Randomized Clinical Trial of Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Management of Patients with BMI &lt; 50 kg/m2

Kehagias, Ioannis; Karamanakos, Stavros; Αργέντου, Μαρία-Ιωάννα; Kalfarentzos, Fotis

doi:10.1007/s11695-011-0479-x

Cited by 314 publications

(214 citation statements)

References 46 publications

(71 reference statements)

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“…The initial search identified 581 publications, of which 576 were excluded, leaving 5 publications for analysis. [14][15][16][17][18] One study, 19 which was the subset of another study, 14 was excluded; another study 20 was the republication of the trial by Woelnerhanssen and colleagues 15 and was also excluded. The 5 trials of LRYGB and LSG for morbid obesity or T2DM with a total of 396 patients that we included in our analysis were retrieved from the electronic databases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Lai

et al. 2013

CJS

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Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for treating morbid obesity is becoming more popular. We compared both techniques to evaluate their efficacy in treating morbid obesity or type 2 diabetes mellitus (T2DM). Methods:We searched the Cochrane Controlled Trials Register databases, Medline, Embase, ISI databases and the Chinese Biomedical Literature Database to identify randomized controlled trials (RCTs) of LRYGB and LSG for morbid obesity or T2DM published in any language. Statistical analyses were carried out using RevMan software.Results: Five worldwide RCTs with 196 patients in the LRYGB group and 200 in the LSG group were included in our analysis. Compared with patients who had LSG, those who had LRYGB had a higher remission rate of T2MD, lost more weight and had lower low-density lipoprotein, triglycerides, homeostasis model assessment index and insulin levels. There was no difference in the reoperation rate between the groups. However, patients treated with LRYGB had a higher incidence of complication than those treated with LSG. Conclusion:Our meta-analysis demonstrates that LRYGB is more effective than LSG for the surgical treatment of T2DM and control of metabolic syndrome. However, LSG is safer and has a reduced rate of complications. Further high-quality RCTs with long follow-up periods are needed to provide more reliable evidence.Contexte : La dérivation gastrique laparoscopique Roux-en-Y (DGRY) est l'une des interventions bariatriques les plus utilisées, et la gastrectomie longitudinale laparoscopique (GLL) gagne en popularité comme intervention en une seule étape pour le traitement de l'obésité morbide. Nous avons comparé les 2 techniques pour en évaluer l'efficacité dans le traitement de l'obésité morbide ou du diabète de type 2 (DT2).

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Section: Discussionmentioning

confidence: 99%

“…Three trials 14,17,18 reported the remission of T2DM, which was much better in the LRYGB group than in the LSG group. The meta-analysis revealed a significant difference between the 2 groups (OR 9.08, 95% CI 2.39-34.41, p = 0.001; Fig.…”

Section: Remission Of T2dmmentioning

confidence: 99%

Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Lai

et al. 2013

CJS

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“…But LSG is not complication-free at all and one of the major postoperative complication is still the staple line leak, which occurs in approximately 2.2-2.4% of patients [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. There are various factors which influence the risk of leak.…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays it has been accepted as a definitive stand-alone procedure due to the excellent results in terms of excess weight loss (%EWL) and control of comorbidities, with significant 3 and 5-year experiences that justify this recommendation [5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Outcomes after Sleeve Gastrostomy: Influence of the Calibrating Bougie

Ms¹,

Água²,

Ab³

et al. 2016

Gen Med

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Purpose: To analyze the outcomes of patients in whom we performed a SG depending on the calibrating bougie.Methods: Retrospective review of patients who underwent SG. Baseline characteristics were analyzed, and outcomes compared between groups. In order to identify the contribution of each predictor in the %EWL, a linear regression univariate and multivariate model was constructed.Results: 168 LSG were performed (120 women), mean age 42.9 years and BMI 51.1. Mortality rate of 0.3% and morbidity rate of 4.7%. No differences in terms of complications between both groups (5.8% vs 3.2%, p=0.735), while %EWL was statistically superior in the 40fr group (67.4±17.9 vs 58.1±15.6 at 24 months, p=0.012). Age, larger bougie size and arthropathy influenced negatively on the %EWL. In the multivariate analysis, the introduction of the variable "surgeon" produced a reduction of the effect of the bougie size in weight loss at 24 months (mean difference between groups is 7.5; 95% CI (3.4 -18.3); p=0.173).Conclusions: There are differences regarding %EWL in the medium term favoring the use of a 40Fr bougie against the 58 Fr one, with no differences in terms of complications. As well as the bougie, the surgeon plays an important role in the %EWL.

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“…Since its introduction in 2007, SG case volumes have increased dramatically, with published weight loss results comparable to RYGB. SG is considered a restrictive procedure; however, it has been increasingly recognized to have metabolic effects similar to those observed after RYGB (21). A recent 5-year outcomes study has reported successful SG results, with an 86% average EWL (22).…”

Section: Weight Lossmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Metabolic effects of bariatric surgery

Corcelles

Daigle

Schauer

2016

European Journal of Endocrinology

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Obesity is associated with an increased risk of type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, osteoarthritis, numerous cancers and increased mortality. It is estimated that at least 2.8 million adults die each year due to obesity-related cardiovascular disease. Increasing in parallel with the global obesity problem is metabolic syndrome, which has also reached epidemic levels. Numerous studies have demonstrated that bariatric surgery is associated with significant and durable weight loss with associated improvement of obesity-related comorbidities. This review aims to summarize the effects of bariatric surgery on the components of metabolic syndrome (hyperglycemia, hyperlipidemia and hypertension), weight loss, perioperative morbidity and mortality, and the long-term impact on cardiovascular risk and mortality.

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Randomized Clinical Trial of Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Management of Patients with BMI < 50 kg/m2

Cited by 314 publications

References 46 publications

Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials

Outcomes after Sleeve Gastrostomy: Influence of the Calibrating Bougie

MANAGEMENT OF ENDOCRINE DISEASE: Metabolic effects of bariatric surgery

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