Key result
Sleeve gastrectomy decreased early and late complications by 55% and 41% compared to Roux-en-Y gastric bypass, whereas the bypass increased excess weight loss by 15.23%.
Why the study?
Does sleeve gastrectomy compared to Roux-en-Y gastric bypass improve safety and efficacy outcomes in elderly patients (>60 years) with severe obesity?
Meta-Analysis
Does sleeve gastrectomy compared to Roux-en-Y gastric bypass improve safety and efficacy outcomes in elderly patients (>60 years) with severe obesity?
Effect estimate: 55% decrease
In elderly patients with severe obesity, sleeve gastrectomy offers a safer profile with lower complications and mortality, whereas Roux-en-Y gastric bypass provides greater weight loss and better remission of hypertension.
Older adult bariatric data remain limited; leaves open optimal RYGB versus SG selection pending prospective trials.
BACKGROUND: Today, bariatric surgeons face the challenge of treating older adults with class III obesity. The indications and outcomes of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) also constitute a controversy. METHODS: PubMed, Web of Science and Scopus were searched to retrieve systematic reviews/meta-analyses published by 1 March 2022. The selected articles were qualitatively evaluated using A Measurement Tool to Assess systematic Reviews (AMSTAR). RESULTS: An umbrella review included six meta-analyses retrieved from the literature. The risk of early-emerging and late-emerging complications decreased by 55% and 41% in the patients underwent SG than in those receiving RYGB, respectively. The chance of the remission of hypertension and obstructive sleep apnoea, respectively increased by 43% and 6%, but type-2 diabetes mellitus decreased by 4% in the patients underwent RYGB than in those receiving SG. RYGB also increased excess weight loss by 15.23% in the patients underwent RYGB than in those receiving SG. CONCLUSION: Lower levels of mortality and early-emerging and late-emerging complications were observed in the older adults undergoing SG than in those receiving RYGB, which was, however, more efficient in term of weight loss outcomes and recurrence of obesity-related diseases.
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Kermansaravi et al. (2023) conducted a meta-analysis in severe obesity. Sleeve gastrectomy vs. Roux-en-Y gastric bypass was evaluated on early-emerging complications (55% decrease). Sleeve gastrectomy decreased early and late complications by 55% and 41% compared to Roux-en-Y gastric bypass, whereas the bypass increased excess weight loss by 15.23%.
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