Abstract
There are several surgical techniques for management of obesity, the most commonly used management strategies were; laparoscopic gastric bypass and laparoscopic sleeve gastrecomy, both techniques have advantages and drawbacks. But there are few published studies which clarified such issue and compare between both management strategies. We aimed in the present study to compare laparoscopic sleeve gastrecomy and laparoscopic gastric bypass as management surgical strategies of morbid obesity regarding technical success, degree of weight loss, degree of weight loss maintenance, postoperative and long term morbidities and degree of presence or absence of nutritional deficiencies. Patients and Methods: This is a prospective study which included a cohort of 100 patients with morbid obesity 50 of them underwent Laparoscopic gastric bypass and performed 50 underwent Laparoscopic sleeve gastrecomy with a five-year follow-up. Results: We showed that weight loss was higher in the laparoscopic sleeve gastrecomy group initially (p = 0.002), then after 2 years total weight loss was higher in the laparoscopic assisted gastric bypass group (p = 0.004). Diabetes, dyslipidemia and hypertension resolution was more common after laparoscopic assisted gastric bypass than after laparoscopic assisted sleeve gastrecomy. Occurrence of nutritional deficiencies was less commonly happened after laparoscopic assisted gastric bypass than after laparoscopic assisted sleeve gastrecomy. Conclusions: We showed a similar rate of weight reduction and resolution of nutritional deficits initially in both between laparoscopic assisted sleeve gastrecomy and laparoscopic gastric bypass maintenance of weight reduction was found more in laparoscopic assisted sleeve gastrecomy but rates of nutritional deficits were higher in such procedure.
Highlights
Obesity has been continually considered a public health problem in most developing and developed countries
We showed that weight loss was higher in the laparoscopic sleeve gastrecomy group initially (p = 0.002), after 2 years total weight loss was higher in the laparoscopic assisted gastric bypass group (p = 0.004)
We showed a similar rate of weight reduction and resolution of nutritional deficits initially in both between laparoscopic assisted sleeve gastrecomy and laparoscopic gastric bypass maintenance of weight reduction was found more in laparoscopic assisted sleeve gastrecomy but rates of nutritional deficits were higher in such procedure
Summary
Obesity has been continually considered a public health problem in most developing and developed countries. Surgical management sometimes considered the only method of solving the problem of morbid obesity, decreasing patients’ weight, controlling most complications, improving quality of life and increasing life expectancy of patients [3]. Laparoscopic sleeve gastrectomy was been reported to be safe and performed but has the disadvantage of nutritional deficiencies which occur to patients following such approach which need a long period of patients follow up to detect and manage health problems resulting from nutritional deficiencies [5] [6] [7] [8]. Previous studies showed that laparoscopic gastric bypass could be safely performed with fewer complications and fewer drawbacks in addition to similar degree of weight loss to laparoscopic sleeve gastrectomy [9]. We aimed in the present study to compare between laparoscopic sleeve gastrecomy and laparoscopic gastric bypass as management surgical strategies of morbid obesity regarding technical success, degree of weight loss, degree of weight loss maintenance, postoperative and long term morbidities and degree of presence or absence of nutritional deficiencies
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