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Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy in Young Adults: a Dutch Registry Study

Abstract

Background

The most commonly performed bariatric procedures worldwide are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), yet outcomes following these procedures in young adults are limited. Therefore, the objective of this study was to compare weight loss outcomes between RYGB and SG in young adults.

Methods

This is a nationwide retrospective cohort study of young adults, aged 18–25 years, who underwent RYGB or SG between 2015 and 2019, with data from the Dutch Audit Treatment of Obesity (DATO). The primary outcome was weight loss expressed as percentage total weight loss (%TWL) in a period of 3 years after surgery. Secondary outcomes were the incidence of complications (< 30 days) and progression of obesity-related comorbidities.

Results

In total, 2313 patients were included, 1246 in the RYGB group and 1067 in the SG group. Percentage TWL was significantly higher in the RYGB group compared to the SG group at 1, 2, and 3 years after surgery (respectively 2.4%, 2.9%, and 3.3% higher, p < 0.001). RYGB was associated with an on-average 2.75 higher %TWL compared to SG in females (p < 0.001), although this was not seen in males (β = 0.63, p = 0.514). No differences were found in the incidence of complications, nor the progression of obesity-related comorbidities except for gastroesophageal reflux disease (GERD). There was more improvement or resolution of GERD in the RYGB group (95.2% vs. 56.3%, p < 0.001).

Conclusion

Similar numbers of RYGB and SG were performed in young adults, whereas RYGB was associated with greater weight loss in the short- and midterm, particularly in females.

Graphical abstract

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Acknowledgements

The authors thank the members of the Dutch Institute for Clinical Auditing (DICA) for the registration of the data and for providing us with the data. The members of the Dutch Audit for Treatment of Obesity research group are co-authors of this study, and we want to thank them for their input.

Dutch Audit for Treatment of Obesity Research Group:

Dhr. dr. L.M. de Brauw, chirurg, Spaarne Gasthuis, Haarlem, the Netherlands

Dhr. dr. S.M.M. de Castro, chirurg, OLVG, Amsterdam, the Netherlands

Dhr. drs. S.L. Damen, chirurg, Medisch Centrum Leeuwarden, Leeuwarden, the Netherlands

Dhr. dr. F.H.W. Jonker, chirurg, Rode Kruis Ziekenhuis, Beverwijk, the Netherlands

Dhr. drs. J.A. Apers, chirurg, Sint Franciscus Gasthuis, Rotterdam, the Netherlands

Dhr. dr. I.F. Faneyte, chirurg, Ziekenhuisgroep Twente, Almelo, the Netherlands

Dhr. prof. dr. J.W.M. Greve, chirurg, Zuyderland Medisch Centrum, Heerlen, the Netherlands

Dhr. prof. dr. E.J. Hazebroek, chirurg, Rijnstate, Arnhem, DSMBS, the Netherlands

Dhr. drs. G. van ’t Hof, chirurg, Bariatrisch Centrum Zuid-West Nederland, Bergen op Zoom, the Netherlands

Dhr. dr. I.M.C. Janssen, chirurg, Medisch Directeur Nederlandse Obesitas Klinieken, Zeist, the Netherlands

Dhr. drs. E.H. Jutte, chirurg, Medisch Centrum Leeuwarden, Leeuwarden, the Netherlands

Dhr. drs. R.A. Klaassen, chirurg, Maasstad Ziekenhuis, Rotterdam, the Netherlands

Dhr. drs. E.A.G.L. Lagae, chirurg, ZorgSaam Zeeuws-Vlaanderen, Terneuzen, the Netherlands

Mw. dr. B.S. Langenhoff, chirurg, ETZ, Tilburg, the Netherlands

Dhr. drs. R.S.L. Liem, chirurg, Groene Hart Ziekenhuis, secretary, Gouda, the Netherlands

Dhr. drs. A.A.P.M. Luijten, Máxima Medisch Centrum, Eindhoven, the Netherlands

Dhr. dr. S.W. Nienhuijs, chirurg, Catharina Ziekenhuis, chairman, Eindhoven, the Netherlands

Dhr. dr. R. Schouten, chirurg, Flevoziekenhuis, Almere, the Netherlands

Dhr. dr. R.M. Smeenk, chirurg, Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands

Dhr. dr. D.J. Swank, chirurg, Nederlandse Obesitas Kliniek West, Den Haag & Gouda, the Netherlands

Dhr. dr. M.J. Wiezer, chirurg, St. Antonius Ziekenhuis, Utrecht, the Netherlands

Dhr. drs. W. Vening, bariatrisch chirurg, Rijnstate, Arnhem, the Netherlands

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Correspondence to Kelly G. H. van de Pas.

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Ethics Approval

All procedures performed in these 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. For this type of study, formal consent is not required.

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Reporting to DATO in the Netherlands is mandatory. Informed consent does not apply according to Dutch law.

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Key Points

- Similar numbers of RYGB and SG are performed in young adults.

- Bariatric surgery in young adults appears to be safe.

- RYGB is associated with greater weight loss, particularly in females.

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van de Pas, K.G.H., Bonouvrie, D.S., Janssen, L. et al. Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy in Young Adults: a Dutch Registry Study. OBES SURG 32, 763–770 (2022). https://doi.org/10.1007/s11695-021-05846-4

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  • DOI: https://doi.org/10.1007/s11695-021-05846-4

Keywords

  • Obesity
  • Bariatric surgery
  • Young adults
  • Gastric bypass
  • Gastric sleeve