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01-11-2020 | Obesity | Original Contributions

Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass in Elderly Bariatric Patients: Safety and Efficacy—a Systematic Review and Meta-analysis

Authors: Sachin S. Shenoy, Andrew Gilliam, Ahmed Mehanna, Venkatesh Kanakala, Gopinath Bussa, Talvinder Gill, Katherine Sanderson, Y. K. S. Viswanath, Venkatesh Shanmugam

Published in: Obesity Surgery | Issue 11/2020

Abstract

Introduction

Obesity is a chronic disease due to excess fat storage, a genetic predisposition, and environmental contribution where surgery offers a viable treatment option. The surgical treatment of obesity in the elderly population (> 55 years) remains controversial.

Purpose

To evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in elderly bariatric patients.

Materials and Methods

Data was sourced from MEDLINE, EMBASE, CINAHL, PubMed, and Cochrane databases for peer-reviewed, randomized controlled trials, and observational studies in the English language were searched from the year 1991 until 2019. From the extracted data, early and late procedural complications and mortality were used as safety outcomes. Weight loss was the primary outcome for effectiveness while the resolution of obesity-related comorbidities was included as secondary outcomes. The Review Manager (Rev Man 5.3)^™ software was used for statistical analysis.

Results

Of the forty-one screened studies, nine studies were included in the final analysis. There was no difference between LSG and LRYGB regarding early complications and mortality 3.6% versus 5.8% (p = 0.15) and 0.1% versus 0.8% (p = 0.27). Patients who underwent LRYGB had more late complications compared with those who underwent LSG (0.07% and 0.03%, p = 0.001). There was no difference in terms of weight loss at the end of 1 year. Patients who underwent LRYGB had a better resolution of obesity-related comorbidities, not statistically significant.

Conclusion

LRYGB has better efficacy when compared with LSG. However, high-risk elderly patients should be considered for LSG given the lesser morbidity and comparable efficacy with LRYGB.

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Title: Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass in Elderly Bariatric Patients: Safety and Efficacy—a Systematic Review and Meta-analysis
Authors: Sachin S. Shenoy
Andrew Gilliam
Ahmed Mehanna
Venkatesh Kanakala
Gopinath Bussa
Talvinder Gill
Katherine Sanderson
Y. K. S. Viswanath
Venkatesh Shanmugam
Publication date: 01-11-2020
Publisher: Springer US
Keywords: Obesity
Obesity
Sleeve Gastrectomy
Bariatric Surgery
Bariatric Surgery
Published in: Obesity Surgery / Issue 11/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-020-04819-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Roux-en-Y Gastric Bypass in Elderly Bariatric Patients: Safety and Efficacy—a Systematic Review and Meta-analysis

Abstract

Introduction

Purpose

Materials and Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Purpose

Materials and Methods

Results

Conclusion

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