Extended pouch Roux-en-Y gastric bypass resulted in a non-significant mean total weight loss of 26.1% compared to 24.1% for standard bypass at 5 to 9 years postoperatively.
RCT (n=62)
Single-blind
Randomized
No
Does an extended pouch Roux-en-Y gastric bypass improve long-term weight loss and quality of life compared to a standard pouch in patients with obesity?
Extended pouch Roux-en-Y gastric bypass showed a non-significant trend towards better long-term weight loss compared to standard pouch, though the study was underpowered due to loss to follow-up.
Absolute Event Rate: 26.1% vs 24.1%
p-value: p=0.45
Abstract Background Metabolic bariatric surgery (MBS) such as the Roux-en-Y gastric bypass (RYGB) is effective in the treatment of obesity. However, not every patient achieves optimal clinical response and recurrent weight gain remains a concern. Hypothetically, a narrow longer pouch could lead to better results by preventing pouch dilatation and slowing down gastric emptying rates. The aim of this study is to evaluate the effect of an extended pouch gastric bypass (EP-RYGB) on weight loss and quality of life 5 to9years (median 109 months 104–116) postoperatively. Methods Follow-up study of a single-blinded RCT including 62 patients who underwent a standard Roux-en-Y gastric bypass (S-RYGB, n = 30) versus EP-RYGB ( n = 32) between September 2014 and October 2015. Outcomes on weight loss, obesity related complications, health-related quality of life (HRQoL), and gastro-intestinal symptomswere compared between S-RYGB and EP-RYGB. Results Mean total weight loss (%TWL) was higher in EP-RYGB compared to S-RYGB (26.1 ± 11.2%, versus 24.1 ± 10.1%) although not statistically significant. More patients in the S-RYGB group tended to experience recurrent weight gain compared to EP-RYGB (70% versus 47%, p = 0.07). HRQoL and gastro-intestinal symptoms were comparable between groups ( p > 0.05 for all). Conclusion EP-RYGB results in slightly better weight loss outcomes and similar HrQoL compared to S-RYGB 5 to 9 years postoperatively. However, due to loss to follow up, the current study is underpowered and a definitive long term advantage of EP-RYGB cannot be concluded.
Harker et al. (Fri,) conducted a rct in Severe obesity (n=62). Extended pouch Roux-en-Y gastric bypass (EP-RYGB) vs. Standard Roux-en-Y gastric bypass (S-RYGB) (6 cm pouch) was evaluated on Mean total weight loss (%TWL) at 109 months (p=0.45). Extended pouch Roux-en-Y gastric bypass resulted in a non-significant mean total weight loss of 26.1% compared to 24.1% for standard bypass at 5 to 9 years postoperatively.