Is the Sleeve Gastrectomy Always a Better Procedure? Five-Year Results from a Retrospective Matched Case-Control Study

Vitiello, Antonio; Pilone, Vincenzo; Ferraro, Luca; Forestieri, Pietro

doi:10.1007/s11695-018-3161-8

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…This appears to be relatively equivalent between procedures, representing ~2-2.5kg/m 2 between the lowest BMI reported at the first postoperative year and that reported at the fifth. This pattern of weight recidivism is consistent with studies of across a range of methodologies that report weight outcomes annually to five years in LRYGB and/or LVSG to five years [22][23][24][25][26] .…”

Section: Discussionsupporting

confidence: 81%

Five-Year Weight Loss Outcomes in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Osland

Alam

Khan

et al. 2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Laparoscopic vertical sleeve gastrectomy (LVSG) has overtaken the laparoscopic Roux-en-Y gastric bypass (LRYGB) as the most frequently performed bariatric surgical procedure. To date little has been reported on the long-term outcomes of the LVSG procedure comparative to the traditionally favoured LRYGB. We undertook a systematic review and meta-analysis to review the five year outcomes of comparing LVSG and LRYGB.We undertook a systematic review and meta-analysis to compare five year weight loss outcomes of randomized controlled trials (RCTs) comparing LVSG to LRYGB.Methods: Searches of electronic databases (Pubmed, EMBASE, CINAHL, Cochrane) were undertaken for RCTs describing weight loss outcomes in adults at five years postoperatively.Where sufficient data was available to undertake meta-analysis, the Hartung-Knapp-Sidik-Jonkman (HKSJ) estimation method for random effects model was utilised. The review was registered with PROSPERO and reported following in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results:Five studies met the inclusion criteria totalling 1028 patients (LVSG=520, LRYGB=508). Moderate but comparable levels of bias were observed within studies.Statistically significant BMI loss ranged from -11.37kg/m 2 (range -6.3 to -15.7 kg/m 2 ) in the LVSG group and -12.6 kg/m 2 (range -9.5 to -15.4 kg/m 2 ) for LRYGB at five years (p<0.001).Systematic review suggested that LRYGB produced a greater weight loss expressed as percent excess weight and percent excess BMI loss than LVSG: this was not corroborated in the meta-analysis. Conclusions:Five year weight loss outcomes suggest both LRYGB and LVSG are effective in achieving significant weight loss at five years postoperatively, however differences in reporting parameters limit the ability to reliably compare the outcomes using statistical methods. Furthermore, results may be impacted by large dropout rates and per protocol 4 analysis of the two largest included studies. Further long-term studies are required to contradict or validate the results of this meta-analysis.

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Section: Discussionsupporting

confidence: 81%

Five-Year Weight Loss Outcomes in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Osland

Alam

Khan

et al. 2020

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Standard technique for LSG has been previously reported [15][16][17]: a five trocars approach (3 × 12 mm, 2 × 5 mm) was used. The gastrectomy started 2-4 cm from the initial weight − final weight∕initial weight × 100.…”

Section: Surgical Techniquementioning

confidence: 99%

Learning curve and global benchmark values of laparoscopic sleeve gastrectomy: results of first 100 cases of a newly trained surgeon in an Italian center of excellence

et al. 2021

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To evaluate whether the learning curve for sleeve gastrectomy could be completed after 50 cases. First 100 patients undergoing LSG under a newly trained laparoscopic surgeon were included in this study and divided into two groups of 50 consecutive patients each. Perioperative outcomes were compared to recently introduced global benchmarks. Short-term weight loss was calculated as Total Weight Loss Percent (%TWL) and complications were classified in accordance with the Clavien–Dindo classification. CUSUM analysis was performed for operative time and hospital stay. Mean preoperative age and BMI were 41.8 ± 10.3 years and 42.9 ± 5.4 kg/m2, respectively. Demographics and rate of patients with previous surgery were comparable preoperatively in the two groups. Mean operative time was 92.1 ± 19.3 min and hospital stay was 3.4 ± 0.6 days as per our standard protocol of discharge. Uneventful postoperative course was recorded in 93% of patients and only one case of staple line leak was registered in the first 50 cases (group 1). No statistical difference in BMI and %TWL was found between the two groups at any time of follow-up. Comparison between two groups showed a significant reduction in hospital stay and operative time after the first 50 LSGs (p < 0.05). LSG can be performed by newly trained surgeons proctored by senior tutors. At least 50 cases are needed to meet global benchmark cut-offs and few more cases may be required to reach the plateau of the learning curve.

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“…The safety and effectiveness of LSG were frequently demonstrated in different studies [28][29][30][31][32] ; however, some studies observed the severity of complications to be higher after LSG than other bariatric procedures [33][34][35] .…”

Section: Khidir Et Al In Interesting Research Indicated the Comparable Weight Loss Results Among Patientsmentioning

confidence: 99%

One-Year Outcomes of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients Regarding Preoperative BMI, Gender, and Age

Tabasi

Farsimadan

Iranpour

et al. 2021

Preprint

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The outcome of laparoscopic sleeve gastrectomy (LSG), one of the most common bariatric surgery (BS) procedure, may differ depending on the patient’s age, gender, preoperative BMI. In this study, we aimed to evaluate the efficacy of LSG technique on weight loss, obesity-associated co-morbidities and complications in patients undergoing LSG over three months and one year, regarding their age, gender, and BMI. The LSG associated complications in participants regarding their preoperative BMI (<39.9 and >39.9), age (30-40 and 40-50), and gender were assessed after 2 3 and 12 months. Besides, the remission and improvement rates of comorbid conditions in patients were examined after 12 months of LSG. Our results showed that LSG led to a significant weight loss in the resolution of obesity-associated co-morbidities and different complications after one year. No significant difference was found in the improvement and the resolution of obesity-associated co-morbidities according to gender. Also, the class 3 patients had significantly higher rates of hearing loss after 12 months and had higher levels of depression and brittle nails three months after the surgery. The younger patients also showed a significantly higher percentage of dry skin, intolerance to bread, and menstrual disorder compared to the older group.

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Is the Sleeve Gastrectomy Always a Better Procedure? Five-Year Results from a Retrospective Matched Case-Control Study

Abstract: LSG achieves better %EWL than LAGB within 5 years, but comorbidities improvement is not significantly different. Severity of complication is higher after LSG. LAGB is still a good option for selected patients.

Cited by 13 publications

References 26 publications

Five-Year Weight Loss Outcomes in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Five-Year Weight Loss Outcomes in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Learning curve and global benchmark values of laparoscopic sleeve gastrectomy: results of first 100 cases of a newly trained surgeon in an Italian center of excellence

One-Year Outcomes of Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients Regarding Preoperative BMI, Gender, and Age

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