Why the study?
It was unclear which bariatric procedure provides the best weight-loss outcomes and type 2 diabetes remission.
Does Roux-en-Y gastric bypass improve weight loss and type 2 diabetes remission compared to sleeve gastrectomy or one-anastomosis gastric bypass in patients undergoing bariatric surgery?
Does Roux-en-Y gastric bypass improve weight loss and type 2 diabetes remission compared to sleeve gastrectomy or one-anastomosis gastric bypass in patients undergoing bariatric surgery?
RYGB provides better mid-term weight loss than SG, while OAGB may offer greater weight loss than RYGB at 1 year, with no difference in type 2 diabetes remission between RYGB and SG.
May favor RYGB for excess weight loss at 3 years; leaves open optimal bariatric choice for diabetes remission.
OBJECTIVE: This study aimed to determine which bariatric procedure allows patients to obtain the best weight-loss outcomes and a remission of type 2 diabetes. METHODS: Databases were searched for randomized-controlled trials comparing Roux-en-Y gastric bypass (RYGB) with sleeve gastrectomy (SG) or one-anastomosis gastric bypass (OAGB). The mean difference (MD) or the relative risk was determined. RESULTS: Twenty-five randomized-controlled trials were analyzed. Excess weight loss (EWL, percentage) was greater for RYGB patients at 3 years (MD: 11.93, p < 0.00001) and 5 years (MD: 13.11, p = 0.0004). Higher excess BMI loss (percentage) was found in RYGB at 1 year (MD: 11.66, p = 0.01). Total weight loss (percentage) was greater for RYGB patients after 3 months (MD: 2.41, p = 0.02), 6 months (MD: 3.83, p < 0.00001), 1 year (MD: 6.35, p < 0.00001), and 5 years (MD: 3.90, p = 0.005). No difference in terms of remission of type 2 diabetes was seen between RYGB and SG. EWL was significantly more important after OAGB than after RYGB after 1 year (MD: -10.82, p = 0.003). CONCLUSIONS: RYGB is more efficient than SG in the midterm. OAGB offers greater EWL than RYGB after 1 year, but further evidence is needed to confirm this result.
No takes yet. Share an insight, caveat, or question.
Uhe et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: