The results of a three year case controlled study show that laparoscopic sleeve gastrectomy compares favorably to laparoscopic Roux-en-Y gastric bypass surgery in terms of surgical results, weight progression, and resolution of comorbid conditions.
Sleeve gastrectomy, also referred to as the gastric sleeve, has become a popular type of weight loss surgery among bariatric surgeons and patients. The operation involves reducing the size of the stomach in order to limit food intake and promote weight loss in morbidly obese patients.
Unlike gastric bypass surgery, sleeve gastrectomy does not involve cutting and rerouting of the small intestine or bypassing of the natural stomach outlet. This makes it less invasive and reduces many of the functional and nutritional complications associated with gastric bypass surgery, including malabsorption.
For this study, researchers set out to compare patient outcomes achieved with laparoscopic sleeve gastrectomy (LSG) to laparoscopic Roux-en-Y gastric bypass (LRYGB).
To this end, from January 2006 to September 2009, they selected 811 patients undergoing LSG as a primary procedure and matched them by age, body mass index (BMI) and gender to 786 patients undergoing LRYGB. They analyzed patient outcomes including complication rate, mortality, and percent excess weight loss (%EWL) after 1, 2, and 3 years.
The data showed LSG had comparable results to LRYGB:
- Mean operative time was less for LSG (76 min) vs LRYGB (106 min)
- Average hospital stay was shorter for LSG (2.8 days) vs LRYGB (3.4 days)
- Early complications were less for LSG (2.9%) vs LRYGB (7.1%)
- Suture leak was less for LSG (0.5%) vs LRYGB (0.7%)
- Average %EWL at 1 year was 86.4 for LSG and 97.2 for LRYGB
- Average %EWL at 2 years was 84.1 for LSG and 94.6 for LRYGB
- Average %EWL at 3 years was 86.8 for LSG and 93.1 for LRYGB
- Resolution of diabetes was 90.9% for LSG and 86.6% for LRYGB
For many years, the gastric sleeve procedure was performed only as the restrictive component of a staged duodenal switch weight loss surgery. It has only been in recent years that it has gained acceptance as a primary bariatric procedure.
The outcomes achieved by patients in this study support laparoscopic sleeve gastrectomy as an acceptable primary bariatric procedure for obesity with results comparable to laparoscopic Roux-en-Y gastric bypass.
Source: Study titled “Laparoscopic Roux-EN-Y Gastric Bypass Vs Laparoscopic Sleeve Gastrectomy: A Case Control Study And 3 Year Follow-Up,” published online in the September 22, 2011 issue of Surgery for Obesity and Related Diseases (SOARD), The Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS).