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Published in: Obesity Surgery 2/2018

01-02-2018 | Original Contributions

Comparison of Outcomes Between Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in a Lebanese Bariatric Surgical Practice

Authors: Hanaa Dakour Aridi, Georges Khazen, Bassem Y. Safadi

Published in: Obesity Surgery | Issue 2/2018

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Abstract

Purpose

Long-term studies on the outcomes of bariatric surgery are still limited in the Middle East. The aim of this study is to compare the outcomes of laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) up to 5 years of follow-up.

Materials and Methods

A retrospective analysis of patients who underwent LRYGB and LSG was performed. The primary outcome was weight loss. Postoperative complications, operative time, and hospital length of stay were secondary outcomes.

Results

Four hundred patients underwent primary LSG and 175 patients underwent LRYGB between 2008 and 2013. Follow-up rates at 5 years were around 60%. Percent total weight loss was similar after 3, 4, and 5 years in both groups, averaging around 28%. Mean percentage of excess weight loss (%EWL) at 5 years was 72.0 ± 31.0% in the LSG group vs. 63.0 ± 21.0% in the LRYGB group (p = 0.03). Patients undergoing LRYGB had a significantly longer operative time as well as a longer hospital stay. No significant difference was found in the rates of short- and long-term complications between the two groups. However, patients undergoing LRYGB were more likely to develop small intestinal obstruction and iron-deficiency anemia.

