Laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass: a single center experience with 2 years follow-up

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Obesity surgery


BACKGROUND: Laparoscopic Sleeve Gastrectomy (LSG) is a relatively new procedure that is gaining wide acceptance. However, laparoscopic Roux-en-Y Gastric Bypass (LRYGB) remains one of the most commonly performed bariatric procedures with the best long-term results. There are few studies comparing LSG with LRYGB. The aim of this study is to compare the safety and outcome of LSG to LRYG in a single accredited center. METHODS: A retrospective analysis of data collected prospectively on patients undergoing either LSG or LRYGB between January 2009 and December 2012 was performed. LSG was performed using 36Fr bougie, while LRYGB was perfromed with a 25-mm circular stapler. The primary outcomes included length of stay (LOS), 30-day complication and readmission rates, and excess weight loss (%EWL) at 3, 6, 12, and 24 months postoperatively. LSG patients were also divided into different categories based on BMI and their %EWL compared to LRYGB. RESULTS: A total of 885 patients were included in our analysis. 547 patients underwent LRYGB (61.8 %) and 338 underwent LSG (38.2 %). Thirty-day complication and readmission rates for LRYGB and LSG were (1.5 and 5.1 % vs 0.6 and 0.3 %, respetively, p > 0.05). %EWL for LRYGB was significantly higher than LSG at 3, 6, 12, and 24 months. LSG with a BMI <40 achieved a similar %EWL to LRYGB in the first 12 months. CONCLUSIONS: LSG seems to have a better safety profile in the short-term compared to LRYGB. However, at 2 years, LRYGB patients achieved a significantly higher EWL compared to LSG patients. Randomized clinical trials are needed to better elucidate our findings.

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