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Obesity Surgery
Published in: Obesity Surgery 5/2020

01-05-2020 | Anemia | Review

In Terms of Nutrition, the Most Suitable Method for Bariatric Surgery: Laparoscopic Sleeve Gastrectomy or Roux-en-Y Gastric Bypass? A Systematic Review and Meta-analysis

Authors: Lihu Gu, Rongrong Fu, Ping Chen, Nannan Du, Siqi Chen, Danyi Mao, Bangsheng Chen, Feiyan Mao, Parikshit Asutosh Khadaroo, Qiong Jin

Published in: Obesity Surgery | Issue 5/2020

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Abstract

This study assesses the differences in postoperative nutritional status between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). We searched the literature from PubMed, Web of Science, Embase, and the Cochrane Library database. Twenty-nine articles were included, with a total of 5437 obese patients. After bariatric surgery, the LSG group had less anemia and iron deficiency anemia than the LRYGB group. The serum iron, ferritin deficiency, and vitamin B12 rates after LSG were lower than patients receiving LRYGB. And PTH and serum phosphorus concentration of patients after LSG were both lower than those after LRYGB. The postoperative results of LSG were better than that of LRYGB. Therefore, we recommend LSG for a better postoperative nutrition, but only for reference.
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Literature
1.
2.
Qasim A, Turcotte M, de Souza RJ, et al. On the origin of obesity: identifying the biological, environmental and cultural drivers of genetic risk among human populations. Obes Rev. 2018;19(2):121–49.PubMedCrossRef
3.
Katsareli EA, Dedoussis GV. Biomarkers in the field of obesity and its related comorbidities. Expert Opin Ther Targets. 2014;18(4):385–401.PubMedCrossRef
4.
Kruseman M, Leimgruber A, Zumbach F, et al. Dietary, weight, and psychological changes among patients with obesity, 8 years after gastric bypass. J Am Diet Assoc. 2010;110(4):527–34.PubMedCrossRef
5.
Bavaresco M, Paganini S, Lima TP, et al. Nutritional course of patients submitted to bariatric surgery. Obes Surg. 2010;20(6):716–21.CrossRefPubMed
6.
Kim G, Tan CS, Tan KW, et al. Sleeve gastrectomy and Roux-en-Y gastric bypass lead to comparable changes in body composition in a multiethnic Asian population. J Gastrointest Surg. 2019;23(3):445–50.PubMedCrossRef
7.
8.
9.
Ferraz AAB, Carvalho MRC, Siqueira LT, et al. Micronutrient deficiencies following bariatric surgery: a comparative analysis between sleeve gastrectomy and Roux-en-Y gastric bypass. Rev Col Bras Cir. 2018;45(6):e2016.CrossRefPubMed
10.
Janmohammadi P, Sajadi F, Alizadeh S, et al. Comparison of energy and food intake between gastric bypass and sleeve gastrectomy: a meta-analysis and systematic review. Obes Surg. 2019;29(3):1040–8.CrossRefPubMed
11.
Kehagias I, Karamanakos SN, Argentou M, et al. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obes Surg. 2011;21(11):1650–6.PubMedCrossRef
12.
Moize V, Andreu A, Flores L, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-en-Y gastric bypass in a Mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.PubMedCrossRef
13.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ (Clin Res ed). 2009;339:b2700.CrossRef
14.
Higgins JP, Altman DG, Gotzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clin Res ed). 2011;343:d5928.CrossRef
15.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.CrossRefPubMed
16.
Paluszkiewicz R, Kalinowski P, Wroblewski T, et al. Prospective randomized clinical trial of laparoscopic sleeve gastrectomy versus open Roux-en-Y gastric bypass for the management of patients with morbid obesity. Wideochir Inne Tech Maloinwazyjne, 2012. 7(4):225–32.CrossRef
17.
Vix M, Liu KH, Diana M, et al. Impact of Roux-en-Y gastric bypass versus sleeve gastrectomy on vitamin D metabolism: short-term results from a prospective randomized clinical trial. Surg Endosc. 2014;28(3):821–6.PubMedCrossRef
18.
de Barros F, Setubal S, Martinho JM, et al. Early endocrine and metabolic changes after bariatric surgery in grade III morbidly obese patients: a randomized clinical trial comparing sleeve gastrectomy and gastric bypass. Metab Syndr Relat Disord. 2015;13(6):264–71.CrossRefPubMed
