Weight Loss Outcomes in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Meta-Analysis and Systematic Review of Randomized Controlled Trials
- 1 February 2017
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
- Vol. 27 (1), 8-18
- https://doi.org/10.1097/sle.0000000000000374
Abstract
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage morbid obesity. The aim of this meta-analysis was to compare the postoperative weight loss outcomes reported in randomized control trials (RCTs) for LVSG versus LRYGB procedures. RCTs comparing the weight loss outcomes following LVSG and LRYGB in adult population between January 2000 and November 2015 were selected from PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane database. The review was prepared in accordance with Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA). Nine unique RCTs described over 10 publications involving a total of 865 patients (LVSG, n=437; LRYGB, n=428) were analyzed. Postoperative follow-up ranged from 3 months to 5 years. Twelve-month excess weight loss (EWL) for LVSG ranged from 69.7% to 83%, and for LRYGB, ranged from 60.5% to 86.4%. A number of studies reported slow weight gain between the second and third years of postoperative follow-up ranging from 1.4% to 4.2%EWL. This trend was seen to continue to 5 years postoperatively (8% to 10%EWL) for both procedures. In conclusion, LRYGB and LVSG are comparable with regards to the weight loss outcomes in the short term, with LRYGB achieving slightly greater weight loss. Slow weight recidivism is observed after the first postoperative year following both procedures. Long-term reporting of outcomes obtained from well-designed studies using intention-to-treat analyses are identified as a major gap in the literature at present.Keywords
This publication has 44 references indexed in Scilit:
- The Role of Hormonal Factors in Weight Loss and Recidivism after Bariatric SurgeryGastroenterology Research and Practice, 2013
- Is Laparoscopic Sleeve Gastrectomy an Acceptable Primary Bariatric Procedure in Obese Patients? Early and 5-Year Postoperative ResultsSurgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2012
- Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypassNutrition, 2012
- Weight regain after Roux-en-Y: A significant 20% complication related to PYYNutrition, 2008
- Weight Loss, Appetite Suppression, and Changes in Fasting and Postprandial Ghrelin and Peptide-YY Levels After Roux-en-Y Gastric Bypass and Sleeve GastrectomyAnnals of Surgery, 2008
- Characterization of weight loss and weight regain mechanisms after Roux-en-Y gastric bypass in ratsAmerican Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2007
- Quantifying heterogeneity in a meta‐analysisStatistics in Medicine, 2002
- Assessing the quality of reports of randomized clinical trials: Is blinding necessary?Controlled Clinical Trials, 1996
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986
- The Combination of Estimates from Different ExperimentsPublished by JSTOR ,1954