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      A meta-analysis of the medium- and long-term effects of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

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          Abstract

          Background

          Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are two representative bariatric surgeries. This study aimed to compare the effects of the LSG and LRYGB based on high-quality analysis and massive amount of data.

          Methods

          For this study databases of PubMed, Web of Science, EBSCO, Medline, and Cochrane Library were searched for articles published until January 2019 comparing the outcomes of LSG and LRYGB.

          Results

          This study included 28 articles. Overall, 9038 patients (4597, LSG group; 4441, LRYGB group) were included. The remission rate of type 2 diabetes mellitus (T2DM) in the LRYGB group was superior to that in the LSG group at the 3-years follow-up. Five-year follow-up results showed that LRYGB had an advantage over LSG for the percentage of excess weight loss and remission of T2DM, hypertension, dyslipidemia, and abnormally low-density lipoprotein.

          Conclusions

          In terms of the long-term effects of bariatric surgery, the effect of LRYGB was better than of LSG.

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          Most cited references38

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          Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity

          Ralph Peterli, Bettina Wölnerhanssen, Thomas Peters … (2018)
          Sleeve gastrectomy is increasingly used in the treatment of morbid obesity, but its long-term outcome vs the standard Roux-en-Y gastric bypass procedure is unknown.
          Article 0 comments Cited 284 times – based on 0 reviews     Review now
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            Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity

            Paulina Salminen, Mika Helmiö, Jari Ovaska … (2018)
            Laparoscopic sleeve gastrectomy for treatment of morbid obesity has increased substantially despite the lack of long-term results compared with laparoscopic Roux-en-Y gastric bypass.
            Article 0 comments Cited 246 times – based on 0 reviews     Review now
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              Obesity-related hypertension: epidemiology, pathophysiology, and clinical management.

              Theodore Kotchen (2010)
              The prevalence of obesity, including childhood obesity, is increasing worldwide. Weight gain is associated with increases in arterial pressure, and it has been estimated that 60-70% of hypertension in adults is attributable to adiposity. Centrally located body fat, associated with insulin resistance and dyslipidemia, is a more potent determinant of blood pressure elevation than peripheral body fat. Obesity-related hypertension may be a distinct hypertensive phenotype with distinct genetic determinants. Mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of renin-angiotensin-aldosterone, and altered vascular function. In overweight individuals, weight loss results in a reduction of blood pressure, however, this effect may be attenuated in the long term. An increasing number of community-based programs (including school programs and worksite programs) are being developed for the prevention and treatment of obesity. Assessment and treatment of the obese hypertensive patient should address overall cardiovascular disease (CVD) risk. There are no compelling clinical trial data to indicate that any one class of antihypertensive agents is superior to others, and in general the principles of pharmacotherapy for obese hypertensive patients are not different from nonobese patients. Future research directions might include: (i) development of effective, culturally sensitive strategies for the prevention and treatment of obesity; (ii) clinical trials to identify the most effective drug therapies for reducing CVD in obese, hypertensive patients; (iii) continued search for the genetic determinants of the obese, hypertensive phenotype.
              Article 0 comments Cited 125 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Lihu Gu: gulihuyuazhi@126.com
                Xiaojing Huang: 793711648@qq.com
                Shengnan Li: 1609132951@qq.com
                Danyi Mao: danyimao1@163.com
                Zefeng Shen: 291821586@qq.com
                Parikshit Asutosh Khadaroo: asutoshkhadaro@hotmail.com
                Derry Minyao Ng: derrym.ng@hotmail.com
                Ping Chen: chenpinghwamei@163.com
                Journal
                Journal ID (nlm-ta): BMC Surg
                Journal ID (iso-abbrev): BMC Surg
                Title: BMC Surgery
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2482
                Publication date (Electronic): 12 February 2020
                Publication date PMC-release: 12 February 2020
                Publication date Collection: 2020
                Volume: 20
                Electronic Location Identifier: 30
                Affiliations
                [1 ]GRID grid.410726.6, ISNI 0000 0004 1797 8419, Department of General Surgery, HwaMei Hospital, , University of Chinese Academy of Sciences, ; Northwest Street 41, Haishu District, Ningbo, Zhejiang, 315010 China
                [2 ]GRID grid.268505.c, ISNI 0000 0000 8744 8924, The Second Clinical Medical College, , Zhejiang Chinese Medical University, ; Hangzhou, Zhejiang China
                [3 ]GRID grid.268505.c, ISNI 0000 0000 8744 8924, Basic Medical College, , Zhejiang Chinese Medical University, ; Hangzhou, Zhejiang China
                [4 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, Department of General Surgery, , Zhejiang University School of Medicine Sir Run Run Shaw Hospital, ; Hangzhou, Zhejiang China
                [5 ]GRID grid.1002.3, ISNI 0000 0004 1936 7857, Monash University School of Public Health and Preventive Medicine, ; Melbourne, Australia
                [6 ]GRID grid.203507.3, ISNI 0000 0000 8950 5267, Medical College of Ningbo University, ; Hangzhou, Zhejiang China
                Article
                Publisher ID: 695
                DOI: 10.1186/s12893-020-00695-x
                PMC ID: 7014764
                PubMed ID: 32050953
                SO-VID: 60aa82a1-3e1a-40cb-84ff-36e7d4f0d6d7
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 27 November 2019
                Date accepted : 7 February 2020
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Surgery
                Keywords: sleeve gastrectomy,roux-en-y gastric bypass,effects,meta-analysis
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: sleeve gastrectomy, roux-en-y gastric bypass, effects, meta-analysis

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