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.
The purpose of this study was to compare long-term weight loss in patients undergoing
LRYGB and LSG.
University hospital, United States.
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.
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).
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.