19.
Peterli R, Wolnerhanssen BK, Vetter D, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized Swiss multicenter bypass or sleeve study (SM-BOSS). Ann Surg. 2017;265(3):466–73.CrossRefPubMed
20.
Ruiz-Tovar J, Carbajo MA, Jimenez JM, et al. Long-term follow-up after sleeve gastrectomy versus Roux-en-Y gastric bypass versus one-anastomosis gastric bypass: a prospective randomized comparative study of weight loss and remission of comorbidities. Surg Endosc. 2019;33(2):401–10.CrossRefPubMed
21.
Crawford MR, Pham N, Khan L, et al. Increased bone turnover in type 2 diabetes patients randomized to bariatric surgery versus medical therapy at 5 years. Endocr Pract. 2018;24(3):256–64.CrossRefPubMed
22.
Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)-a prospective study. Obes Surg. 2010;20(4):447–53.CrossRefPubMed
23.
Ruz M, Carrasco F, Rojas P, et al. Heme- and nonheme-iron absorption and iron status 12 mo after sleeve gastrectomy and Roux-en-Y gastric bypass in morbidly obese women. Am J Clin Nutr. 2012;96(4):810–7.CrossRefPubMed
24.
Coupaye M, Riviere P, Breuil MC, et al. Comparison of nutritional status during the first year after sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Surg. 2014;24(2):276–83.CrossRefPubMed
25.
Moore CE, Sherman V. Vitamin D supplementation efficacy: sleeve gastrectomy versus gastric bypass surgery. Obes Surg. 2014;24(12):2055–60.CrossRefPubMed
26.
Leyba JL, Llopis SN, Aulestia SN. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. A prospective study with 5 years of follow-up. Obes Surg. 2014;24(12):2094–8.CrossRefPubMed
27.
Lanzarini E, Nogues X, Goday A, et al. High-dose vitamin D supplementation is necessary after bariatric surgery: a prospective 2-year follow-up study. Obes Surg. 2015;25(9):1633–8.CrossRefPubMed
28.
Verger EO, Aron-Wisnewsky J, Dao MC, et al. Micronutrient and protein deficiencies after gastric bypass and sleeve gastrectomy: a 1-year follow-up. Obes Surg. 2016;26(4):785–96.CrossRefPubMed
29.
Duran ID, Gulcelik NE, Bulut B, et al. Differences in calcium metabolism and thyroid physiology after sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Surg. 2019;29(2):705–12.CrossRefPubMed
30.
Bredella MA, Greenblatt LB, Eajazi A, et al. Effects of Roux-en-Y gastric bypass and sleeve gastrectomy on bone mineral density and marrow adipose tissue. Bone. 2017;95:85–90.PubMedCrossRef
31.
Vilarrasa N, de Gordejuela AG, Gomez-Vaquero C, et al. Effect of bariatric surgery on bone mineral density: comparison of gastric bypass and sleeve gastrectomy. Obes Surg. 2013;23(12):2086–91.PubMedCrossRef
32.
Alexandrou A, Armeni E, Kouskouni E, et al. Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surg Obes Relat Dis. 2014;10(2):262–8.PubMedCrossRef
33.
Lancha A, Moncada R, Valenti V, et al. Comparative effects of gastric bypass and sleeve gastrectomy on plasma osteopontin concentrations in humans. Surg Endosc. 2014;28(8):2412–20.PubMedCrossRef
34.
Lee WJ, Pok EH, Almulaifi A, et al. Medium-term results of laparoscopic sleeve gastrectomy: a matched comparison with gastric bypass. Obes Surg. 2015;25(8):1431–8.PubMedCrossRef
35.
Maffazioli GD, Stanford FC, Campoverde Reyes KJ, et al. Comparing outcomes of two types of bariatric surgery in an adolescent obese population: Roux-en-Y gastric bypass vs. sleeve gastrectomy. Front Pediatr. 2016;4:78.PubMedPubMedCentralCrossRef
36.
Kheniser KG, Kashyap SR, Schauer PR, et al. Prevalence of anemia in subjects randomized into Roux-en-Y gastric bypass or sleeve gastrectomy. Obes Surg. 2017;27(5):1381–6.PubMedCrossRef
37.
Nassour I, Almandoz JP, Adams-Huet B, et al. Metabolic syndrome remission after Roux-en-Y gastric bypass or sleeve gastrectomy. Diabetes Metab Syndr Obes. 2017;10:393–402.PubMedPubMedCentralCrossRef
38.
Carrasco F, Basfi-Fer K, Rojas P, et al. Calcium absorption may be affected after either sleeve gastrectomy or Roux-en-Y gastric bypass in premenopausal women: a 2-y prospective study. Am J Clin Nutr. 2018;108(1):24–32.PubMedCrossRef
39.
Bhandari M, Reddy M, Kosta S, et al. Laparoscopic sleeve gastrectomy versus laparoscopic gastric bypass: a retrospective cohort study. Int J Surg (Lond). 2019;67:47–53.CrossRef
