Metabolic Parameters, Weight Loss, and Comorbidities 4 Years After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Lager, Corey; Esfandiari, Nazanene H.; Luo, Yingying; Subauste, Angela; Kraftson, Andrew; Brown, Morton B.; Varban, Oliver A.; Meral, Rasimcan; Cassidy, Ruth; Nay, Catherine; Lockwood, Amy; Bellers, Darlene; Buda, Colleen M.; Oral, Elif A.

doi:10.1007/s11695-018-3346-1

Cited by 36 publications

(23 citation statements)

References 43 publications

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“…Because hypertension (in particularly in combination with obesity) is a major risk factor for an acute coronary event, remission of hypertension would seem a likely explanation for this preventive effect. Although the remission rate of hypertension was well in line with the rates reported for similar groups of patients [10,25,26], the 31% remission rate at 4 years in the present study was lower than that reported in the only randomised clinical trial to date on the subject, the GATEWAY trial [11]. The GATEWAY trial, however, was conducted on a healthier group of patients with lower BMI compared with the present study.…”

Section: Plos Medicinesupporting

confidence: 82%

Association between metabolic surgery and cardiovascular outcome in patients with hypertension: A nationwide matched cohort study

et al. 2020

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Background Hypertension, together with obesity, is a leading cause of mortality and disability. Whilst metabolic surgery offers remission of several metabolic comorbidities, the effect for patients with hypertension remains controversial. The objective of the present study was to evaluate the effect of metabolic surgery on cardiovascular events and mortality on patients with morbid obesity (body mass index [BMI] � 35 kg/m 2) and hypertension. Methods and findings We conducted a matched cohort study of 11,863 patients with morbid obesity and pharmacologically treated hypertension operated on with metabolic surgery and a matched nonoperated-on control group of 26,199 subjects with hypertension (matched by age, sex, and area of residence) of varied matching ratios from 1:1 to 1:9, using data from the Scandinavian Obesity Surgery Register (SOReg), the Swedish National Patient Registers (NPR) for in-hospital and outpatient care, the Swedish Prescribed Drug Register, and Statistics Sweden. The main outcome was major adverse cardiovascular event (MACE), defined as first occurrence of acute coronary syndrome (ACS) event, cerebrovascular event, fatal cardiovascular event, or unattended sudden cardiac death. The mean age in the study group was 52.1 ± 7.46 years, with 65.8% being women (n = 7,810), and mean BMI was 41.9 ± 5.43 kg/ m 2. MACEs occurred in 379 operated-on patients (3.2%) and 1,125 subjects in the control group (4.5%). After adjustment for duration of hypertension, comorbidities, and education, a reduction in risk was seen in the metabolic surgery group (adjusted hazard ratio [HR] 0.73, 95% confidence intervals [CIs] 0.64-0.84, P < 0.001). The surgery group had lower risk for ACS events (adjusted HR 0.52, 95% CI 0.41-0.66, P < 0.001) and a tendency towards lower risk for cerebrovascular events (adjusted HR 0.81, 95% CI 0.63-1.01, P = 0.060)

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Section: Plos Medicinesupporting

confidence: 82%

Association between metabolic surgery and cardiovascular outcome in patients with hypertension: A nationwide matched cohort study

et al. 2020

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“…Some studies indicated that LRYGB was superior to LSG [5,15,16] in the remission of T2DM, while other studies suggested that the remission rates were similar in both groups [17]. Previous studies had shown an advantage for LRYGB in the remission of hypertension [18][19][20]. With these differences in results, this study aimed to scientifically compare the advantages of LRYGB and LSG based on highquality analysis and massive amount of data.…”

Section: Introductionmentioning

confidence: 99%

A meta-analysis of the medium- and long-term effects of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Huang

et al. 2020

BMC Surg

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Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are two representative bariatric surgeries. This study aimed to compare the effects of the LSG and LRYGB based on highquality analysis and massive amount of data.Methods: For this study databases of PubMed, Web of Science, EBSCO, Medline, and Cochrane Library were searched for articles published until January 2019 comparing the outcomes of LSG and LRYGB.Results: This study included 28 articles. Overall, 9038 patients (4597, LSG group; 4441, LRYGB group) were included. The remission rate of type 2 diabetes mellitus (T2DM) in the LRYGB group was superior to that in the LSG group at the 3-years follow-up. Five-year follow-up results showed that LRYGB had an advantage over LSG for the percentage of excess weight loss and remission of T2DM, hypertension, dyslipidemia, and abnormally low-density lipoprotein.Conclusions: In terms of the long-term effects of bariatric surgery, the effect of LRYGB was better than of LSG.

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“…Bariatric surgery has been well-established to significantly reduce or even eliminate obesity-related comorbidities, such as diabetes, hypertension, obstructive sleep apnea, cardiovascular disease, and mortality [18][19][20]. In this study, the incidence of obstructive sleep apnea was found to be significantly lower in patients undergoing conversion to SG compared to primary SG.…”

Section: Operative Technique For Conversionsmentioning

confidence: 65%

Single Stage Conversion from Laparoscopic Adjustable Gastric Band to Laparoscopic Sleeve Gastrectomy is Safer than Laparoscopic Adjustable Gastric Band to Roux-en-Y Gastric Bypass: Results of a 10-Year Analysis of Complications

S.¹,

Meredith²,

Petrone³

et al. 2020

Adv Laparoscopy

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Background: Conversion from laparoscopic Adjustable Gastric Band (AGB) to Roux-en-y gastric bypass (RNY) or Sleeve Gastrectomy (SG) is now common. Complication rates up to 25% have been reported. We reviewed the experience at a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center of Excellence.Study Design: Our prospective database was retrospectively reviewed for single-stage conversions over a 10-year period ending in 2017 to assess outcomes compared to primary procedures. In revisions, we reinforce staple lines with buttress material, oversew staple lines in high-risk patients, and avoid stapling or anastomosing into scar capsule tissue. Statistical analysis was performed using t-test, chi-square, Fisher's Exact, McNemar's, and Wilcoxon signed rank tests.Results: † Fisher's Exact test for conversion RNY vs. conversion SG re-op p = 0.0039 Conclusions:The risk of leak appears to be higher with conversion to RNY vs. SG. This finding should be weighed heavily when selecting revision procedures for high-risk patients.

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Metabolic Parameters, Weight Loss, and Comorbidities 4 Years After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Cited by 36 publications

References 43 publications

Association between metabolic surgery and cardiovascular outcome in patients with hypertension: A nationwide matched cohort study

Association between metabolic surgery and cardiovascular outcome in patients with hypertension: A nationwide matched cohort study

A meta-analysis of the medium- and long-term effects of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Single Stage Conversion from Laparoscopic Adjustable Gastric Band to Laparoscopic Sleeve Gastrectomy is Safer than Laparoscopic Adjustable Gastric Band to Roux-en-Y Gastric Bypass: Results of a 10-Year Analysis of Complications

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