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SLEEVEPASS: A randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results

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Abstract

Background

The long-term efficacy of laparoscopic Roux-en-Y gastric bypass (RYGB) in the treatment of morbid obesity has been demonstrated. Laparoscopic sleeve gastrectomy (SG) as a single procedure has shown promising short-term results, but the long-term efficacy of SG has not yet been demonstrated. The aim of this study was to determine the preliminary 30-day morbidity and mortality of RYGB and SG in a prospective multicenter randomized setting.

Methods

A total of 240 morbidly obese (BMI = 35–66 kg/m²) patients evaluated by a multidisciplinary team were randomized to undergo either RYGB or SG. There were 117 patients in the RYGB group and 121 in the SG group; two patients had to be excluded after randomization. Both study groups were comparable regarding age, gender, BMI, and comorbidities.

Results

There was no 30-day mortality. The median operating time was significantly shorter in the SG group (66 min vs. 94 min, p < 0.001). All complications were recorded thoroughly. There were 7 (5.8 %) major complications following SG and 11 (9.4 %) after RYGB (p = 0.292). Nine (7.4 %) SG patients and 20 (17.1 %) RYGB patients had minor complications (p = 0.023). The overall morbidity was 13.2 % after SG and 26.5 % after RYGB (p = 0.010). There were three (2.5 %) early reoperations after SG and four (3.3 %) after RYGB (p = 0.719).

Conclusions

At 30-day analysis SG is associated with a shorter operating time and fewer early minor complications compared to RYGB. There were no significant differences in major complications or early reoperations. Long-term follow-up is required to determine the effect on weight loss, resolution of obesity-related comorbidities, and improvement of quality of life.

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References

  1. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB (2003) Years of life lost due to obesity. JAMA 289(2):187–193

    Article  PubMed  Google Scholar 

  2. Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH (1999) The disease burden associated with overweight and obesity. JAMA 282(16):1523–1529

    Article  PubMed  CAS  Google Scholar 

  3. (2000) Overweight, obesity, and health risk. National Task Force on the Prevention and Treatment of Obesity. Arch Intern Med 160(7):898–904

  4. Colquitt JL, Picot J, Loveman E, Clegg AJ (2009) Surgery for obesity. Cochrane Database Syst Rev. 15(2):CD003641

    Google Scholar 

  5. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292(14):1724–1737

    Article  PubMed  CAS  Google Scholar 

  6. Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjostrom CD, Sullivan M, Wedel H (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693

    Article  PubMed  Google Scholar 

  7. Regan JP, Inabnet WB, Gagner M, Pomp A (2003) Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg 13(6):861–864

    Article  PubMed  CAS  Google Scholar 

  8. Tucker ON, Szomstein S, Rosenthal RJ (2008) Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg 12(4):662–667

    Article  PubMed  CAS  Google Scholar 

  9. Nocca D, Krawczykowsky D, Bomans B, Noël P, Picot MC, Blanc PM, de Seguin de Hons C, Millat B, Gagner M, Monnier L, Fabre JM (2008) A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg 18(5):560–565

    Article  PubMed  CAS  Google Scholar 

  10. Himpens J, Dobbeleir J, Peeters G (2010) Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 252(2):319–324

    Article  PubMed  Google Scholar 

  11. Fuks D, Verhaeghe P, Brehant O, Sabbagh C, Dumont F, Riboulot M, Delcenserie R, Regimbeau JM (2009) Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery 145(1):106–113

    Article  PubMed  Google Scholar 

  12. Shi X, Karmali S, Sharma AM, Birch DW (2010) A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 20(8):1171–1177

    Article  PubMed  Google Scholar 

  13. Basso N, Casella G, Rizzello M, Abbatini F, Soricelli E, Alessandri G, Maglio C, Fantini A (2011) Laparoscopic sleeve gastrectomy as first stage or definitive intent in 300 consecutive cases. Surg Endosc 25(2):444–449

    Article  PubMed  CAS  Google Scholar 

  14. 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 

  15. Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH, Nguyen NT, Li Z, Mojica WA, Hilton L, Rhodes S, Morton SC, Shekelle PG (2005) Meta-analysis: surgical treatment of obesity. Ann Intern Med 142(7):547–559

    PubMed  Google Scholar 

  16. Ikonen TS, Anttila H, Gylling H, Isojärvi J, Koivukangas V, Kumpulainen T, Mustajoki P, Mäklin S, Saarni S, Saarni S, Sintonen H, Victorzon M, Malmivaara A (2009) Surgical treatment of morbid obesity. Available at http://www.thl.fi/thl-client/pdfs/739965e6-bf7f-4d48-9d29-31b2275c9976 (Accessed)

  17. Cotton PB, Lehman G, Vennes J, Geenen JE, Russell RC, Meyers WC, Liguory C, Nickl N (1991) Endoscopic sphincterotomy complications and their management: an attempt at consensus. Gastrointest Endosc 37(3):383–393

    Article  PubMed  CAS  Google Scholar 

  18. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  PubMed  Google Scholar 

  19. (1991) NIH conference Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med 115(12):956–961

Download references

Acknowledgments

Orion-Farmos Research Foundation grant, Turku University Hospital research grant and Vaasa Central Hospital research grant.

Disclosures

Drs. M. Helmiö, L. Victorzon, J. Ovaska, M. Leivonen, A. Juuti, N. Jaser, P. Peromaa, P. Tolonen, S. Hurme, and P. Salminen have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Turku University Hospital, PL 52, 20521, Turku, Finland

    Mika Helmiö, Jari Ovaska & Paulina Salminen

  2. Department of Emergency, Turku University Hospital, Turku, Finland

    Paulina Salminen

  3. Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland

    Marja Leivonen, Anne Juuti & Nabil Jaser

  4. Department of Surgery, Vaasa Central Hospital, Vaasa, Finland

    Mikael Victorzon, Pipsa Peromaa & Pekka Tolonen

  5. Department of Surgery, Hatanpää Hospital, Tampere, Finland

    Pipsa Peromaa

  6. Department of Biostatistics, University of Turku, Turku, Finland

    Saija Hurme

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  1. Mika Helmiö
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  2. Mikael Victorzon
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  3. Jari Ovaska
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  4. Marja Leivonen
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  7. Pipsa Peromaa
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  8. Pekka Tolonen
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  9. Saija Hurme
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  10. Paulina Salminen
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Correspondence to Mika Helmiö.

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Helmiö, M., Victorzon, M., Ovaska, J. et al. SLEEVEPASS: A randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results. Surg Endosc 26, 2521–2526 (2012). https://doi.org/10.1007/s00464-012-2225-4

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  • DOI: https://doi.org/10.1007/s00464-012-2225-4

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