40.
Antoniewicz A, Kalinowski P, Kotulecka KJ, et al. Nutritional deficiencies in patients after Roux-en-Y gastric bypass and sleeve gastrectomy during 12-month follow-up. Obes Surg. 2019; 29 (10):3277–3284.PubMedCrossRef
41.
Wei JH, Lee WJ. High incidence of secondary hyperparathyroidism in bariatric patients: comparing different procedures. Obes Surg. 2018;28(3):798–804.PubMedCrossRef
42.
von Drygalski A, Andris DA. Anemia after bariatric surgery: more than just iron deficiency. Nutr Clin Pract. 2009;24(2):217–26.CrossRef
43.
44.
Cummings DE, Overduin J, Foster-Schubert KE. Gastric bypass for obesity: mechanisms of weight loss and diabetes resolution. J Clin Endocrinol Metab. 2004;89(6):2608–15.PubMedCrossRef
45.
Weng TC, Chang CH, Dong YH, et al. Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open. 2015;5(7):e006964.PubMedPubMedCentralCrossRef
46.
Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-en-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26(5):926–32.PubMedCrossRef
47.
Thakkar K, Billa G. Treatment of vitamin B12 deficiency-methylcobalamine? Cyancobalamine? Hydroxocobalamin?-clearing the confusion. Eur J Clin Nutr. 2015;69(1):1–2.PubMedCrossRef
48.
Nielsen MJ, Rasmussen MR, Andersen CB, et al. Vitamin B12 transport from food to the body’s cells--a sophisticated, multistep pathway. Nat Rev Gastroenterol Hepatol. 2012;9(6):345–54.PubMedCrossRef
49.
50.
Shipton MJ, Thachil J. Vitamin B12 deficiency - a 21st century perspective. Clini Med (Lond). 2015;15(2):145–50.CrossRef
51.
Peterli R, Wolnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. Jama. 2018;319(3):255–65.PubMedPubMedCentralCrossRef
52.
Nazki FH, Sameer AS, Ganaie BA. Folate: metabolism, genes, polymorphisms and the associated diseases. Gene. 2014;533(1):11–20.CrossRefPubMed
53.
Khundmiri SJ, Murray RD, Lederer E. PTH and vitamin D. Comprehen Physiol. 2016;6(2):561–601.CrossRef
54.
Tian Z, Fan XT, Li SZ, Zhai T, Dong J. Changes in bone metabolism after sleeve gastrectomy versus gastric bypass: a meta-analysis. 2019.
55.
Al-Shoha A, Qiu S, Palnitkar S, et al. Osteomalacia with bone marrow fibrosis due to severe vitamin D deficiency after a gastrointestinal bypass operation for severe obesity. Endocr Pract. 2009;15(6):528–33.PubMedCrossRef
56.
Ferrone F, Pepe J, Danese VC, et al. The relative influence of serum ionized calcium and 25-hydroxyvitamin D in regulating PTH secretion in healthy subjects. Bone. 2019;125:200–6.PubMedCrossRef
57.
Blom-Hogestol IK, Hewitt S, Chahal-Kummen M, et al. Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass. Bone. 2019;127:436–45.PubMedCrossRef
58.
Calvo MS, Moshfegh AJ, Tucker KL. Assessing the health impact of phosphorus in the food supply: issues and considerations. Adv Nutr (Bethesda). 2014;5(1):104–13.CrossRef
59.
Cipriani C, Pepe J, Colangelo L, et al. Vitamin D and secondary hyperparathyroid states. Front Horm Res. 2018;50:138–48.PubMedCrossRef
60.
Burt LA, Billington EO, Rose MS, et al. Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength: a randomized clinical trial. Jama. 2019;322(8):736–45.PubMedPubMedCentralCrossRef
61.
Bloomberg RD, Fleishman A, Nalle JE, et al. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145–54.CrossRefPubMed
62.
Ziegler O, Sirveaux MA, Brunaud L, et al. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009;35(6 Pt 2):544–57.CrossRefPubMed
63.
Kuin C, den Ouden F, Brandts H, Deden L. Treatment of severe protein malnutrition after bariatric surgery. Obes Surg. 2019; 29 (10):3095–3102.CrossRefPubMed
64.
Schubert ML. Physiologic, pathophysiologic, and pharmacologic regulation of gastric acid secretion. Curr Opin Gastroenterol. 2017;33(6):430–8.CrossRefPubMed
Metadata
Title
In Terms of Nutrition, the Most Suitable Method for Bariatric Surgery: Laparoscopic Sleeve Gastrectomy or Roux-en-Y Gastric Bypass? A Systematic Review and Meta-analysis
Authors
Lihu Gu
Rongrong Fu
Ping Chen
Nannan Du
Siqi Chen
Danyi Mao
Bangsheng Chen
Feiyan Mao
Parikshit Asutosh Khadaroo
Qiong Jin
Publication date
01-05-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04488-2

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