Prospective, multicentric, comparative study between sleeve gastrectomy and Roux-en-Y gastric bypass, 277 patients, 3 years follow-up - 16/05/19
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Highlights |
• | This study simultaneously compared the efficacy and safety of LSG and LYRGB. LSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up but GERD increased in LSG group and decreased in LRYGB group. |
Summary |
Background |
Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en Y gastric bypass (LRYGB) are commonly performed, but few studies have shown superiority of one strategy over the other.
Objective |
Simultaneously compare LSG and LRYGB in terms of weight loss and morbimortality over a 36-month follow-up period.
Setting |
University hospital and bariatric surgery centers, France.
Methods |
Prospective, comparative study between LSG and RYGBP. The primary endpoint of this study was a joint hypothesis during the 36-month follow-up: the first primary outcome pertained to the frequency of patients with an excess weight loss (EWL) greater than 50% (% EWL>50%) after LSG or RYGB; the second primary outcome was defined as a composite endpoint of at least one major complication. Secondary objectives were regression of comorbidities and improvement in quality of life.
Results |
Two hundred and seventy-seven patients were included (91 RYGBP, 186 LSG). The mean age was 41.1±11.1 years, and average preoperative body mass index of 45.3±5.5kg/m2. After 36months, the %EWL>50% was not inferior in the case of LSG (82.2%) relative to LRYGB (82.1%); while major complications rates were significantly higher in LRYGB (15.4%) vs. LSG (5.4%, P=0.005). After 36months, all secondary objectives were comparable between groups while only gastroesophageal reflux disease (GERD) increased in LSG group and decreased in LRYGB group.
Conclusions |
LSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up. But GERD increased in LSG group and decreased in LRYGB group.
Le texte complet de cet article est disponible en PDF.Keywords : Roux-en-Y gastric bypass, Sleeve gastrectomy, Prospective comparative study, Clinical trial, Morbid obesity
Plan
☆ | Presented as Oral communication: (1) 22nd World Congress of International Federation For the Surgery of Obesity and Metabolic Disorders (IFSO-2017) in London, United Kingdom, 29 August–2 September 2017. (2) 26th International EAES Congress in London, United Kingdom, 30 May–1 June 2018. |
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