Comparative effectiveness of 3 bariatric surgery procedures: Roux-en-Y gastric bypass, laparoscopic adjustable gastric band, and sleeve gastrectomy

Effectiveness of bariatric surgical procedures

“…Our results were generally consistent with previous studies that examined comprehensive evidence of bariatric surgical procedures, that is, RYGB was superior to LAGB in terms of weight loss, but with greater number of complications, and SG was positioned between RYGB and LAGB in complication rates, but had conflicting evidence in terms of its weight loss effect compared with RYGB. [ 11 – 13 ] When using only RCTs, our study indicated that even though the differences in weight loss from RYGB and SG were not statistically significant, SG showed a tendency of better weight reduction. Similar trend was seen when comparing the effectiveness of RYGB and SG in other meta-analyses.…”

“…The evidence examining the weight loss effect of SG in relation to RYGB is controversial. [ 11 – 13 ] Several meta-analyses have been performed to compare the effectiveness of bariatric surgery procedures; however, their results were based on older evidence. [ 7 , 12 – 14 ] With technological advances in surgical procedures, especially with newer procedures like SG and improved bariatric patient-care management, [ 13 ] an updated quantitative comparative effectiveness research was needed to aid in healthcare decision making.…”

Missing Something? Comparisons of Effectiveness and Outcomes of Bariatric Surgery Procedures and Their Preferred Reporting: Refining the Evidence Base

“…Comparisons of short-, medium-, or long-term effectiveness and outcomes of various bariatric surgery (BS) procedures, and comparisons of effectiveness and outcomes of BS vs no surgery usually encompass a range of variables. Important outcomes include safety (e.g., adverse events, operative mortality, perioperative complications, readmissions, long-term reoperation rates) or other relevant indicators (e.g., length of hospital stay) [1][2][3][4][5][6][7]. In addition to such variables, the indicators of effectiveness employed for comparisons frequently comprise three main components.…”

“…In addition to such variables, the indicators of effectiveness employed for comparisons frequently comprise three main components. These components include various anthropometric weight loss (WL) measures [e.g., WL, BMI, %BMI change, % excess BMI loss, percent total weight loss (%TWL), percent excess weight loss (%EWL), others)], a range of biochemical/ metabolic/clinical outcomes (FBG, HA1c, lipids, others), and improvements or worsening of comorbidities (e.g., type 2 diabetes mellitus) that are frequently gauged based on the post-BS levels of biochemical/clinical parameters [4,7,8]. However, the extent and quality of a patient's post-operative (post-op) physical activity (PA) and/or diet can both influence these anthropometric WL and biochemical/ clinical outcomes, directly (e.g., via WL) or indirectly (e.g., via improvements in insulin sensitivity, metabolic health).…”

Bariatric Surgery Among Medicare Subgroups: Short‐ and Long‐Term Outcomes

“…Bariatric surgical outcomes in the Medicare population are of increasing importance given the rising prevalence of obesity and concomitant increase in life expectancy associated with surgery . However, the majority of analyses focused on Medicare populations have used retrospective administrative or clinical data, limiting the availability and specificity of certain important outcomes. In addition, large gaps in the literature persist in comparisons of specific bariatric procedures in Medicare recipients, a concern highlighted in a recently published systematic review from the Agency for Healthcare Research and Quality .…”