Skip to main content
Erschienen in: Obesity Surgery 6/2019

05.04.2019 | Review Article

Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy for Super Super Obese and Super Obese: Systematic Review and Meta-analysis of Weight Results, Comorbidity Resolution

verfasst von: Yong Wang, Ying-han Song, Jing Chen, Rui Zhao, Lin Xia, Ya-ping Cui, Zhi-yong Rao, Yong Zhou, Xiao-ting Wu

Erschienen in: Obesity Surgery | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) used for super obesity (SO) and super super obesity (SSO) remain controversial. The meta-analysis was to summarize the evidence.

Methods

We searched in MEDLINE and PubMed for studies concerning RYGB and SG for SO or SSO and pooled complication, percentage excess weight loss (%EWL), and resolution of comorbidities.

Results

Twelve studies were identified. RYGB achieved higher %EWL at 12 months, but no significant difference at 24 months. Resolution of diabetes mellitus and dyslipidemia reached a statistical significance; however, there was no significant difference in hypertension.

Conclusions

RYGB was superior in %EWL for SSO and SO at 12 months. However, regarding at 24 months, RYGB was equal to SG, which is from a meta-analysis and cannot be seen as a definitive conclusion.
Literatur
1.
Zurück zum Zitat Guh DP, Zhang W, Bansback N, et al. The incidence of comorbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.CrossRef Guh DP, Zhang W, Bansback N, et al. The incidence of comorbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.CrossRef
2.
Zurück zum Zitat Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307:56–65.CrossRef Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307:56–65.CrossRef
4.
Zurück zum Zitat Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRef Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRef
5.
Zurück zum Zitat Spaniolas K, Kasten KR, Brinkley JS, et al. The changing bariatric surgery landscape in the USA. Obes Surg. 2015;25:1544–6.CrossRef Spaniolas K, Kasten KR, Brinkley JS, et al. The changing bariatric surgery landscape in the USA. Obes Surg. 2015;25:1544–6.CrossRef
6.
Zurück zum Zitat Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308:1122–31.CrossRef Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308:1122–31.CrossRef
7.
Zurück zum Zitat Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.CrossRef Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252:319–24.CrossRef
8.
Zurück zum Zitat Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013;9:21–5.CrossRef Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013;9:21–5.CrossRef
9.
Zurück zum Zitat Sarela AI, Dexter SP, OʼKane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8–9-year results. Surg Obes Relat Dis. 2012;8:679–84.CrossRef Sarela AI, Dexter SP, OʼKane M, et al. Long-term follow-up after laparoscopic sleeve gastrectomy: 8–9-year results. Surg Obes Relat Dis. 2012;8:679–84.CrossRef
10.
Zurück zum Zitat Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256:262–5.CrossRef Eid GM, Brethauer S, Mattar SG, et al. Laparoscopic sleeve gastrectomy for super obese patients: forty-eight percent excess weight loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012;256:262–5.CrossRef
11.
Zurück zum Zitat Dorman RB, Serrot FJ, Miller CJ, et al. Case-matched outcomes in bariatric surgery for treatment of type2 diabetes in the morbidly obese patient. Ann Surg. 2012;255:287–93.CrossRef Dorman RB, Serrot FJ, Miller CJ, et al. Case-matched outcomes in bariatric surgery for treatment of type2 diabetes in the morbidly obese patient. Ann Surg. 2012;255:287–93.CrossRef
12.
Zurück zum Zitat Golzarand M, Toolabi K, Farid R. The bariatric surgery and weight losing: a meta-analysis in the long- and very long-term effects of laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy on weight loss in adults. Surg Endosc. 2017;31(11):4331–45.CrossRef Golzarand M, Toolabi K, Farid R. The bariatric surgery and weight losing: a meta-analysis in the long- and very long-term effects of laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy on weight loss in adults. Surg Endosc. 2017;31(11):4331–45.CrossRef
13.
Zurück zum Zitat Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005. 5:13. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005. 5:13.
14.
Zurück zum Zitat Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.CrossRef Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.CrossRef
15.
Zurück zum Zitat Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.CrossRef Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.CrossRef
16.
Zurück zum Zitat Serrano OK, Tannebaum JE, Cumella L, et al. Weight loss outcomes and complications from bariatric surgery in the super super obese. Surg Endosc. 2016 Jun;30(6):2505–11.CrossRef Serrano OK, Tannebaum JE, Cumella L, et al. Weight loss outcomes and complications from bariatric surgery in the super super obese. Surg Endosc. 2016 Jun;30(6):2505–11.CrossRef
17.
