A Comparison Between the Postoperative Complications of Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (RNYGB) in Patients With Morbid Obesity: A Meta-Analysis

Abstract

The most successful method for treating obesity is bariatric surgery. The two most common surgeries for treating morbid obesity are the laparoscopic Roux-en-Y gastric bypass (RNYGB) and the laparoscopic sleeve gastrectomy (LSG). However, there has not been a thorough analysis of the differences in their adverse effects. The aim of this study was to analyze if RNYGB and LSG had comparable postoperative complications and mortality. To that end, results from trials comparing those who underwent RNYGB and those who underwent LSG were combined. We explored the Cochrane Library, PubMed, EMBASE, and Web of Science databases for collecting pertinent data, and 10 RCTs were included in the study. Standard deviations were used to determine the risk ratio (RR) and the 95% confidence interval (CI). No substantial difference in mortality was observed between the two procedures. However, our pooled analysis showed that patients who underwent RNYGB needed some reoperation at a higher rate compared to those who had LSG, with a pooled RR of 0.64 (95% CI: 0.42-0.98; p=0.04). Patients who had LSG suffered from fewer postoperative sequelae. While the risk of other complications was higher in RNYGB, our analysis showed that the frequency of gastroesophageal reflux disease (GERD) after LSG was greater than after RNYGB, with a pooled RR of 4.00 (95% CI: 2.55-6.28; p<0.001). Based on the above-mentioned findings, RNYGB and LSG had comparable mortality rates; however, patients who underwent LSG had a reduced risk of complications and reoperations after surgery compared to those who had RNYGB.

Factors influencing body weight one year after bariatric surgery

“…This pattern was maintained until the 12th month (5.8% vs 14.7%, respectively; P = .031). [31] In addition, this study showed that at the 12-month postoperative follow-up, there was a significantly decreasing rate of gallstone formation in the UDCA group compared with control group 4 (4.2%) and 24 patients (25.2%), respectively. And that proved the regular intake of UDCA 6 months after surgery reduced incidence of cholelithiasis after OAGB.…”

“…On the other hand, the incidence of gastroesophageal reflux disease after LSG was greater than that in RYGB. [31] Also, a study confirmed that increase risk of gastroesophageal reflux disease and Barrett esophagus post LSG. [32] The rate of reoperation was higher in the patient who underwent RYGB as compared to those who had LSG.…”

“…Also, the risk of other complications such as gastric outlet obstruction wound infection, pneumonia, dehydration, and stricture formation was observed more in RYGB. [31] In addition, a study showed that dumping syndrome occurs with any gastric procedure but more expected after RYGB. [10] Nutritional deficiencies are less common with LSG compared with malabsorptive surgeries.…”

“…Also, the risk of other complications such as gastric outlet obstruction wound infection, pneumonia, dehydration, and stricture formation was observed more in RYGB. [31]…”

Leveraging Artificial Intelligence and Machine Learning to Optimize Enhanced Recovery After Surgery (ERAS) Protocols

“…Enhanced recovery after surgery (ERAS) protocols have revolutionized perioperative care by employing evidence-based practices to enhance patient recovery following surgical procedures [ 1 ]. These protocols encompass a multidisciplinary approach focusing on preoperative, intraoperative, and postoperative interventions to accelerate patient recovery, reduce complications, and shorten hospital stays.…”