Skip to main content
Top
Published in: Obesity Surgery 2/2011

01-02-2011 | Clinical Research

Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity. A Prospective Study of 117 Patients

Authors: Jose Luis Leyba, Salvador Navarrete Aulestia, Salvador Navarrete Llopis

Published in: Obesity Surgery | Issue 2/2011

Login to get access

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. In this study, we prospectively compared both techniques in order to establish whether there is any superiority of one over the other based on morbidity and effectiveness. From January 2008 to December 2008, 117 obese patients with indication for bariatric surgery were assigned by patient choice after informed consent to either a LRYGB procedure (n = 75) or a LSG procedure (n = 42). We determined operative time, length of stay, morbidity, co-morbidity outcomes, and excess weight loss at 1 year postoperative. Both groups were comparable in age, sex, body mass index, and co-morbidities. Mean operative time of LSG was 82 min while LRYGB was 98 min (p < 0.05). Differences in length of stay, major complications, improvement in co-morbidities, and excess weight loss were not significant (p > 0.05). One year after surgery, average excess weight loss was 86% in LRYGB and 78.8% in LSG (p > 0.05). In the short term, both techniques are comparable regarding safety and effectiveness, so not one procedure is clearly superior to the other.
Literature
1.
go back to reference Satia-Abouta J. Dietary acculturation: definition, process, assessment, and implications. IJHE. 2003;4:71–86. Satia-Abouta J. Dietary acculturation: definition, process, assessment, and implications. IJHE. 2003;4:71–86.
2.
go back to reference Lacy A, Delgado S. Controversias en Cirugía Laparoscópica de la obesidad. Contraindicaciones y límites de la cirugía laparoscópica. Cir Esp. 2004;75:287–9. Lacy A, Delgado S. Controversias en Cirugía Laparoscópica de la obesidad. Contraindicaciones y límites de la cirugía laparoscópica. Cir Esp. 2004;75:287–9.
3.
go back to reference Samuel I, Mason E, Renquist K, et al. Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry. Am J Surg. 2006;192:657–62.CrossRefPubMed Samuel I, Mason E, Renquist K, et al. Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry. Am J Surg. 2006;192:657–62.CrossRefPubMed
4.
go back to reference Nguyen NT, Goldman C, Rosenquist J, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and cost. Ann Surg. 2001;234:279–91.CrossRefPubMed Nguyen NT, Goldman C, Rosenquist J, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and cost. Ann Surg. 2001;234:279–91.CrossRefPubMed
6.
go back to reference Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:41. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:41.
7.
go back to reference Søvik TT, Aasheim ET, Kristinsson J, et al. Establishing laparoscopic Roux-en-Y gastric bypass: perioperative outcome and characteristics of the learning curve. Obes Surg. 2009;19:158–65.CrossRefPubMed Søvik TT, Aasheim ET, Kristinsson J, et al. Establishing laparoscopic Roux-en-Y gastric bypass: perioperative outcome and characteristics of the learning curve. Obes Surg. 2009;19:158–65.CrossRefPubMed
8.
go back to reference Stephens DJ, Saunders JK, Belsley S, et al. Short-term outcomes for super-super obese (BMI > or =60 kg/m2) patients undergoing weight loss surgery at a high-volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and open tubular gastric bypass. Surg Obes Relat Dis. 2008;4:408–15.CrossRefPubMed Stephens DJ, Saunders JK, Belsley S, et al. Short-term outcomes for super-super obese (BMI > or =60 kg/m2) patients undergoing weight loss surgery at a high-volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and open tubular gastric bypass. Surg Obes Relat Dis. 2008;4:408–15.CrossRefPubMed
9.
go back to reference Aggarwal S, Kini SU, Herron D. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3:189–94.CrossRefPubMed Aggarwal S, Kini SU, Herron D. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3:189–94.CrossRefPubMed
10.
go back to reference Baltazar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.CrossRef Baltazar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.CrossRef
11.
go back to reference Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRefPubMed Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRefPubMed
12.
go back to reference Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.CrossRefPubMed Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.CrossRefPubMed
13.
go back to reference Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.CrossRefPubMed Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.CrossRefPubMed
14.
go back to reference Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17:1442–50.CrossRefPubMed Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17:1442–50.CrossRefPubMed
15.
go back to reference Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol. 2008;14:821–7.CrossRefPubMed Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol. 2008;14:821–7.CrossRefPubMed
16.
go back to reference Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18:560–5.CrossRefPubMed Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18:560–5.CrossRefPubMed
17.
go back to reference Kasalicky M, Michalsky D, Housova J, et al. Laparoscopic sleeve gastrectomy without an over-sewing of the staple line. Obes Surg. 2008;18:1257–62.CrossRefPubMed Kasalicky M, Michalsky D, Housova J, et al. Laparoscopic sleeve gastrectomy without an over-sewing of the staple line. Obes Surg. 2008;18:1257–62.CrossRefPubMed
18.
go back to reference Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.CrossRefPubMed Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.CrossRefPubMed
19.
go back to reference Fuks D, Verhaeghe P, Brehant O, et al. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery. 2009;145:106–13.CrossRefPubMed Fuks D, Verhaeghe P, Brehant O, et al. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery. 2009;145:106–13.CrossRefPubMed
20.
go back to reference Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.CrossRefPubMed Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.CrossRefPubMed
21.
go back to reference Rubin M, Yehoshua RT, Stein M, et al. Laparoscopic sleeve gastrectomy with minimal morbidity. Early results in 120 morbidly obese patients. Obes Surg. 2008;18:1567–70.CrossRefPubMed Rubin M, Yehoshua RT, Stein M, et al. Laparoscopic sleeve gastrectomy with minimal morbidity. Early results in 120 morbidly obese patients. Obes Surg. 2008;18:1567–70.CrossRefPubMed
22.
go back to reference Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12:662–7.CrossRefPubMed Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12:662–7.CrossRefPubMed
23.
go back to reference Ross MD, Gagner M. The first International Consensus Summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRef Ross MD, Gagner M. The first International Consensus Summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.CrossRef
24.
go back to reference Felberbauer FX, Langer F, Shakeri-Manesch S, et al. Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obes Surg. 2008;18:814–8.CrossRefPubMed Felberbauer FX, Langer F, Shakeri-Manesch S, et al. Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obes Surg. 2008;18:814–8.CrossRefPubMed
25.
go back to reference Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and paptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy. A prospective, double blind study. Ann Surg. 2008;247:401–7.CrossRefPubMed Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and paptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy. A prospective, double blind study. Ann Surg. 2008;247:401–7.CrossRefPubMed
26.
go back to reference Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMed Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMed
27.
go back to reference Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250:234–41.CrossRefPubMed Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250:234–41.CrossRefPubMed
28.
go back to reference 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;20:447–53.CrossRefPubMed 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;20:447–53.CrossRefPubMed
Metadata
Title
Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity. A Prospective Study of 117 Patients
Authors
Jose Luis Leyba
Salvador Navarrete Aulestia
Salvador Navarrete Llopis
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 2/2011
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-010-0279-8

Other articles of this Issue 2/2011

Obesity Surgery 2/2011 Go to the issue