Laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: outcomes of 3-year follow-up

doi:10.3877/cma.j.issn.1674-6899.2016.06.004

Abstract

Abstract:

Objective

A retrospective cohort study with 3-year follow-up aimed to compare the safety and efficacy of LSG with LRYGB for morbid obesity.

Methods

From Jan. 2009 to May. 2013, 74 patients undergoing LRYGB and 82 patients undergoing LSG were enrolled in this study. Major complications, BMI, and percentage of excess weight loss (EWL%) after 12, 24, and 36 months were compared.

Results

The preoperative characters of patients between two groups were comparable. Hospital stay and operative time in LSG was significantly shorter than LRYGB group, and there was no significant difference of major complications. No significant differences in mean percentage of excess weight loss, EWL% and BMI were observed at 12, 24 months. At 3-year follow-up, mean EWL% in the LRYGB group was significantly higher than in the LSG group [(74.7±8.3)% vs (69.1±10.7)%] and, consequently, mean BMI was significantly lower in LRYGB [(28.3 ± 1.6) kg/m² vs (28.9 ± 1.8) kg/m^2, P<0.05].

Conclusions

LSG were safe and effective bariatric procedures compared with LRYGB, but LRYGB was superior to LSG in terms of mid-term weight loss.

Key words: Bariatric surgery, Morbid obesity, Weight loss, Sleeve gastrectomy, Roux-en-Y gastric bypass

Xiao Du, Xianghui Fu, Lei Shi, Hua Zhuang, Jiankun Hu, Zongguang Zhou, Zhong Cheng. Laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: outcomes of 3-year follow-up[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(06): 331-334.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2016.06.004

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2016/V09/I06/331

Figures/Tables 3

References 17

1	Poloz Y, Stambolic V. Obesity and cancer, a case for insulin signaling [J]. Cell Death & Disease, 2015, 6 (12): 2037.
2	O′Rourke RW. Obesity and cancer: at the crossroads of cellular metabolism and proliferation [J]. Surg Obes Relat Dis, 2014, 10 (6): 1208-1219.
3	Mitka M. Bariatric surgery continues to show benefits for patients with diabetes [J]. Jama the Journal of the American Medical Association, 2012, 307 (18): 1901-1902.
4	Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013 [J]. Obesity Surgery, 2015, 25 (10): 1822-1832.
5	Boza C, Gamboa C, Salinas J, et al. Laparoscopic roux－en－y gastric bypass versus laparoscopic sleeve gastrectomy: a case－control study and 3 years of follow－up [J]. Surgery for Obesity & Related Diseases Official Journal of the American Society for Bariatric Surgery, 2012, 8 (3): 243-249.
6	刘金刚，郑成竹，王勇．中国肥胖和2型糖尿病外科治疗指南 (2014) [J]. 中国实用外科杂志，2014, 8 (11): 499-504.
7	Buwen JP, Kammerer MR, Beekley AC, et al. Laparoscopic sleeve gastrectomy: the rightful gold standard weight loss surgery procedure [J]. Surgery for Obesity & Related Diseases, 2015, 11 (6): 1383-1385.
8	Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity [J]. Obesity Surgery, 2010, 20 (8): 1171-1177.
9	Lim DM, Taller J, Bertucci W, et al. Comparison of laparoscopic sleeve gastrectomy to laparoscopic Roux－en－Y gastric bypass for morbid obesity in a military institution [J]. Surgery for Obesity & Related Diseases Official Journal of the American Society for Bariatric Surgery, 1900, 10 (2): 269-276.
10	Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux－en－Y gastric bypass and sleeve gastrectomy for the treatment of morbid obesity in China: a 5－year outcome [J]. Obesity Surgery, 2014, 24 (10): 1617-1624.
11	Zhang Y, Wang J, Sun X, et al. Erratum to: laparoscopic sleeve gastrectomy versus laparoscopic Roux－En－Y gastric bypass for morbid obesity and related comorbidities: a meta－analysis of 21 studies [J]. Obesity Surgery, 2015, 25 (1): 19-26.
12	Ralph P, Yves B, Beatrice K, et al. Early results of the swiss multicentre bypass or sleeve study (SM－BOSS) [J]. Annals of Surgery, 2013, 258 (5): 690-695.
13	Reinehr T, Roth CL, Schernthaner GH, et al. Peptide yy and glucagon－like peptide－1 in morbidly obese patients before and after surgically induced weight loss [J]. Obesity Surgery, 2007, 17 (12): 1571-1577.
14	Ochner CN, Kwok Y, Conceicao E, et al. Selective reduction in neural responses to high calorie foods following gastric bypass surgery [J]. Annals of Surgery, 2011, 253 (3): 502-507.
15	Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and Peptide－YY levels after Roux－en－Y gastric bypass and sleeve gastrectomy: a prospective, double blind study [J]. Ann Surg, 2008, 247 (3): 401-407.
16	Kehagias I, Karamanakos SN, Argentou M, et al. Randomized clinical trial of laparoscopic Roux－en－Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m ² [J]. Obes Surg, 2011, 21 (11): 1650-1656.
17	Zellmer JD, Mathiason MA, Kallies KJ, et al. Is laparoscopic sleeve gastrectomy a lower risk bariatric procedure compared with laparoscopic Roux－en－Y gastric bypass? a meta－analysis [J]. Am J Surg, 2014, 208 (6): 903-910.

