Abstract
PurposeTo systematically and comprehensively evaluate the differences between laparoscopic Roux-en-Y gastric bypass (LRYGB) versus sleeve gastrectomy (LSG) in obese patients.MethodsA systematic literature search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to December 2018. The meta-analysis was performed by the RevMan 5.3 software.ResultsTwenty-three articles with 7443 patients were included. In short term (< 3 years), LRYGB was superior to LSG in terms of improving comorbidities (T2D, odds ratio (OR) 1.93, 1.06–3.52, P < 0.05, hypertension, OR 1.59, 1.08–2.34, P < 0.05, dyslipidemia, OR 1.61, 1.05–2.46, P < 0.05), but there were no differences in the midterm and long term. Quality of life (QoL) after bariatric surgery was included, but no differences were observed in the QoL after LRYGB or LSG (gastrointestinal quality of life index (GIQLI) and Moorehead–Ardelt quality of life questionnaire (M-A-Q), P > 0.05). LRYGB achieved a higher EWL% than LSG (after 3 years, WMD 5.48, 0.13–10.84. P < 0.05; after 5 years, WMD 4.55, 1.04–8.05, P < 0.05) in long term, but no significant differences were found during 0.25- to 2.0-year follow-up. The rate of early and late complications was much higher in LRYGB than in LSG (early complications, OR = 2.11, 95% CI = 1.53–2.91, P < 0.001; late complications, OR = 2.60, 95% CI = 1.93–3.49, P < 0.001).ConclusionsThis meta-analysis showed that LRYGB was more effective than LSG in comorbidities’ resolution or improvement in short term. For weight loss, LRYGB had better long-term effects than LSG. In addition, no differences were observed in the quality of life after LRYGB or LSG. LRYGB was associated with more complications than LSG.
Highlights
With its increasing prevalence, obesity has become a global public health problem over the past few decades [1]
laparoscopic Roux-en-Y gastric bypass (LRYGB) was significantly associated with more early complications than laparoscopic sleeve gastrectomy (LSG), and the same result was observed for the late complications, which may be related to the difficulty of the LRYGB surgery
There were some differences in our conclusion: we found that there was no significant difference in EWL% between the two surgical procedures during 0.25–2.0-year follow-up, but in the midterm and long term (3 years and 5 years, respectively), the LRYGB group had better effects than the LSG group in weight loss; this finding differs between our study and other studies
Summary
Obesity has become a global public health problem over the past few decades [1]. Compared with various strategies, including medications, behavior changes, and diet therapy, bariatric. Primary bariatric procedures include Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (AGB), laparoscopic vertical banded gastroplasty (VBG), sleeve gastrectomy (SG), mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB), biliopancreatic diversion/duodenal switch (BPD/DS), and singleanastomosis duodeno-ileal bypass (SADI). Among these techniques, laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) have gained the most popularity. Some studies suggest that LSG is easier and faster to perform and potentially safer compared with LRYGB [8, 10], while some indicate that LRYGB is more potent than LSG [11,12,13]
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