Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy for Super Super Obese and Super Obese: Systematic Review and Meta-analysis of Weight Results, Comorbidity Resolution

Obes Surg. 2019 Jun;29(6):1954-1964. doi: 10.1007/s11695-019-03817-4.

Abstract

Background: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) used for super obesity (SO) and super super obesity (SSO) remain controversial. The meta-analysis was to summarize the evidence.

Methods: We searched in MEDLINE and PubMed for studies concerning RYGB and SG for SO or SSO and pooled complication, percentage excess weight loss (%EWL), and resolution of comorbidities.

Results: Twelve studies were identified. RYGB achieved higher %EWL at 12 months, but no significant difference at 24 months. Resolution of diabetes mellitus and dyslipidemia reached a statistical significance; however, there was no significant difference in hypertension.

Conclusions: RYGB was superior in %EWL for SSO and SO at 12 months. However, regarding at 24 months, RYGB was equal to SG, which is from a meta-analysis and cannot be seen as a definitive conclusion.

Keywords: Roux-en-Y gastric bypass; Sleeve gastrectomy; Super obesity; Super super obesity.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Body Mass Index
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / surgery
  • Dyslipidemias / complications
  • Dyslipidemias / epidemiology
  • Dyslipidemias / surgery
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Gastrectomy / statistics & numerical data
  • Gastric Bypass / adverse effects
  • Gastric Bypass / methods*
  • Gastric Bypass / statistics & numerical data
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / surgery
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery*
  • Treatment Outcome
  • Weight Loss / physiology*