项目		腹腔镜胃旁路术组(74例)	腹腔镜袖状胃切除术组(82例)	P值
性别(男性/女性，例)		28/46	35/47	0.54
年龄(岁， ±s)		36.7 ± 8.3	34.1 ± 9.6	0.07
体质量指数(kg/m²， ±s)		37.4 ± 5.1	38.7 ± 5.5	0.13
腰围(cm， ±s)		95.4 ± 6.7	96.5 ± 7.9	0.35
合并症[例(%)]		?	?	?
?	2型糖尿病	23 (31.1)	15 (18.3)	0.06
?	高血压	28 (37.8)	30 (36.6)	0.87
?	高脂血症	37 (50.0)	38 (46.3)	0.65
?	高尿酸血症	12 (16.2)	18 (22.0)	0.36
手术时间 (min， ±s)		112.2 ± 18.5	78.6 ± 20.2	<0.01
住院时间 (d， ±s)		4.8 ± 4.7	3.5 ± 1.6	0.02
严重并发症[例(%)]		2 (2.7)	0 (0)	>0.99

项目		腹腔镜胃旁路术组(74例)	腹腔镜袖状胃切除术组(82例)	P值
性别(男性/女性，例)		28/46	35/47	0.54
年龄(岁， ±s)		36.7 ± 8.3	34.1 ± 9.6	0.07
体质量指数(kg/m²， ±s)		37.4 ± 5.1	38.7 ± 5.5	0.13
腰围(cm， ±s)		95.4 ± 6.7	96.5 ± 7.9	0.35
合并症[例(%)]		?	?	?
?	2型糖尿病	23 (31.1)	15 (18.3)	0.06
?	高血压	28 (37.8)	30 (36.6)	0.87
?	高脂血症	37 (50.0)	38 (46.3)	0.65
?	高尿酸血症	12 (16.2)	18 (22.0)	0.36
手术时间 (min， ±s)		112.2 ± 18.5	78.6 ± 20.2	<0.01
住院时间 (d， ±s)		4.8 ± 4.7	3.5 ± 1.6	0.02
严重并发症[例(%)]		2 (2.7)	0 (0)	>0.99

项目	例数	术前	术后12个月	术后24个月	术后36个月
腹腔镜胃旁路术组	74	37.4 ± 5.1	27.8 ± 1.6	28.0 ± 1.4	28.3 ± 1.6
腹腔镜袖状胃切除术组	82	38.7 ± 5.5	28.1 ± 1.7	28.3 ± 1.7	28.9 ± 1.8
P值	?	0.13	0.28	0.17	0.01

项目	例数	术前	术后12个月	术后24个月	术后36个月
腹腔镜胃旁路术组	74	37.4 ± 5.1	27.8 ± 1.6	28.0 ± 1.4	28.3 ± 1.6
腹腔镜袖状胃切除术组	82	38.7 ± 5.5	28.1 ± 1.7	28.3 ± 1.7	28.9 ± 1.8
P值	?	0.13	0.28	0.17	0.01

项目	例数	术后12个月	术后24个月	术后36个月
腹腔镜胃旁路术组	74	82.3 ± 8.0	77.1 ± 8.3	74.7 ± 8.3
腹腔镜袖状胃切除术组	82	79.3 ± 10.0	75.9 ± 9.8	69.1 ± 10.7
P值	?	0.19	0.41	< 0.01

Please choose a citation manager

Content to export