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Postoperative Early Major and Minor Complications in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Meta-Analysis and Systematic Review

Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage obesity-related chronic disease. The aim of this meta-analysis and systematic review was to compare the “early postoperative complication rate i.e. within 30-days” reported from randomized control trials (RCTs) comparing these two procedures.

Methods

RCTs comparing the early complication rates following LVSG and LRYGB between 2000 and 2015 were selected from PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane database. The outcome variables analyzed included 30-day mortality, major and minor complications and interventions required for their management, length of hospital stay, readmission rates, operating time, and conversions from laparoscopic to open procedures.

Results

Six RCTs involving a total of 695 patients (LVSG n = 347, LRYGB n = 348) reported on early major complications. A statistically significant reduction in relative odds of early major complications favoring the LVSG procedure was noted (p = 0.05). Five RCTs representing 633 patients (LVSG n = 317, LRYGB n = 316) reported early minor complications. A non-statically significant reduction in relative odds of 29 % favoring the LVSG procedure was observed for early minor complications (p = 0.4). However, other outcomes directly related to complications which included reoperation rates, readmission rate, and 30-day mortality rate showed comparable effect size for both surgical procedures.

Conclusions

This meta-analysis and systematic review of RCTs suggests that fewer early major and minor complications are associated with LVSG compared with LRYGB procedure. However, this does not translate into higher readmission rate, reoperation rate, or 30-day mortality for either procedure.

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Authors’ contributions

1. MAM was responsible for the concept and design of this meta-analysis. Furthermore, he takes full responsibility for the integrity of the work as a whole, from inception to published article.

2. EO and MAM were responsible for acquisition and interpretation of the data.

3. RMY, SK, and TA were responsible for analyzing and interpretation of the data in depth from the statistical point of view. They were responsible for producing all the statistical diagrams (Forest and Funnel plots).

4. All authors were involved in drafting the manuscript and revising it critically for important intellectual content and have given final approval of the version to be published. Furthermore, all authors have participated sufficiently in the work to take public responsibility for its content.

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Correspondence to Muhammed Ashraf Memon.

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The authors declare that they have no competing interests.

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For this type of study, i.e., meta-analysis, formal consent is not required.

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Osland, E., Yunus, R.M., Khan, S. et al. Postoperative Early Major and Minor Complications in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Meta-Analysis and Systematic Review. OBES SURG 26, 2273–2284 (2016). https://doi.org/10.1007/s11695-016-2101-8

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Keywords

  • Bariatric surgery
  • Laparoscopic
  • Sleeve gastrectomy
  • Roux-en-Y gastric bypass
  • Meta-analysis
  • Systematic review