Sleeve gastrectomy or gastric bypass: a “post-code” lottery? A comprehensive national analysis of the utilization of bariatric surgery in Switzerland between 2011–2017

Gerö, Dániel; Schneider, Marcel; Suter, Michel; Peterli, Ralph; Vonlanthen, René; Turina, Matthias; Bueter, Marco

doi:10.1016/j.soard.2020.10.023

Cited by 10 publications

(10 citation statements)

References 48 publications

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“…It is considered as efficient as RYGB, easier to perform, and less likely to cause morbidity and mortality ( 17 , 18 , 19 ). However, numerous authors have suggested that this technique is responsible for more bile reflux ( 20 , 21 ) and, owing to the lack of available high‐quality evidence as of yet, this procedure is not yet widely accepted ( 22 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

Roux‐en‐Y gastric bypass, sleeve gastrectomy, or one‐anastomosis gastric bypass? A systematic review and meta‐analysis of randomized‐controlled trials

Uhe¹,

Douissard²,

Podetta³

et al. 2022

Obesity

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Objective This study aimed to determine which bariatric procedure allows patients to obtain the best weight‐loss outcomes and a remission of type 2 diabetes. Methods Databases were searched for randomized‐controlled trials comparing Roux‐en‐Y gastric bypass (RYGB) with sleeve gastrectomy (SG) or one‐anastomosis gastric bypass (OAGB). The mean difference (MD) or the relative risk was determined. Results Twenty‐five randomized‐controlled trials were analyzed. Excess weight loss (EWL, percentage) was greater for RYGB patients at 3 years (MD: 11.93, p < 0.00001) and 5 years (MD: 13.11, p = 0.0004). Higher excess BMI loss (percentage) was found in RYGB at 1 year (MD: 11.66, p = 0.01). Total weight loss (percentage) was greater for RYGB patients after 3 months (MD: 2.41, p = 0.02), 6 months (MD: 3.83, p < 0.00001), 1 year (MD: 6.35, p < 0.00001), and 5 years (MD: 3.90, p = 0.005). No difference in terms of remission of type 2 diabetes was seen between RYGB and SG. EWL was significantly more important after OAGB than after RYGB after 1 year (MD: −10.82, p = 0.003). Conclusions RYGB is more efficient than SG in the midterm. OAGB offers greater EWL than RYGB after 1 year, but further evidence is needed to confirm this result.

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Section: Introductionmentioning

confidence: 99%

Roux‐en‐Y gastric bypass, sleeve gastrectomy, or one‐anastomosis gastric bypass? A systematic review and meta‐analysis of randomized‐controlled trials

Uhe¹,

Douissard²,

Podetta³

et al. 2022

Obesity

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“…The long-standing nature of these national surveys permits monitoring of BS activity in the country and their importance should not be underestimated [1]. Similar have been conducted in other countries in the past and frequently by IFSO worldwide, and represent precious testimony of BS practice evolution [2][3][4][5][6][7][8]. Data analysis has surfaced some clear trends.…”

Section: Discussionmentioning

confidence: 99%

Evolution of Bariatric Surgery in Italy in the Last 11 Years: Data from the SICOB Yearly National Survey

et al. 2023

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Background Bariatric surgery (BS) is a relatively novel surgical field and is in continuous expansion and evolution. Purpose Aim of this study was to report changes in Italian surgical practice in the last decade. Methods The Società Italiana di Chirurgia dell’Obesità (SICOB) conducted annual surveys to cense activity of SICOB centers between 2011 and 2021. Primary outcome was to detect differences in frequency of performance of adjustable gastric banding (AGB), sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), bilio-pancreatic diversion (BPD), and gastric plication (GP). Secondary outcome was to detect differences in performance of main non-malabsorptive procedures (AGB + SG) and overall bypass procedures (RYGB + OAGB). Geographical differences were also investigated. Results Median response rate was 92%. AGB declined from 36% of procedures in 2011 to 5% in 2021 (p < 0.0001). SG increased from 30% in 2011 to 55% in 2021 (p < 0.0001). RYGB declined from 25 to 12% of procedures (p < 0.0001). OAGB rose from 0% of procedures in 2011 to 15% in 2021 (p < 0.0001). BPD underwent decrease from 6.2 to 0.2% in 2011 and 2021, respectively (p < 0.0001). Main non-malabsorptive procedures significantly decreased while overall bypass procedures remained stable. There were significant differences among regions in performance of SG, RYGB, and OAGB. Conclusions BS in Italy evolved significantly during the past 10 years. AGB underwent a decline, as did BPD and GP which are disappearing and RYGB which is giving way to OAGB. The latter is rising and is the second most-performed procedure after SG which has been confirmed as the preferred procedure by Italian bariatric surgeons. Graphical Abstract

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“…Our survey data also hypothesize that the surgeon has a significant influence on the choice of surgical method which has already previously been reported. 26 Even if the future candidates for BS made up their minds about the preferred surgical technique, the surgeons still seem to be noticed as important counsellors and allies on the patient's path for BS. This is in line with the literature highlighting a shared decision‐making to achieve satisfying post‐bariatric results but also to address patients' concerns and expectations.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, this approach allowed to pool patient opinions from three neighbouring countries (Switzerland, Germany and Austria) with very different healthcare systems and use of BS. 26 …”

Section: Discussionmentioning

confidence: 99%

Online survey on factors influencing patients' motivation to undergo bariatric surgery

et al. 2021

Self Cite

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Given the worldwide increasing prevalence of severe obesity and considering the amount of scientific evidence demonstrating the beneficial effects of bariatric surgery (BS), it is surprising that only a fraction of patients with obesity undergo BS. We therefore conducted an anonymized online survey among individuals with a history of BS to understand factors influencing the deciding process leading to BS. Respondents were recruited on a voluntary basis from obesity-related social media groups between April and June 2020. The selfdesigned, non-validated questionnaire consisted of 20 questions and was open to any participants with a history of BS. Of 851 participants who started the survey, 665 completed the questionnaire (completion rate of 78.1%). Five years after BS, still 70% of the surveyparticipants were very satisfied or satisfied with the surgical result. However, the majority (73.3%) would have undergone BS earlier. The main motivation to choose BS was related to health status or quality of life. Important characteristics for a bariatric surgeon to obtain patients' trust are "taking time and listen" (74.7%), empathy (64%) and sympathy (56%).Post-operative satisfaction with the surgical outcome was high and long-lasting in this large cohort of BS patients. However, most participants would retrospectively have undergone BS earlier. The main reason to choose BS as treatment for their obesity were impaired physical health or reduced quality of life. Nearby location to patients' residence and availability of surgeons with empathy were decisive motives for bariatric centre selection.

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Sleeve gastrectomy or gastric bypass: a “post-code” lottery? A comprehensive national analysis of the utilization of bariatric surgery in Switzerland between 2011–2017

Cited by 10 publications

References 48 publications

Roux‐en‐Y gastric bypass, sleeve gastrectomy, or one‐anastomosis gastric bypass? A systematic review and meta‐analysis of randomized‐controlled trials

Roux‐en‐Y gastric bypass, sleeve gastrectomy, or one‐anastomosis gastric bypass? A systematic review and meta‐analysis of randomized‐controlled trials

Evolution of Bariatric Surgery in Italy in the Last 11 Years: Data from the SICOB Yearly National Survey

Online survey on factors influencing patients' motivation to undergo bariatric surgery

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