Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity.

Abstract

IntroductionRoux-en-Y gastric bypass (RYGB) is considered the gold standard bariatric procedure with documented safety and effectiveness. Laparoscopic sleeve gastrectomy (LSG) is a newer procedure being done with increasing frequency. Randomized comparisons of LSG and other bariatric procedures are limited. We present the results of the first prospective randomized trial comparing LSG and RYGB in the Polish population.AimTo assess the efficacy and safety of LSG versus RYGB in the treatment of morbid obesity and obesity-related comorbidities.Material and methodsSeventy-two morbidly obese patients were randomized to RYGB (36 patients) or LSG (36 patients). Both groups were comparable regarding age, gender, body mass index (BMI) and comorbidities. The follow-up period was at least 12 months. Baseline and 6 and 12 month outcomes were analyzed including assessment of percent excess weight lost (%EWL), reduction in BMI, morbidity (minor, major, early and late complications), mortality, reoperations, comorbidities and nutritional deficiencies.ResultsThere was no 30-day mortality and no significant difference in major complication rate (0% after RYGB and 8.3% after LSG, p > 0.05) or minor complication rate (16.6% after RYGB and 10.1% after LSG, p > 0.05). There were no early reoperations after RYGB and 2 after LSG (5.5%) (p > 0.05). Weight loss was significant after RYGB and LSG but there was no difference between both groups at 6 and 12 months of follow-up. At 12 months %EWL in RYGB and LSG groups reached 64.2% and 67.6% respectively (p > 0.05). There was no significant difference in the overall prevalence of comorbidities and nutritional deficiencies.ConclusionsBoth LSG and RYGB produce significant weight loss at 6 and 12 months after surgery. The procedures are equally effective with regard to %EWL, reduction in BMI and amelioration of comorbidities at 6 and 12 months of follow-up. Laparoscopic sleeve gastrectomy and RYGB are comparably safe techniques with no significant differences in minor and major complication rates at 6 and 12 months.

Effectiveness of bariatric procedures based on selected laboratory parameters of patients from rural areas in Polish population

“…[24][25][26][27] The present study obtained similar results. The largest BMI reduction at the 6-month follow up was observed for SG (12.29%), and the smallest BMI reduction was observed for LAGB (9.02%).…”

“…Several studies have assessed the use of RYGB and compared its outcomes with those of other bariatric procedures. [24][25][26][27] RYGB was shown to very effectively reduce body weight; however, a higher incidence of complications associated with anastomotic leakage, pulmonary embolism, deep vein thrombosis, as well as frequent wound infections and postoperative hernia was observed. In the present study, the patients were qualified for the procedures on the basis of the current guidelines and a number of tests developed by a specialist panel, as well as consultations and each patient's personal commitment.…”

“…The largest BMI reduction at the 6-month follow up was observed for SG (12.29%), and the smallest BMI reduction was observed for LAGB (9.02%). The patients who qualified for SG had a mean preopera- [24][25][26][27][28] Earlier studies have shown a marked improvement and normalization of parameters assessing diabetes control following bariatric treatment. 29,30 The present study assessed only SG and RYGB in this respect, because LAGB was used in only 1 patient with type 2 diabetes.…”

Cross-sectional study of male sexual function in bariatric patients.

“…In the case of obese patients, multiple factors could play a role in male sexual dysfunction, including medical treatment, which can interfere with sexual function, vascular damage due to uncontrolled diabetes or hypertension and lack of self-esteem [4]. Bariatric surgery is an effective treatment option for obese people [7, 8]. At present, laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are the most popular types of bariatric operations [9, 10].…”

An Evaluation of Knowledge regarding Surgical Treatment of Obesity among Final Year Medical Students and Recent Graduate Physicians from King Abdulaziz University

“…The benefits of surgical treatment are not limited only to the reduction of body mass. Results of numerous studies have indicated the reduction of mortality risk in long-term follow-up in the group of patients treated surgically when compared with patients treated conservatively [6,[8][9][10][11].…”