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Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥ 50 kg/m².
Surg Obes Relat Dis. 2015 Jul-Aug; 11(4):785-90.SO

Abstract

BACKGROUND

Although laparoscopic sleeve gastrectomy (LSG) was initially described as the first step of a 2-stage procedure for high-risk patients requiring laparoscopic Roux-en-Y gastric bypass (LRYGB), it is now being used as a single-stage procedure. Experience with laparoscopic bariatric surgery is growing, such that LRYGB is increasingly feasible for patients with body mass index (BMI) ≥ 50 kg/m². Nevertheless, outcomes for such category of patients following LSG and LRYGB are lacking.

OBJECTIVE

To compare weight loss and changes in obesity related co-morbidities at one year following LSG with LRYGB in patients with BMI ≥ 50 kg/m².

SETTINGS

The prospective database of a single surgery university center was queried for clinical and other relevant data.

METHODS

From January 2004 to January 2013, 74 and 285 patients underwent LSG or LRYGB with a BMI ≥ 50 kg/m². At one year, rate of follow-up was 92.8%. Success of surgery was defined as % of excess weight loss (%EWL)≥ 50% at one year. Logistic regression was used to compute odds ratio (OR) to evaluate the success at one year of surgery.

RESULTS

LSG (N = 74) and LGBP (N = 285) groups did not differ for initial BMI (57.2 ± 7.1 versus 56.7 ± 5.5 kg/m²; P = .52), % of female (64.6% versus 73.7%, P = .13) or major adverse postoperative events (5.7% versus 6.7%; P = .85). At one year, the mean percentage of weight loss (%) (22.0 ± 7.6 versus 30.3 ± 7.4; P < .0001) and percentage of excess weight loss (%) (40.2 ± 15.2 versus 55.0 ± 14.6; P < .0001) and rates of remission of diabetes (47.5% versus 70.7%; P = .01) were greater in the LGBP than LSG group. In multivariate analyses (OR), LSG was an independent factor of failure of weight loss (.12; P < .0001) CONCLUSION: After 1 year of follow-up in patients with a BMI ≥ 50 kg/m², LRYGB provides better weight loss and resolution in diabetes than LSG with similar postoperative morbidity. Further long-term studies are needed to confirm these results.

Authors+Show Affiliations

Department of General, Digestive and Metabolic Surgery, the Department of Nutrition. Ambroise Paré University Hospital, Versailles Saint-Quentin University, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.Department of General, Digestive and Metabolic Surgery, the Department of Nutrition. Ambroise Paré University Hospital, Versailles Saint-Quentin University, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique- Hôpitaux de Paris, Pierre-et-Marie-Curie-Paris 6 University, Human Nutrition Research Centre Île-de-France (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique- Hôpitaux de Paris, Pierre-et-Marie-Curie-Paris 6 University, Human Nutrition Research Centre Île-de-France (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.Department of General, Digestive and Metabolic Surgery, the Department of Nutrition. Ambroise Paré University Hospital, Versailles Saint-Quentin University, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France; Centre for Epidemiologic Cohort in Population (INSERM UMS 011), Villejuif, France.Department of General, Digestive and Metabolic Surgery, the Department of Nutrition. Ambroise Paré University Hospital, Versailles Saint-Quentin University, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France. Electronic address: jl.bouillot@apr.aphp.fr.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25771441

Citation

Thereaux, Jérémie, et al. "Comparison of Results After One Year Between Sleeve Gastrectomy and Gastric Bypass in Patients With BMI ≥ 50 Kg/m²." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 11, no. 4, 2015, pp. 785-90.
Thereaux J, Corigliano N, Poitou C, et al. Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥ 50 kg/m². Surg Obes Relat Dis. 2015;11(4):785-90.
Thereaux, J., Corigliano, N., Poitou, C., Oppert, J. M., Czernichow, S., & Bouillot, J. L. (2015). Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥ 50 kg/m². Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 11(4), 785-90. https://doi.org/10.1016/j.soard.2014.11.022
Thereaux J, et al. Comparison of Results After One Year Between Sleeve Gastrectomy and Gastric Bypass in Patients With BMI ≥ 50 Kg/m². Surg Obes Relat Dis. 2015 Jul-Aug;11(4):785-90. PubMed PMID: 25771441.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥ 50 kg/m². AU - Thereaux,Jérémie, AU - Corigliano,Nicola, AU - Poitou,Christine, AU - Oppert,Jean-Michel, AU - Czernichow,Sebastien, AU - Bouillot,Jean-Luc, Y1 - 2014/12/04/ PY - 2014/09/15/received PY - 2014/11/03/revised PY - 2014/11/23/accepted PY - 2015/3/16/entrez PY - 2015/3/17/pubmed PY - 2016/5/4/medline KW - Bariatric surgery KW - Gastric bypass KW - Sleeve gastrectomy KW - Super obesity KW - Super-super obesity SP - 785 EP - 90 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 11 IS - 4 N2 - BACKGROUND: Although laparoscopic sleeve gastrectomy (LSG) was initially described as the first step of a 2-stage procedure for high-risk patients requiring laparoscopic Roux-en-Y gastric bypass (LRYGB), it is now being used as a single-stage procedure. Experience with laparoscopic bariatric surgery is growing, such that LRYGB is increasingly feasible for patients with body mass index (BMI) ≥ 50 kg/m². Nevertheless, outcomes for such category of patients following LSG and LRYGB are lacking. OBJECTIVE: To compare weight loss and changes in obesity related co-morbidities at one year following LSG with LRYGB in patients with BMI ≥ 50 kg/m². SETTINGS: The prospective database of a single surgery university center was queried for clinical and other relevant data. METHODS: From January 2004 to January 2013, 74 and 285 patients underwent LSG or LRYGB with a BMI ≥ 50 kg/m². At one year, rate of follow-up was 92.8%. Success of surgery was defined as % of excess weight loss (%EWL)≥ 50% at one year. Logistic regression was used to compute odds ratio (OR) to evaluate the success at one year of surgery. RESULTS: LSG (N = 74) and LGBP (N = 285) groups did not differ for initial BMI (57.2 ± 7.1 versus 56.7 ± 5.5 kg/m²; P = .52), % of female (64.6% versus 73.7%, P = .13) or major adverse postoperative events (5.7% versus 6.7%; P = .85). At one year, the mean percentage of weight loss (%) (22.0 ± 7.6 versus 30.3 ± 7.4; P < .0001) and percentage of excess weight loss (%) (40.2 ± 15.2 versus 55.0 ± 14.6; P < .0001) and rates of remission of diabetes (47.5% versus 70.7%; P = .01) were greater in the LGBP than LSG group. In multivariate analyses (OR), LSG was an independent factor of failure of weight loss (.12; P < .0001) CONCLUSION: After 1 year of follow-up in patients with a BMI ≥ 50 kg/m², LRYGB provides better weight loss and resolution in diabetes than LSG with similar postoperative morbidity. Further long-term studies are needed to confirm these results. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/25771441/Comparison_of_results_after_one_year_between_sleeve_gastrectomy_and_gastric_bypass_in_patients_with_BMI_≥_50_kg/m²_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(14)00468-7 DB - PRIME DP - Unbound Medicine ER -