Meta-analysis of metabolic surgery for obesity with metabolic syndrome: A comparison between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Abstract

Objective To assess the evidence-based support of short-term efficacy of sleeve gastrectomy and Roux-en-Y gastric bypass in obesity with metabolic syndrome by laparoscopy. Methods Electronic literature search was performed on PubMed, EMBASE, Cochrane Library, CNKI database for the efficacy of sleeve gostrectomy and Roux-en-Y gastric bypass in the treatment of obese patients with metabolic syndrome from Jan. 2011 to Jun. 2016. The inclusion and exclusion criteria were selected for quality evaluation, data extraction. Review Manager 5.3 software was used to conduct the statistical analysis. Results Thirteen articles were included in the Meta-analysis, including 5 randomized controlled trails, eight case-control studies with 18, 850 cases, including 2, 559 cases in the sleeve gastrectomy group and 16, 291 cases in the Roux-en-Y gastric bypass group. The results of the Meta-analysis showed that there was no significant difference in the remission rate of type 2 diabetes mellietus between sleeve gastrectomy and Roux-en-Y gastric bypass group (78.7% vs 83.0%; RR=0.94, 95%CI: 0.81~1.09, P>0.05), the reduction of body mass index was significantly higher in Roux-en-Y gastric bypass group than sleeve gastrectomy group from the short-term follow-up (MD=-2.03, 95%CI: -3.25~0.81, P<0.05). Both two surgeries can reduce the incidence of high blood lipids and hypertension, but there was no significant difference between them as well as type 2 diabetes mellitus remission. Conclusion Both sleeve gastrectomy and Roux-en-Y gastric bypass are effective in treating obesity complicated with metabolic syndrome, and can reduce the incidence of type 2 diabetes mellitus, hypertension and hyperlipidemia and reduce the body weight. Roux-en-Y gastric bypass is superior to sleeve gastrectomy in the treatment of obesity. Key words: Gastrectomy; Gastric bypass; Metabolic syndrome; Diabetes mellitus, Type 2; Body weight