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Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity.
Wideochir Inne Tech Maloinwazyjne. 2012 Dec; 7(4):225-32.WI

Abstract

INTRODUCTION

Roux-en-Y gastric bypass (RYGB) is considered the gold standard bariatric procedure with documented safety and effectiveness. Laparoscopic sleeve gastrectomy (LSG) is a newer procedure being done with increasing frequency. Randomized comparisons of LSG and other bariatric procedures are limited. We present the results of the first prospective randomized trial comparing LSG and RYGB in the Polish population.

AIM

To assess the efficacy and safety of LSG versus RYGB in the treatment of morbid obesity and obesity-related comorbidities.

MATERIAL AND METHODS

Seventy-two morbidly obese patients were randomized to RYGB (36 patients) or LSG (36 patients). Both groups were comparable regarding age, gender, body mass index (BMI) and comorbidities. The follow-up period was at least 12 months. Baseline and 6 and 12 month outcomes were analyzed including assessment of percent excess weight lost (%EWL), reduction in BMI, morbidity (minor, major, early and late complications), mortality, reoperations, comorbidities and nutritional deficiencies.

RESULTS

There was no 30-day mortality and no significant difference in major complication rate (0% after RYGB and 8.3% after LSG, p > 0.05) or minor complication rate (16.6% after RYGB and 10.1% after LSG, p > 0.05). There were no early reoperations after RYGB and 2 after LSG (5.5%) (p > 0.05). Weight loss was significant after RYGB and LSG but there was no difference between both groups at 6 and 12 months of follow-up. At 12 months %EWL in RYGB and LSG groups reached 64.2% and 67.6% respectively (p > 0.05). There was no significant difference in the overall prevalence of comorbidities and nutritional deficiencies.

CONCLUSIONS

Both LSG and RYGB produce significant weight loss at 6 and 12 months after surgery. The procedures are equally effective with regard to %EWL, reduction in BMI and amelioration of comorbidities at 6 and 12 months of follow-up. Laparoscopic sleeve gastrectomy and RYGB are comparably safe techniques with no significant differences in minor and major complication rates at 6 and 12 months.

Authors+Show Affiliations

Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23362420

Citation

Paluszkiewicz, Rafał, et al. "Prospective Randomized Clinical Trial of Laparoscopic Sleeve Gastrectomy Versus Open Roux-en-Y Gastric Bypass for the Management of Patients With Morbid Obesity." Wideochirurgia I Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques, vol. 7, no. 4, 2012, pp. 225-32.
Paluszkiewicz R, Kalinowski P, Wróblewski T, et al. Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity. Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques. 2012;7(4):225-32.
Paluszkiewicz, R., Kalinowski, P., Wróblewski, T., Bartoszewicz, Z., Białobrzeska-Paluszkiewicz, J., Ziarkiewicz-Wróblewska, B., Remiszewski, P., Grodzicki, M., & Krawczyk, M. (2012). Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity. Wideochirurgia I Inne Techniki Maloinwazyjne = Videosurgery and Other Miniinvasive Techniques, 7(4), 225-32. https://doi.org/10.5114/wiitm.2012.32384
Paluszkiewicz R, et al. Prospective Randomized Clinical Trial of Laparoscopic Sleeve Gastrectomy Versus Open Roux-en-Y Gastric Bypass for the Management of Patients With Morbid Obesity. Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques. 2012;7(4):225-32. PubMed PMID: 23362420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity. AU - Paluszkiewicz,Rafał, AU - Kalinowski,Piotr, AU - Wróblewski,Tadeusz, AU - Bartoszewicz,Zbigniew, AU - Białobrzeska-Paluszkiewicz,Janina, AU - Ziarkiewicz-Wróblewska,Bogna, AU - Remiszewski,Piotr, AU - Grodzicki,Mariusz, AU - Krawczyk,Marek, Y1 - 2012/12/20/ PY - 2012/10/01/received PY - 2012/10/18/revised PY - 2012/10/20/accepted PY - 2013/1/31/entrez PY - 2013/1/31/pubmed PY - 2013/1/31/medline KW - bariatric surgery KW - gastric bypass KW - morbid obesity KW - randomized trial KW - sleeve gastrectomy SP - 225 EP - 32 JF - Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques VL - 7 IS - 4 N2 - INTRODUCTION: Roux-en-Y gastric bypass (RYGB) is considered the gold standard bariatric procedure with documented safety and effectiveness. Laparoscopic sleeve gastrectomy (LSG) is a newer procedure being done with increasing frequency. Randomized comparisons of LSG and other bariatric procedures are limited. We present the results of the first prospective randomized trial comparing LSG and RYGB in the Polish population. AIM: To assess the efficacy and safety of LSG versus RYGB in the treatment of morbid obesity and obesity-related comorbidities. MATERIAL AND METHODS: Seventy-two morbidly obese patients were randomized to RYGB (36 patients) or LSG (36 patients). Both groups were comparable regarding age, gender, body mass index (BMI) and comorbidities. The follow-up period was at least 12 months. Baseline and 6 and 12 month outcomes were analyzed including assessment of percent excess weight lost (%EWL), reduction in BMI, morbidity (minor, major, early and late complications), mortality, reoperations, comorbidities and nutritional deficiencies. RESULTS: There was no 30-day mortality and no significant difference in major complication rate (0% after RYGB and 8.3% after LSG, p > 0.05) or minor complication rate (16.6% after RYGB and 10.1% after LSG, p > 0.05). There were no early reoperations after RYGB and 2 after LSG (5.5%) (p > 0.05). Weight loss was significant after RYGB and LSG but there was no difference between both groups at 6 and 12 months of follow-up. At 12 months %EWL in RYGB and LSG groups reached 64.2% and 67.6% respectively (p > 0.05). There was no significant difference in the overall prevalence of comorbidities and nutritional deficiencies. CONCLUSIONS: Both LSG and RYGB produce significant weight loss at 6 and 12 months after surgery. The procedures are equally effective with regard to %EWL, reduction in BMI and amelioration of comorbidities at 6 and 12 months of follow-up. Laparoscopic sleeve gastrectomy and RYGB are comparably safe techniques with no significant differences in minor and major complication rates at 6 and 12 months. SN - 1895-4588 UR - https://www.unboundmedicine.com/medline/citation/23362420/Prospective_randomized_clinical_trial_of_laparoscopic_sleeve_gastrectomy_versus_open_Roux_en_Y_gastric_bypass_for_the_management_of_patients_with_morbid_obesity_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23362420/ DB - PRIME DP - Unbound Medicine ER -