Laparoscopic Roux-en-Y gastric bypass (n=196) was more effective than sleeve gastrectomy (n=200) for T2DM remission and weight loss, but had a higher complication rate.
Meta-Analysis (n=396)
Yes
Does laparoscopic Roux-en-Y gastric bypass improve T2DM remission and weight loss compared to laparoscopic sleeve gastrectomy in patients with morbid obesity or T2DM?
LRYGB is more effective than LSG for T2DM remission and metabolic control, but LSG is safer with fewer complications.
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for treating morbid obesity is becoming more popular. We compared both techniques to evaluate their efficacy in treating morbid obesity or type 2 diabetes mellitus (T2DM). METHODS: We searched the Cochrane Controlled Trials Register databases, Medline, Embase, ISI databases and the Chinese Biomedical Literature Database to identify randomized controlled trials (RCTs) of LRYGB and LSG for morbid obesity or T2DM published in any language. Statistical analyses were carried out using RevMan software. RESULTS: Five worldwide RCTs with 196 patients in the LRYGB group and 200 in the LSG group were included in our analysis. Compared with patients who had LSG, those who had LRYGB had a higher remission rate of T2MD, lost more weight and had lower low-density lipoprotein, triglycerides, homeostasis model assessment index and insulin levels. There was no difference in the reoperation rate between the groups. However, patients treated with LRYGB had a higher incidence of complication than those treated with LSG. CONCLUSION: Our meta-analysis demonstrates that LRYGB is more effective than LSG for the surgical treatment of T2DM and control of metabolic syndrome. However, LSG is safer and has a reduced rate of complications. Further high-quality RCTs with long follow-up periods are needed to provide more reliable evidence.
Li et al. (Sun,) conducted a meta-analysis in Morbid obesity or type 2 diabetes mellitus (n=396). Laparoscopic Roux-en-Y gastric bypass (LRYGB) vs. Laparoscopic sleeve gastrectomy (LSG) was evaluated on Remission rate of T2DM, weight loss, and metabolic parameters. Laparoscopic Roux-en-Y gastric bypass (n=196) was more effective than sleeve gastrectomy (n=200) for T2DM remission and weight loss, but had a higher complication rate.