Superior Gastric Reduction Procedure for Morbid Obesity; A Prospective, Randomized Trial

Abstract

A prospective randomized clinical trial was undertaken to compare the effects of gastric bypass with Roux-en-Y gastrojejunostomy and a gastric partitioning procedure. Operative groups were comparable, with regard to preoperative weight, age, sex, historic findings and operative complications. Post-operative weight loss was followed for one year. Patients receiving the gastric partitioning procedure showed significantly poorer weight loss as early as three months postoperatively than did those receiving gastric bypass. This poorer performance persisted throughout the study period.

The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation

“…A total of 15 RCTs compared different surgical procedures: eight RCTs comparing GB with GP, [45][46][47][48][49][50][51][52][53][54][55][56][57]61 two RCTs comparing GB with JB, [40][41][42]44 one RCT comparing VBG with horizontal GP, 38 one RCT comparing VBG with AGB, 35 two RCTs comparing open versus laparoscopic GB, 36,37 and one RCT that compared open versus laparoscopic ASGB. 43 Methodological quality varied between RCTs ( Table 7 ).…”

“…43 Methodological quality varied between RCTs ( Table 7 ). In all, 11 of the RCTs had proper random assignment, [35][36][37][38][40][41][42][43]45,47,[51][52][53][54][55][56][57]61 in three studies the method of randomisation was not stated, 46,[48][49][50] and in one study randomisation was substandard as hospital numbers were used. 44 Consecutive patients were included in five studies.…”

“…44 Consecutive patients were included in five studies. 37,38,45,47,[51][52][53][54][55][56] In three studies the sample size allowed adequately precise estimates of weight loss, as demonstrated by a sample size calculation. 37,43,45 All included studies were thought to have clear methods for measuring primary outcomes.…”

Bariatric Surgery for Obesity: A Systematic Review and Meta-Analysis

“…Four and five patients in the GBP and the VBG group respectively developed gall stone disease. 48 found the rate of early postoperative complications to be higher in the GBP group compared to the VBG group (17.8% vs 2.5%, P<0.05). One patient in the GBP group had a conversion to open procedure due to retrogastric adhesion; two patients developed anastomotic leak requiring reoperation; one developed intra-abdominal abscess requiring percutaneous drainage and total parenteral nutrition.…”

“…• Five RCTs compared Roux-en-Y gastric bypass (RYGB) with vertical banded gastroplasty (VBG) 44,[47][48][49][50] • Three RCTs compared vertical banded gastroplasty (VBG) with adjustable gastric banding (AGB) 45, 51, 52…”