Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Data from IFSO-European Chapter Center of Excellence Program

Obes Surg. 2017 Apr;27(4):847-855. doi: 10.1007/s11695-016-2395-6.

Abstract

Background: The purpose of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) performed in Institutions participating in IFSO-European Chapter, Center of Excellence (COE) program.

Methods: Since the initiation of the program in January 2010, 6413 SGs and 10,622 RYGBPs performed as primary procedures by December 31, 2014, with at least 12-month follow-up, were retrospectively compared.

Results: There were steadily increasing numbers of patients underwent SG from 2010 to 2015. Early (<30 days) postoperative complication rate of 3.02 % for RYGBP was significantly higher than 2.12 % seen after SG (p = 0.0006). Only two patients, one in each group, died in the first 30 postoperative days (0.016 % mortality for SG vs 0.009 % for RYGBP-NS). From SG group, 103 patients, 1.61 %, and 206 patients, 1.94 %, from RYGBP group required readmission following hospital discharge in the first 30 days following bariatric surgery-NS. From the readmitted patients in the SG group, 75.72 % were reoperated vs 50.50 % in the RYGBP group (p < 0.0001). SG patients were heavier (BMI 44.93 vs 43.96 kg/m2, p < 0.0001). However, significantly better % excess weight loss were seen following RYGBP in all postoperative years (60.36 vs 67.72 %, p = 0.002 at fifth year). Better remission rates were seen for diabetes, arterial hypertension, dyslipidemia, and sleep apnea syndrome after RYGBP in the first postoperative year.

Conclusions: Both procedures were performed with very low complications, mortality, readmissions, and reoperations rate. Better weight loss was observed following RYGBP, the first five postoperative years.

Keywords: Bariatric surgery; Center of Excellence; John Melissas and Konstantinos Stavroulakis contributed equally in this article.; Morbid obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Anastomosis, Roux-en-Y / methods
  • Anastomosis, Roux-en-Y / mortality
  • Europe / epidemiology
  • Female
  • Gastrectomy / methods*
  • Gastrectomy / mortality
  • Gastrectomy / standards
  • Gastric Bypass / methods*
  • Gastric Bypass / mortality
  • Gastric Bypass / standards
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / surgery
  • Postoperative Period
  • Reoperation / mortality
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Weight Loss