Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: A case control study

• 作者: Harshit Garg Pratyusha Priyadarshini Rachna Chaudhary Samagra Agarwal Sandeep Aggarwal
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Bariatric 外科 Laparoscopic 袖子 gastrectomy Laparoscopic Roux-en-Y 胃绕过 重量损失 COMORBIDITIES
• 年，卷（期）: 2017,（4）
• 页码范围: 162-170
• 页数: 9页
• 分类号: R656.6

摘要

AIM To compare the impact of laparoscopic Roux-en-Y gastric bypass(LRYGB) and laparoscopic sleeve gastrectomy(LSG) on weight loss and obesity related comorbidities over two year follow-up via case control study design.METHODS Forty patients undergoing LRYGB, who completed their two year follow-up were matched with 40 patients undergoing LSG for age, gender, body mass index and presence of type 2 diabetes mellitus(T2DM). Data of these patients was retrospectively reviewed to compare the outcome in terms of weight loss and improvement in comorbidities, i.e., T2 DM, hypertension(HTN), obstructive sleep apnea syndrome(OSAS), hypothyroidism and gastroesophageal reflux disease(GERD).RESULTS Percentage excess weight loss(EWL%) was similar in LRYGB and LSG groups at one year follow-up(70.5% vs 66.5%, P = 0.36) while it was significantly greater for LRYGB group after two years as compared to LSG group(76.5% vs 67.9%, P = 0.04). The complication rate after LRYGB and LSG was similar(10% vs 7.5%,P = 0.99). The median duration of T2 DM and mean number of oral hypoglycemic agents were higher in LRYGB group than LSG group(7 years vs 5 years and 2.2 vs 1.8 respectively, P < 0.05). Both LRYGB and LSG had significant but similar improvement in T2 DM, HTN, OSAS and hypothyroidism. However, GERD resolved in all patients undergoing LRYGB while it resolved in only 50% cases with LSG. Eight point three percent patients developed new-onset GERD after LSG.CONCLUSION LRYGB has better outcomes in terms of weight loss two years after surgery as compared to LSG. The impact of LRYGB and LSG on T2 DM, HTN, OSAS and hypothyroidism is similar. However, LRYGB has significant resolution of GERD as compared to LSG.