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

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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.

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References

  1. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  2. Melissas J. IFSO guidelines for safety, quality and excellence in bariatric surgery. Obes Surg. 2008;18(5):497–500.

    Article  PubMed  Google Scholar 

  3. Melissas J, Torres A, Yaskov Y, Lemmens LAG, et al. IFSO–European chapter, Center of Excellence Program for bariatric and metabolic surgery. In: Agrawal S, editor. Obesity, bariatric and metabolic surgery—a practical guide. Switzerland: Springer International Publishing; 2015. p. 575–80.

    Google Scholar 

  4. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.

    Article  CAS  PubMed  Google Scholar 

  5. DeMaria EJ, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database.Surg Obes Relat Dis. 2010;6(4):347–55.

    Article  PubMed  Google Scholar 

  6. Nguyen NT, Nguyen B, Nguyen VQ, et al. Outcomes of bariatric surgery performed at accredited vs non-accredited centers. J Am Coll Surg. 2012;215:467–74.

    Article  PubMed  Google Scholar 

  7. Young MT, Gebhart A, Phelan MJ, et al. Use and outcomes of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass: analysis of the American College of Surgeons NSQIP. J Am Coll Surg. 2015;220(5):880–5.

    Article  PubMed  Google Scholar 

  8. Zerrweck C, Sepúlveda EM, Maydón HG, et al. Laparoscopic gastric bypass vs. sleeve gastrectomy in the super obese patient: early outcomes of an observational study. Obes Surg. 2014;24(5):712–7.

    Article  PubMed  Google Scholar 

  9. Huang CK, Garg A, Kuao HC, et al. Bariatric surgery in old age: a comparative study of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in an Asia center of excellence. J Biomed Res. 2015;29(2):118–24.

    PubMed  PubMed Central  Google Scholar 

  10. Pallati P, Buettner S, Simorov A, et al. Trends in adolescent bariatric surgery evaluated by UHC database collection. Surg Endosc. 2012;26(11):3077–81.

    Article  PubMed  Google Scholar 

  11. Villamere J, Gebhart A, Vu S, Nguyen NT. Body mass index is predictive of higher in-hospital mortality in patients undergoing laparoscopic gastric bypass but not laparoscopic sleeve gastrectomy or gastric banding. Am Surg. 2014;80(10):1039–43.

    PubMed  Google Scholar 

  12. Park JY, Kim YJ. Laparoscopic gastric bypass vs sleeve gastrectomy in obese Korean patients. World J Gastroenterol. 2015;21(44):12612–9.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Iannelli A, Anty R, Schneck AS, et al. Inflammation, insulin resistance, lipid disturbances, anthropometrics, and metabolic syndrome in morbidly obese patients: a case control study comparing laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy. Surgery. 2011;149(3):364–70.

    Article  PubMed  Google Scholar 

  14. Li P, Fu P, Chen J, et al. Laparoscopic Roux-en-Y gastric bypass vs. laparoscopic sleeve gastrectomy for morbid obesity and diabetes mellitus: a meta-analysis of sixteen recent studies. Hepato-Gastroenterology. 2013;60(121):132–7.

    PubMed  Google Scholar 

  15. Gupta PK, Franck C, Miller WJ, et al. Development and validation of a bariatric surgery morbidity risk calculator using the prospective, multicenter NSQIP dataset. J Am Coll Surg. 2011;212(3):301–9.

    Article  PubMed  Google Scholar 

  16. Saunders JK, Ballantyne GH, Belsley S, et al. 30-day readmission rates at a high volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass. Obes Surg. 2007;17(9):1171–7.

    Article  PubMed  Google Scholar 

  17. Peterli R, Borbély Y, Kern B, et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258(5):690–4.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Weller WE, Rosati C, Hannan EL. Relationship between surgeon and hospital volume and readmission after bariatric operation. J Am Coll Surg. 2007;204(3):383–91.

