Safety and efficacy of laparoscopic sleeve gastrectomy versus laparoscopic Roux‐en‐Y gastric bypass: A systematic review and meta‐analysis

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are widely performed to cure obesity and obesity-related diseases. Our aim was to compare these two procedures. Materials and methods:An electronic literature search was performed from inception to December 2018. The clinical outcomes between LSG and LRYGB were pooled using software RevMan5.3. Results: A total of 1076 patients from 11 studies were analysed. LSG had shorter operation time (mean difference [MD] = −33.81; 95% confidence interval [CI], −46.04 to −21.57; P < .00001) and less early complications rate (risk ratio [RR] = 0.55;95% CI, 0.36-0.84; P = .005) compared with LRYGB. There were no significant difference about the readmission rate (RR = 0.57; 95% CI, 0.21-1.54; P = .27) and reoperation rate (RR = 0.43; 95% CI, 0.14-1.27; P = .13) between LSG and LRYGB.The conversion to open rate and mortality rate within 30 days was low in both LSG and LRYGB. Mean hospital stay in LSG group (0.3-5.2 d) seems shorter than that in the LRYGB group (2.3-6.6 d). As to the effect of LSG and LRYGB on the percentage of excess weight loss (EWL), there was no significant difference between these two surgeries in EWL (MD = −4.05; 95% CI, −8.89 to 0.80; P = .10). LSG was equal to LRYGB on remission of T2DM (RR = 0.94; 95% CI, 0.84-1.06; P = .31). Conclusions: Both LSG and LRYGB can be performed with very low conversion toopen rate and mortality rate. The readmission rate and re-operation rate are comparable between these two surgeries. The efficacy of these two surgeries on EWL and T2DM is equivalent, but LSG has an advantage over LRYGB in operation time and early complications rate.

Outcomes of the One Anastomosis Gastric Bypass with Various Biliopancreatic Limb Lengths: a Retrospective Single-Center Cohort Study

“…Mean BMI after 3 years was 29 ± 4 kg/m 2 and %EWL 77 ± 24 %. This wide distribution of outcomes in BMI and %EWL are comparable with other large cohort studies in both OAGB and RYGB [ 27 , 28 ]. Weight loss surgery aims to achieve an optimum weight loss striving for a metabolically healthy BMI of 25 kg/m 2 in combination with a minimum of side effects.…”

Two-year outcomes of sleeve gastrectomy versus gastric bypass: first report based on Tehran obesity treatment study (TOTS)

“…In the current study, SG had more favorable outcomes regarding surgery duration and early complications. Consistently, Zhao et al [34], in a recent meta-analysis, reported that SG is a superior surgical procedure to GB regarding the surgery duration and early complications. Similarly, another meta-analysis reported that SG was associated with fewer early complications (major and minor) [35].…”

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

“…Notwithstanding these limitations, the present work has several strengths that are unique to the reviews on this topic [49][50][51][52][53][54] . First, the strictest possible inclusion criteria have been adopted to minimise the influence of confounding factors.…”