth of bariatric surgery with the introduction of minimally invasive surgery. Arch Surg 140(12):1198–1202

    Article  PubMed  Google Scholar 

  16. Rutledge T, Adler S, Friedman R (2011) A prospective assessment of psychosocial factors among bariatric versus non-bariatric surgery candidates. Obes Surg 21(10):1570–1579

    Article  PubMed  Google Scholar 

  17. Kehagias I, Karamanakos SN, Argentou M et al (2011) 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 21:1650–1656

    Article  PubMed  Google Scholar 

  18. Boza C, Gamboa C, Salinas J et al (2012) Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: a case control study and 3 years of follow-up. Surg Obes Relat Dis 8:243–249

    Article  PubMed  Google Scholar 

  19. Leyba JL, Aulestia SN, Lopis SN (2011) Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg 21:212–216

    Article  PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  21. Vidal P, Ramon JM, Goday A et al (2013) Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results. Obes Surg 23:292–299

    Article  PubMed  Google Scholar 

  22. Peterli R, Borbely Y, Kern B et al (2013) 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 258:690–694

    Article  PubMed  PubMed Central  Google Scholar 

  23. Buchwald H, Oien DM (2013) Metabolic/bariatric surgery worldwide 2011. Obes Surg 23:427–436

    Article  PubMed  Google Scholar 

  24. Buchwald H, Estok R, Fahrbach K et al (2009) Weight and type 2 diabetes after bariatric surgery: systematic review and meta analysis. Am J Med 122(3):248.e5–256.e5

    Article  Google Scholar 

  25. Fischer L, Hildebrandt C, Bruckner T et al (2012) Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg 22:721–731

    Article  PubMed  Google Scholar 

  26. Leyba JL, Aulestia SN, Llopis SN (2011) Laparoscopic Roux en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study of 117 patients. Obes Surg 21(2):212–216

    Article  PubMed  Google Scholar 

  27. Boza C, Gamboa C, Salinas J et al (2012) Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: a case–control study and 3 years of follow-up. Surg Obes Relat Dis 8(3):243–249

    Article  PubMed  Google Scholar 

  28. Bellanger DE, Greenway FL (2011) Laparoscopic sleeve gastrectomy, 529 cases without a leak: short-term results and technical considerations. Obes Surg 21(2):146–150

    Article  PubMed  Google Scholar 

  29. Li JF, Lai DD, Lin Z et al (2014) 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 24:1–11

    Article  PubMed  Google Scholar 

  30. Lakdawala MA, Bhasker A, Mulchandani D et al (2010) 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 20(1):1–6

    Article  PubMed  Google Scholar 

  31. Helmio M, Victorzon M, Ovaska J et al (2012) SLEEVEPASS: a randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results. Surg Endosc 26(9):2521–2526

    Article  PubMed  Google Scholar 

  32. Chouillard EK, Karaa A, Elkhoury M et al (2011) Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for morbid obesity: case-control study. Surg Obes Relat Dis 7(4):500–505

    Article  PubMed  Google Scholar 

  33. Choullard EK, Karaa A, Elkhoury M et al (2011) Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for morbid obesity: case–control study. Surg Obes Relat Dis 7:500–505

    Article  Google Scholar 

  34. Yaghoubian A, Tolan A, Stabile BE et al (2012) Laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy achieve comparable weight loss at 1 year. Am Surg 78:1325–1328

    PubMed  Google Scholar 

  35. Lakdawala MA, Bhasker A, Mulchandani D et al (2010) 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 20:1–6

    Article  PubMed  Google Scholar 

  36. Gill RS, Birch DW, Shi X et al (2010) Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis 6:707–713

    Article  PubMed  Google Scholar 

  37. Trastulli S, Desiderio J, Guarino S et al (2013) Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis 9(5):816–830

    Article  PubMed  Google Scholar 

  38. Chikunguwo SM, Wolfe LG, Dodson P et al (2010) Analysis of factors associated with durable remission of diabetes after Roux-en-Y gastric bypass. Surg Obes Relat Dis 6:254–259

    Article  PubMed  Google Scholar 

  39. Arterburn DE, Bogart A, Sherwood NE et al (2013) A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg 23:93–102

    Article  PubMed  PubMed Central  Google Scholar 

  40. Perrone F, Bianciardi E, Gentileschi P et al (2016) Gender influence on long-term weight loss and comorbidities after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass: a prospective study with a 5-year follow-up. Obes Surg 26(2):276–281

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. General Surgery Unit, Department of Experimental Medicine and Surgery, University of Rome, Tor Vergata, Rome, Italy

    Federico Perrone & Paolo Gentileschi

  2. Bariatric Surgery Unit, Department of Experimental Medicine and Surgery, University of Rome, Tor Vergata, Rome, Italy

    Paolo Gentileschi

  3. Psychiatric Unit, Department of System Medicine, University of Rome, Tor Vergata, Rome, Italy

    Emanuela Bianciardi

  4. University of Rome, Tor Vergata, Rome, Italy

    Simona Ippoliti, Jennifer Nardella & Francesco Fabi

Authors
  1. Federico Perrone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emanuela Bianciardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simona Ippoliti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer Nardella
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesco Fabi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paolo Gentileschi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Federico Perrone.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical approval

All patients were invited to participate in this prospective cohort study. All procedures performed in studies involving human participants were 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. The study was approved by the Ethics Committee.

Research involving human participants and/or animals

This article does not contain any study with animals performed by any of the authors.

Informed consent

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

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Perrone, F., Bianciardi, E., Ippoliti, S. et al. Long-term effects of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for the treatment of morbid obesity: a monocentric prospective study with minimum follow-up of 5 years. Updates Surg 69, 101–107 (2017). https://doi.org/10.1007/s13304-017-0426-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-017-0426-z

Keywords

Search

Navigation