Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study

Ahmed, Bestoun; King, Wendy C.; Gourash, William; Belle, Steven H.; Hinerman, Amanda; Pomp, Alfons; Dakin, Greg; Courcoulas, Anita P.

doi:10.1016/j.surg.2018.06.008

Cited by 77 publications

(30 citation statements)

References 24 publications

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“…A 65,000-patient retrospective multicenter cohort demonstrated 6.7% greater total weight loss after RYGB compared to SG at 5 year follow up [11]. In a longitudinal study, mean weight loss at 7 years follow up was significantly higher in RYGB (30.4%) vs SG (23.6%) [12]. A meta-analysis of over 5000 patients showed superior weight loss after RYGB with a mean difference of 17% at greater than 5 years follow up [13].…”

Section: Introductionmentioning

confidence: 92%

Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

et al. 2020

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Background Laparoscopic sleeve gastrectomy (SG) has surpassed Roux-en-Y gastric bypass (RYGB) as the most prevalent bariatric procedure worldwide. While RYGB and SG demonstrate equivalent short-term weight loss, long-term weight loss tends to be greater after RYGB. Differences in the effect of these procedures on gastrointestinal hormones that regulate energy homeostasis are felt to partially underlie differences in outcomes. The objective of this study was to prospectively quantify blood levels of gut hormones of energy and glucose homeostasis at one year follow up to delineate possible reasons for greater efficacy of RYGB over SG in achieving weight loss. Methods Patients undergoing SG (n = 19) and RYGB (n = 40) were studied before surgery and at 2,12, 26, and 52 weeks postoperatively. Blood samples drawn in the fasted state and after a liquid mixed meal were assayed at baseline, 26, and 52 weeks for peptide YY (PYY), glucagon-like peptide-1 (GLP-1), ghrelin, insulin, glucose, and leptin. Fasting and postprandial appetitive sensations were assessed by visual analog scale. Results At 1 year there was greater weight loss in RYGB compared with SG patients (30% vs 27%; P = 0.03). Area under the curve (AUC) after the mixed meal for PYY was greater in RYGB patients (P<0.001). RYGB patients had significant increases in GLP-1 AUC compared to baseline (P = 0.002). Ghrelin levels decreased only after SG compared to baseline (P<0.001) but were not significantly different from RYGB. There was a trend toward decreased sweet cravings in RYGB patients (P = 0.056).

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Section: Introductionmentioning

confidence: 92%

Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

et al. 2020

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“…By reducing food intake and nutrition absorption, bariatric surgery is an effective treatment option for not only long-term weight loss [1] but also improving visceral fat and declining the risk of cardiovascular diseases [2], significantly ameliorating obesity-related comorbidities. The most common bariatric surgeries for obesity therapy are Roux-en-Y gastric bypass (RYGB) [3], sleeve gastrectomy [4], and sleeve gastrectomy with jejunal bypass (SGJB) [5]. RYGB surgery could reduce food intake and absorption by directly linking small stomach capsule and small intestine, which has been studied earlier and performed more frequently in patients with weight loss and diabetes.…”

Section: Introductionmentioning

confidence: 99%

Comparative Effects of Three Kinds of Bariatric Surgery: A Randomized Case–Control Study in Obese Patients

et al. 2019

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Introduction: Laparoscopic bariatric surgery is necessary for obese patients who cannot control body weight through daily diet and exercise, or other non-surgical ways. Three kinds of laparoscopic bariatric surgery, namely Roux-en-Y gastric bypass, sleeve gastrectomy, and sleeve gastrectomy with jejunal bypass, are available for weight loss in clinical practice, but their comparative effects are unclear. In this study, these were compared to illustrate their clinical effects. Methods: A case-control study was conducted on 175 participants who fulfilled the inclusion criteria of laparoscopic bariatric surgery, while the controls were the same subjects before and after surgery, as well as with different surgeries specifically. Standardized weight loss measures were compared using analysis of covariance, with months from surgery as the covariant, including percentage total weight loss and excess body mass index (BMI) loss. Results: A total of 175 patients were enrolled in this study (age 38 ± 10 years; BMI 46 ± 5 kg/ m 2), with a mean postsurgery follow-up of 18 ± 6 months. No significant difference was included among the enlisted patients before bariatric surgery. However, after surgery according to personal health indexes of patients and professional assessment by doctors, patients specifically receiving one of Roux-en-Y gastric bypass, sleeve gastrectomy, and sleeve gastrectomy with jejunal bypass had no significant difference between weight loss and BMI, while the most important factors were dietary control and exercise after bariatric surgery. Conclusion: This study suggests that bariatric surgery is only a prerequisite for weight loss, and the long-term dietary control and exercise can help patients achieve optimal weight loss. Dan Luo and Qingling Yang are co-first authors.

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“…The use of less force has been previously validated as being a good indicator of proper, more respectful and safer tissue-handling [20,21]. The use of less force is, in other studies, also a recurring indicator of more experience in performing the action or more experience with tissue and instrument handling as seen in experts compared to novices [22]. One can interpret this as that the action is performed more subtle and with more "feeling", indicating better anticipation to the tissue properties.…”

Section: Discussionmentioning

confidence: 96%

Haptic exploration improves performance of a laparoscopic training task

et al. 2020

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Background Laparoscopy has reduced tactile and visual feedback compared to open surgery. There is increasing evidence that visual and haptic information converge to form a more robust mental representation of an object. We investigated whether tactile exploration of an object prior to executing a laparoscopic action on it improves performance. Methods A prospective cohort study with 20 medical students randomized in two different groups was conducted. A silicone ileocecal model, on which a laparoscopic action had to be performed, was used inside an outside a ForceSense box trainer. During the pre-test, students either did a combined manual and visual exploration or only visual exploration of the caecum model. To track performance during the trials of the study we used force, motion and time parameters as representatives of technical skills development. The final trial data were used for statistical comparison between groups. Results All included time and motion parameters did not show any clear differences between groups. However, the force parameters Mean force non-zero (p = 004), Maximal force (p = 0.01) Maximal impulse (p = 0.02), Force volume (p = 0.02) and SD force (p = 0.01) showed significant lower values in favour of the tactile exploration group for the final trials. Conclusions By adding haptic sensation to the existing visual information during training of laparoscopic tasks on lifelike models, tissue manipulation skills improve during training.

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Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study

Abstract: Higher-risk or super-obese participants after sleeve gastrectomy lost less weight than did matched Roux-en-Y gastric bypass counterparts throughout 7 years. Both groups exhibited improvements in comorbidities from presurgery through 5 years.

Cited by 77 publications

References 24 publications

Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

Prospective study of gut hormone and metabolic changes after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

Comparative Effects of Three Kinds of Bariatric Surgery: A Randomized Case–Control Study in Obese Patients

Haptic exploration improves performance of a laparoscopic training task

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