Conclusions

Both LSG and LRYGB result in satisfactory weight loss within 5 years. Patients’ comorbidities and potential risks must be included in the choice of the appropriate bariatric procedure. LSG appears to give durable weight loss with less risk of major long-term complications.
Literature
1.
go back to reference Fahed AC, El-Hage-Sleiman AK, Farhat TI, et al. Diet, genetics, and disease: a focus on the middle east and north Africa region. J Nutr Metab. 2012;2012:109037.CrossRefPubMedPubMedCentral Fahed AC, El-Hage-Sleiman AK, Farhat TI, et al. Diet, genetics, and disease: a focus on the middle east and north Africa region. J Nutr Metab. 2012;2012:109037.CrossRefPubMedPubMedCentral
2.
go back to reference Haskins O. Obesity in the Middle East. Bariatric News. 2014;22:1–2. Haskins O. Obesity in the Middle East. Bariatric News. 2014;22:1–2.
3.
go back to reference Gilbert EW, Wolfe BM. Bariatric surgery for the management of obesity: state of the field. Plast Reconstr Surg. 2012;130:948–54.CrossRefPubMed Gilbert EW, Wolfe BM. Bariatric surgery for the management of obesity: state of the field. Plast Reconstr Surg. 2012;130:948–54.CrossRefPubMed
4.
go back to reference Li JF, Lai DD, Lin ZH, et al. Comparison of the long-term results of Roux-en-Y gastric bypass and sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis of randomized and nonrandomized trials. Surg Laparosc Endosc Percutan Tech. 2014;24(1):1–11.CrossRefPubMed Li JF, Lai DD, Lin ZH, et al. Comparison of the long-term results of Roux-en-Y gastric bypass and sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis of randomized and nonrandomized trials. Surg Laparosc Endosc Percutan Tech. 2014;24(1):1–11.CrossRefPubMed
5.
go back to reference Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux-en Y gastric bypass and sleeve gastrectomy for the treatment ofmorbid obesity in China: a 5-year outcome. Obes Surg. 2014;24(10):1617–24.CrossRefPubMed Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux-en Y gastric bypass and sleeve gastrectomy for the treatment ofmorbid obesity in China: a 5-year outcome. Obes Surg. 2014;24(10):1617–24.CrossRefPubMed
6.
go back to reference Buwen JP, Kammerer MR, Beekley AC, et al. Laparoscopic sleeve gastrectomy: the rightful gold standard weight loss surgery procedure. Surg Obes Relat Dis. 2015;11(6):1383–5.CrossRefPubMed Buwen JP, Kammerer MR, Beekley AC, et al. Laparoscopic sleeve gastrectomy: the rightful gold standard weight loss surgery procedure. Surg Obes Relat Dis. 2015;11(6):1383–5.CrossRefPubMed
7.
go back to reference Dakour Aridi H, Alami R, Tamim H et al. Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience. Surg Obes Relat Dis. 2015. Dakour Aridi H, Alami R, Tamim H et al. Long-term outcomes of laparoscopic sleeve gastrectomy: a Lebanese center experience. Surg Obes Relat Dis. 2015.
8.
go back to reference Dogan K, Gadiot RP, Aarts EO, et al. Effectiveness and safety of sleeve gastrectomy, gastric bypass, and adjustable gastric banding in morbidly obese patients: a multicenter, retrospective. Matched Cohort Study Obes Surg. 2015;25(7):1110–8.CrossRefPubMed Dogan K, Gadiot RP, Aarts EO, et al. Effectiveness and safety of sleeve gastrectomy, gastric bypass, and adjustable gastric banding in morbidly obese patients: a multicenter, retrospective. Matched Cohort Study Obes Surg. 2015;25(7):1110–8.CrossRefPubMed
9.
go back to reference Arman GA, Himpens J, Dhaenens J et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal refluxtreatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016. Arman GA, Himpens J, Dhaenens J et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal refluxtreatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016.
10.
go back to reference Brethauer SA, Kim J, el Chaar M. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.CrossRefPubMed Brethauer SA, Kim J, el Chaar M. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.CrossRefPubMed
12.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
13.
go back to reference Abdallah E, El Nakeeb A, Yousef T, et al. Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study). Obes Surg. 2014;24(10):1587–94.CrossRefPubMed Abdallah E, El Nakeeb A, Yousef T, et al. Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study). Obes Surg. 2014;24(10):1587–94.CrossRefPubMed
14.
go back to reference ElGeidie A, ElHemaly M, Hamdy E et al. The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial. Surg Obes Relat Dis. 2014. ElGeidie A, ElHemaly M, Hamdy E et al. The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial. Surg Obes Relat Dis.​ 2014.
15.
go back to reference Abd Ellatif ME, Abdallah E, Askar W, et al. Long term predictors of success after laparoscopic sleeve gastrectomy. Int J Surg. 2014;12(5):504–8.CrossRefPubMed Abd Ellatif ME, Abdallah E, Askar W, et al. Long term predictors of success after laparoscopic sleeve gastrectomy. Int J Surg. 2014;12(5):504–8.CrossRefPubMed
16.
go back to reference Mahdy T, Atia S, Farid M, et al. Effect of Roux-en Y gastric bypass on bone metabolism in patients with morbid obesity: Mansoura experiences. Obes Surg. 2008;18(12):1526–31.CrossRefPubMed Mahdy T, Atia S, Farid M, et al. Effect of Roux-en Y gastric bypass on bone metabolism in patients with morbid obesity: Mansoura experiences. Obes Surg. 2008;18(12):1526–31.CrossRefPubMed
17.
go back to reference Al Zabadi H, Daqour A, Hawari A, et al. Short-term outcomes of laparoscopic sleeve gastrectomy among obesity patients in the northern West Bank: a retrospective records review. BMC Res Notes. 2014;7:85.CrossRefPubMedPubMedCentral Al Zabadi H, Daqour A, Hawari A, et al. Short-term outcomes of laparoscopic sleeve gastrectomy among obesity patients in the northern West Bank: a retrospective records review. BMC Res Notes. 2014;7:85.CrossRefPubMedPubMedCentral
18.
go back to reference Abusnana S, Abdi S, Tagure B, et al. Bariatric surgery outcomes: a single-center study in the United Arab Emirates. Diabetes Metab Syndr Obes. 2015;8:461–71.PubMedPubMedCentral Abusnana S, Abdi S, Tagure B, et al. Bariatric surgery outcomes: a single-center study in the United Arab Emirates. Diabetes Metab Syndr Obes. 2015;8:461–71.PubMedPubMedCentral
20.
go back to reference Toolabi K, Arefanian S, Golzarand M, et al. Effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) on weight loss and biomarker parameters in morbidly obese patients: a 12-month follow-up. Obes Surg. 2011;21(12):1834–42.CrossRefPubMed Toolabi K, Arefanian S, Golzarand M, et al. Effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) on weight loss and biomarker parameters in morbidly obese patients: a 12-month follow-up. Obes Surg. 2011;21(12):1834–42.CrossRefPubMed
21.
go back to reference Alqahtani AR, Elahmedi MO. Pediatric bariatric surgery: the clinical pathway. Obes Surg. 2015;25(5):910–21.CrossRefPubMed Alqahtani AR, Elahmedi MO. Pediatric bariatric surgery: the clinical pathway. Obes Surg. 2015;25(5):910–21.CrossRefPubMed
22.
go back to reference Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. SurgGynecol Obstet. 1982;155:385–94. Reinhold RB. Critical analysis of long-term weight loss following gastric bypass. SurgGynecol Obstet. 1982;155:385–94.
23.
go back to reference Te Riele WW, Boerma D, Wiezer MJ, et al. Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg. 2010;97(10):1535–40.CrossRef Te Riele WW, Boerma D, Wiezer MJ, et al. Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg. 2010;97(10):1535–40.CrossRef
25.
go back to reference Schauer PR, Bhatt DL, Kirwan JP, et al. STAMPEDE investigators. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMedPubMedCentral Schauer PR, Bhatt DL, Kirwan JP, et al. STAMPEDE investigators. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMedPubMedCentral
26.
go back to reference Shah K, Johnny Nergard B, Stray Frazier K, et al. Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome in patients with morbid obesity. Surg Obes Relat Dis. 2016. Shah K, Johnny Nergard B, Stray Frazier K, et al. Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome in patients with morbid obesity. Surg Obes Relat Dis. 2016.
Metadata
Title
Comparison of Outcomes Between Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in a Lebanese Bariatric Surgical Practice
Authors
Hanaa Dakour Aridi
Georges Khazen
Bassem Y. Safadi
Publication date
01-02-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2849-5

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