Long-term outcomes of Roux-En-Y gastric bypass vs sleeve gastrectomy

  • Sharples AJ & al.
  • Obes Surg
  • 13 Nov 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Roux-En-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) showed sustained weight loss and comorbidity control at 5 years.
  • RYGB was associated with a greater percentage excessive weight loss (%EWL), improved dyslipidaemia outcome and a lower incidence of postoperative gastro-oesophageal reflux disease (GORD).

Why this matters

  • Findings warrant further research in the super obese and elder patients to determine whether the long-term outcomes of RYGB and SG are consistent in different patient groups.

Study design

  • Meta-analysis included 5 randomised controlled trials (RCTs) that compared RYGB with SG and assessed weight loss and/or comorbidity resolution at 5 years after surgery.
  • Funding: None disclosed.

Key results

  • At 5 years, patients who underwent RYGB vs SG had experienced significantly greater %EWL (65.7% vs 57.3%; P<.0001>
  • No significant difference was observed in resolution (37.4% and 27.5%) or improvement (77.5% vs 74.0%) rates of diabetes between RYGB and SG groups.
  • Similarly, glycated haemoglobin levels did not differ between RYGB and SG groups (P=.0671).
  • Dyslipidaemia resolution rates were significantly higher in the RYGB vs SG group (68.6% vs 55.2%; P=.0443).
  • Overall, 60.4% of patients in the RYGB group achieved GORD remission vs 25.0% in SG group (P=.002).

Limitations

  • Heterogeneity among included studies.
  • Small number of studies.