Highlights
- •There is limited long term data of patients after laparoscopic sleeve gastrectomy
- •75 sleeve patients identified and matched by age, sex, and BMI with bypass patients
- •Bypass patients had significantly more weight loss than sleeve patients
- •No difference seen in patients with follow-up in bariatric clinic vs other setting
Abstract
Background
Laparoscopic sleeve gastrectomy (LSG) has demonstrated excellent short-term outcomes.
However, existing studies suffer from loss to follow-up, and most long-term data focus
on laparoscopic Roux-en-Y gastric bypass (LRYGB). This study compares weight loss
in patients ≥5 years from LSG with that in matched patients who underwent LRYGB.
Objectives
The purpose of this study was to compare long-term weight loss in patients undergoing
LRYGB and LSG.
Setting
University hospital, United States.
Methods
We retrospectively evaluated patients who underwent LSG before August 2012 with follow-up
data ≥5 years. LSG patients were matched 1:1 with LRYGB patients by sex, age at surgery,
and preoperative body mass index. Univariate and multivariate analyses were performed
with weight loss at the longest duration the primary outcome.
Results
One-hundred and sixty-five patients underwent LSG during the study period. Long-term
follow-up data (≥5 years) were available for 85 patients (52%). There were no preoperative
differences between those with and without follow-up data. Six LSG patients (7%) were
excluded because they underwent reoperation that altered intestinal anatomy. Of the
79 patients remaining, 75 were matched with post-LRYGB patients. The average follow-up
period was 6.4 years for LSG patients and 6.5 years for LRYGB patients (P = .08, not significant). Change in body mass index was 6.81 kg/m2 for LSG patients and 13.11 kg/m2 for LRYGB patients. Percentage of total body weight loss was 15.25% for LSG patients
and 28.73% for LRYGB patients. Percentage of excess body weight loss was 37% for LSG
patients and 67% for LRYGB patients (P < .0001). Weight loss for LSG patient follow-up in clinic versus outside the clinic
was 46% versus 34% (P = .18, not significant).
Conclusions
LSG is now the most common bariatric surgery in the United States. Long-term data
are needed to confirm that observed short-term favorable outcomes are maintained.
Recent studies have produced divergent results. We observed significantly less weight
loss at ≥5 years in LSG patients compared with matched LRYGB patients.
Key words
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References
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Article info
Publication history
Published online: March 17, 2022
Accepted:
March 13,
2022
Received:
September 9,
2021
Identification
Copyright
© 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
