Roux-en-Y gastric bypass resulted in significantly greater total body weight loss at 24 months compared to sleeve gastrectomy (41.9 kg vs. 34.6 kg), but was associated with a higher rate of surgical complications.
Cohort (n=719)
No
Does Roux-en-Y gastric bypass improve weight loss and metabolic parameters compared to sleeve gastrectomy in patients undergoing bariatric surgery?
Roux-en-Y gastric bypass provides greater weight loss at 2 years compared to sleeve gastrectomy, but carries a higher risk of surgical complications.
Absolute Event Rate: 41.9% vs 34.6%
p-value: p=<0.0001
BACKGROUND: The purpose of the study was to compare weight loss, metabolic parameters, and postoperative complications in patients undergoing Roux-en-Y gastric bypass (GB) and sleeve gastrectomy (SG). METHODS: We retrospectively studied 30-day postoperative complications as well as change in weight, blood pressure, cholesterol, hemoglobin, hemoglobin A1C, and creatinine from baseline to 2, 6, 12, and 24 months postoperatively in 383 patients undergoing GB and 336 patients undergoing SG at the University of Michigan from January 2008 to November 2013. For a study population which typically has high attrition rates, there were excellent follow-up rates (706/719 at 2 months, 566/719 at 6 months, 519/719 at 12 months, and 382/719 at 24 months). RESULTS: Baseline characteristics were similar in both groups except for higher weight and BMI in the SG group. The GB group experienced greater total body weight loss at 6, 12, and 24 months (41.9 vs. 34.6 kg at 24 months, p < 0.0001). Excess weight loss was 69.7 and 51.7 % following GB and SG respectively at 24 months (p < 0.0001). BP improved significantly in both groups. Surgical complication rates were greater after GB (10.1 vs. 3.5 %, p = 0.0007) with no significant difference in life-threatening or potentially life-threatening complications. CONCLUSIONS: Weight loss was greater following GB compared to SG at 2 years. The risk for surgical complications was greater following GB. Surgical intervention should be tailored to surgical risk, comorbidities, and desired weight loss.
Lager et al. (Fri,) conducted a cohort in Obesity (n=719). Roux-en-Y gastric bypass vs. Sleeve gastrectomy was evaluated on Total body weight loss at 24 months (kg) (p=<0.0001). Roux-en-Y gastric bypass resulted in significantly greater total body weight loss at 24 months compared to sleeve gastrectomy (41.9 kg vs. 34.6 kg), but was associated with a higher rate of surgical complications.
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