    Article  PubMed  Google Scholar 

  19. Helmiö M, Victorzon M, Ovaska J, et al. SLEEVEPASS: a randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results. Surg Endosc. 2012;26(9):2521–6.

    Article  PubMed  Google Scholar 

  20. Zak Y, Petrusa E, Gee DW. Laparoscopic Roux-en-Y gastric bypass patients have an increased lifetime risk of repeat operations when compared to laparoscopic sleeve gastrectomy patients. Surg Endosc. 2015.

  21. Iannelli A, Anty R, Schneck AS, et al. Evolution of low-grade systemic inflammation, insulin resistance, anthropometrics, resting energy expenditure and metabolic syndrome after bariatric surgery: a comparative study between gastric bypass and sleeve gastrectomy. J Visc Surg. 2013;150(4):269–75.

    Article  CAS  PubMed  Google Scholar 

  22. Yaghoubian A, Tolan A, Stabile BE, et al. Laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy achieve comparable weight loss at 1 year. Am Surg. 2012;78(12):1325–8.

    PubMed  Google Scholar 

  23. Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250(2):234–41.

    Article  PubMed  Google Scholar 

  24. Cutolo PP, Nosso G, Vitolo G, et al. Clinical efficacy of laparoscopic sleeve gastrectomy vs laparoscopic gastric bypass in obese type 2 diabetic patients: a retrospective comparison. Obes Surg. 2012;22(10):1535–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Yang J, Wang C, Cao G, et al. Long-term effects of laparoscopic sleeve gastrectomy versus roux-en-Y gastric bypass for the treatment of Chinese type 2 diabetes mellitus patients with body mass index 28-35 kg/m(2). BMC Surg. 2015;15:88.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Vix M, Diana M, Liu KH, et al. Evolution of glycolipid profile after sleeve gastrectomy vs. Roux-en-Y gastric bypass: results of a prospective randomized clinical trial. Obes Surg. 2013;23(5):613–21.

    Article  PubMed  Google Scholar 

  27. Keidar A, Hershkop KJ, Marko L, et al. Roux-en-Y gastric bypass vs sleeve gastrectomy for obese patients with type 2 diabetes: a randomised trial. Diabetologia. 2013;56(9):1914–8.

    Article  PubMed  Google Scholar 

  28. Zhang N, Maffei A, Cerabona T, et al. Reduction in obesity-related comorbidities: is gastric bypass better than sleeve gastrectomy? Surg Endosc. 2013;27(4):1273–80.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors acknowledge and express their sincere thanks and appreciation to all participating surgeons at IFSO-EC COE program for entering their patients’ data into the IBAR™, therefore allowing the accomplishment of this manuscript.

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Authors and Affiliations

  1. Bariatric Unit, Heraklion University Hospital, 164 Erythreas str, 71409, Heraklion, Greece

    John Melissas, Konstantinos Stavroulakis, Vassilis Tzikoulis & Angeliki Peristeri

  2. Department of Internal Medicine, Heraklion University Hospital, Heraklion, Crete, Greece

    John A Papadakis

  3. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran

    Abdolreza Pazouki & Ali Kabir

  4. Tehran Obesity Treatment Center, Department of Surgery, Shahed University, Tehran, Iran

    Alireza Khalaj

Authors
  1. John Melissas
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  2. Konstantinos Stavroulakis
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  3. Vassilis Tzikoulis
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  4. Angeliki Peristeri
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Corresponding author

Correspondence to John Melissas.

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Conflict of Interest

Author 1 reports other from EAC-BS, during the conduct of the study, and other from EAC-BS, outside the submitted work. The rest of the authors have nothing to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Melissas, J., Stavroulakis, K., Tzikoulis, V. et al. Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass. Data from IFSO-European Chapter Center of Excellence Program. OBES SURG 27, 847–855 (2017). https://doi.org/10.1007/s11695-016-2395-6

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  • DOI: https://doi.org/10.1007/s11695-016-2395-6

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