Long-term effects of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for the treatment of morbid obesity: a monocentric prospective study with minimum follow-up of 5 years

Updates Surg. 2017 Mar;69(1):101-107. doi: 10.1007/s13304-017-0426-z. Epub 2017 Mar 6.

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most widely used bariatric procedures nowadays. The aim of this study was to compare long-term results on weight loss and comorbidities improvement for both procedures. A cohort of 304 consecutive patients underwent surgery in 2006-2009: 162 underwent LSG and 142 underwent LRYGB. The mean follow-up time was 75.8 ± 8.4 months (range 60-96). LSG showed greater effectiveness in percentage of excess weight loss (%EWL) at 180 days and at 1 year of follow-up. Instead, at 5th year follow-up LRYGB and LSG showed similar %EWL values (72.34 versus 70.26). LSG group showed a lack of weight loss in patients from 3 to 5 years after surgery, whereas LRYGB group patients maintained an effective weight loss during the entire follow-up period. In LSG group both length of stay and operative time were found to be shorter. LRYGB showed better effectiveness in type 2 diabetes mellitus (T2DM) resolution rate. None of the two techniques has proven to be clearly better than the other on a long-term follow-up analysis, except for the LRYGB better results in T2DM healing. According to our findings, in LSG Group after 3 years the weight remains stable.

Keywords: Bariatric surgery; Gastric bypass; Obesity; Sleeve gastrectomy; Weight loss.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Bariatric Surgery / methods
  • Follow-Up Studies
  • Gastrectomy / methods*
  • Gastric Bypass*
  • Humans
  • Laparoscopy*
  • Length of Stay
  • Obesity, Morbid / surgery*
  • Prospective Studies
  • Weight Loss