Long-Term Weight Loss Results, Remission of Comorbidities and Nutritional Deficiencies of Sleeve Gastrectomy (SG), Roux-En-Y Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) on Type 2 Diabetic (T2D) Patients

Abstract

This study aimed to compare the long-term weight loss results, remission of comorbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and One-Anastomosis gastric bypass (OAGB) on type 2 diabetic (T2D) patients. Patients and Methods: A retrospective analysis of all the morbidly obese and diabetic patients undergoing SG, RYGB, and OAGB as primary bariatric procedures between February 2010 and June 2015 was performed. Anthropometric parameters, remission of comorbidities, nutritional deficiencies and supplementation requirements at 1, 2 and 5 years’ follow-up were monitored. Patients lost to follow-up 5 years after surgery were excluded from the analysis. Results: 358 patients were included. The follow-up rate was 84.8%. Finally, 83 SG, 152 RYGB, and 123 OAGB patients were included in the analysis. OAGB obtained significantly greater weight loss and remission of dyslipidemia than the other techniques. There was a trend towards greater T2D and hypertension remission rate after OAGB, while fasting glucose and glycated hemoglobin levels were significantly lower after OAGB. There were no significant differences in hemoglobin or protein levels between groups. SG obtained lower iron deficiencies than the other techniques, while there were no significant differences in other nutritional deficiencies between groups. Conclusion: OAGB obtained greater weight loss and remission of dyslipidemia than RYGB or SG. Excluding lower iron deficiency rates after SG, there were no significant differences in the development of nutritional deficiencies between groups.

The effect of different types of laparoscopic bariatric procedures on type 2 diabetic obese patients

“…Our findings extend and support some secondary and exploratory outcomes from the STAMPEDE trial, which showed that the proportion of patients with diabetes remission was non-significantly higher 1 year after gastric bypass than after sleeve gastrectomy (42% vs 27%), and that the proportion of patients not using any antidiabetic medication at 1 year was 78% after gastric bypass and 51% after sleeve gastrectomy (Castro et al, 2020).…”

Effects of sleeve gastrectomy versus omega-loop gastric bypass. What is best for weight loss, perioperative adverse events, and comorbidities?

“…This was also true for BMI reduction (p < 0.001) at one-year follow-up. Our results follow the findings in the literature [15]. According to Salvi et al [10], faster weight loss was reported in the first year after OAGB than after SG.…”

Bariatric Surgery With Roux-En-Y Gastric Bypass or Sleeve Gastrectomy for Treatment of Obesity and Comorbidities: Current Evidence and Practice

“…In all studies conducting a comparative analysis of the two procedures, RYGB was shown to have a higher %EWL at all periods, including two months, six months, and annually during years one to five postoperatively [16][17][18][19][20][21][22]. However, both the RYGB and SG show significant weight loss at all periods postoperatively.…”

“…Patients are asked to attend clinic follow-up visits for the continuance of weight loss measurement and post-operative assessments. Subsequent visits typically occur during the two-month to two-year postoperative period; however, some studies have followed patients for up to five years [16][17][18][19][20][21][22].…”

“…Due to the changes in absorption and decreased reservoir capacity of the stomach, weight loss has been the most prominent outcome. In multiple studies, both prospective and retrospective observational studies, patients were followed postoperatively with weight loss recorded throughout various time intervals [16][17][18][19][20][21][22].…”