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Beyond 5 years: a matched cohort of sleeve gastrectomy versus gastric bypass. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Blevins, K. S., Garcia, L., Forrester, J. D., Morton, J. M., Azagury, D. E. 2022

Abstract

Laparoscopic sleeve gastrectomy (LSG) has demonstrated excellent short-term outcomes. However, existing studies suffer from loss to follow-up, and most long-term data focus on laparoscopic Roux-en-Y gastric bypass (LRYGB). This study compares weight loss in patients =5 years from LSG with that in matched patients who underwent LRYGB.The purpose of this study was to compare long-term weight loss in patients undergoing LRYGB and LSG.University hospital, United States.We retrospectively evaluated patients who underwent LSG before August 2012 with follow-up data =5 years. LSG patients were matched 1:1 with LRYGB patients by sex, age at surgery, and preoperative body mass index. Univariate and multivariate analyses were performed with weight loss at the longest duration the primary outcome.One-hundred and sixty-five patients underwent LSG during the study period. Long-term follow-up data (=5 years) were available for 85 patients (52%). There were no preoperative differences between those with and without follow-up data. Six LSG patients (7%) were excluded because they underwent reoperation that altered intestinal anatomy. Of the 79 patients remaining, 75 were matched with post-LRYGB patients. The average follow-up period was 6.4 years for LSG patients and 6.5 years for LRYGB patients (P = .08, not significant). Change in body mass index was 6.81 kg/m2 for LSG patients and 13.11 kg/m2 for LRYGB patients. Percentage of total body weight loss was 15.25% for LSG patients and 28.73% for LRYGB patients. Percentage of excess body weight loss was 37% for LSG patients and 67% for LRYGB patients (P < .0001). Weight loss for LSG patient follow-up in clinic versus outside the clinic was 46% versus 34% (P = .18, not significant).LSG is now the most common bariatric surgery in the United States. Long-term data are needed to confirm that observed short-term favorable outcomes are maintained. Recent studies have produced divergent results. We observed significantly less weight loss at =5 years in LSG patients compared with matched LRYGB patients.

View details for DOI 10.1016/j.soard.2022.03.008

View details for PubMedID 35484048