Zurück zum Zitat Gonzalez-Heredia R, Sanchez-Johnsen L, Valbuena VS, et al. Surgical management of super–super obese patients: Roux-en-Y gastric bypass versus sleeve gastrectomy. Surg Endosc. 2016;30(5):2097–102.CrossRef Gonzalez-Heredia R, Sanchez-Johnsen L, Valbuena VS, et al. Surgical management of super–super obese patients: Roux-en-Y gastric bypass versus sleeve gastrectomy. Surg Endosc. 2016;30(5):2097–102.CrossRef
18.
Zurück zum Zitat Duprée A, El Gammal AT, Wolter S, et al. Perioperative short-term outcome in super-super-obese patients undergoing bariatric surgery. Obes Surg. 2018;28(7):1895–901.CrossRef Duprée A, El Gammal AT, Wolter S, et al. Perioperative short-term outcome in super-super-obese patients undergoing bariatric surgery. Obes Surg. 2018;28(7):1895–901.CrossRef
19.
Zurück zum Zitat Celio AC, Wu Q, Kasten KR, et al. Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in super obese patients. Surg Endosc. 2017;31(1):317–23.CrossRef Celio AC, Wu Q, Kasten KR, et al. Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in super obese patients. Surg Endosc. 2017;31(1):317–23.CrossRef
20.
Zurück zum Zitat Bettencourt-Silva R, Neves JS, Pedro J.et al. Comparative effectiveness of different bariatric procedures in super morbid obesity. Obes Surg. 2019;29(1):281–91.CrossRef Bettencourt-Silva R, Neves JS, Pedro J.et al. Comparative effectiveness of different bariatric procedures in super morbid obesity. Obes Surg. 2019;29(1):281–91.CrossRef
21.
Zurück zum Zitat Uno K, Seki Y, Kasama K, et al. A comparison of the bariatric procedures that are performed in the treatment of super morbid obesity. Obes Surg. 2017;27(10):2537–45.CrossRef Uno K, Seki Y, Kasama K, et al. A comparison of the bariatric procedures that are performed in the treatment of super morbid obesity. Obes Surg. 2017;27(10):2537–45.CrossRef
22.
Zurück zum Zitat Thereaux J, Corigliano N, Poitou C, et al. Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥50 kg/m2. Surg Obes Relat Dis. 2015;11(4):785–90.CrossRef Thereaux J, Corigliano N, Poitou C, et al. Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI ≥50 kg/m2. Surg Obes Relat Dis. 2015;11(4):785–90.CrossRef
23.
Zurück zum Zitat Jain D, Sill A, Averbach A. Do patients with higher baseline BMI have improved weight loss with Roux-en-Y gastric bypass versus sleeve gastrectomy? Surg Obes Relat Dis. 2018;14(9):1304–9.CrossRef Jain D, Sill A, Averbach A. Do patients with higher baseline BMI have improved weight loss with Roux-en-Y gastric bypass versus sleeve gastrectomy? Surg Obes Relat Dis. 2018;14(9):1304–9.CrossRef
24.
Zurück zum Zitat Hong J, Park S, Menzo EL, et al. Midterm outcomes of laparoscopic sleeve gastrectomy as a stand-alone procedure in super-obese patients. Surg Obes Relat Dis. 2018;03(14):3. Hong J, Park S, Menzo EL, et al. Midterm outcomes of laparoscopic sleeve gastrectomy as a stand-alone procedure in super-obese patients. Surg Obes Relat Dis. 2018;03(14):3.
25.
Zurück zum Zitat Daigle CR, Andalib A, Corcelles R, et al. Bariatric and metabolic outcomes in the super-obese elderly. Surg Obes Relat Dis. 2016;12(1):132–7.CrossRef Daigle CR, Andalib A, Corcelles R, et al. Bariatric and metabolic outcomes in the super-obese elderly. Surg Obes Relat Dis. 2016;12(1):132–7.CrossRef
27.
Zurück zum Zitat Onyewu SC, Ogundimu OO, Gezzer Ortega BS, et al. Bariatric surgery outcomes in black patients with super morbid obesity: a 1-year postoperative review. Am J Surg. 2017;213:64–8.CrossRef Onyewu SC, Ogundimu OO, Gezzer Ortega BS, et al. Bariatric surgery outcomes in black patients with super morbid obesity: a 1-year postoperative review. Am J Surg. 2017;213:64–8.CrossRef
28.
Zurück zum Zitat Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65.CrossRef Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA. 2018;319(3):255–65.CrossRef
29.
Zurück zum Zitat Zhang Y, Wang J, Ju W, et al. Laparoscopic sleeve gastrectomy versus laparoscopic Roux-En-Y gastric bypass for morbid obesity and related comorbidities: a meta-analysis of 21 studies. Obes Surg. 2015;25:19–26.CrossRef Zhang Y, Wang J, Ju W, et al. Laparoscopic sleeve gastrectomy versus laparoscopic Roux-En-Y gastric bypass for morbid obesity and related comorbidities: a meta-analysis of 21 studies. Obes Surg. 2015;25:19–26.CrossRef
30.
Zurück zum Zitat Corcelles R, Boules M, Froylich D, et al. Total weight loss as the outcome measure of choice after Roux-en-Y gastric bypass. Obes Surg. 2016;26(8):1794–8.CrossRef Corcelles R, Boules M, Froylich D, et al. Total weight loss as the outcome measure of choice after Roux-en-Y gastric bypass. Obes Surg. 2016;26(8):1794–8.CrossRef
31.
Zurück zum Zitat Garg H, Aggarwal S, Misra MC, et al. Mid to long term outcomes of laparoscopic sleeve gastrectomy in Indian population: 3-7 year results - a retrospective cohort study. Int J Surg. 2017;48:201–9.CrossRef Garg H, Aggarwal S, Misra MC, et al. Mid to long term outcomes of laparoscopic sleeve gastrectomy in Indian population: 3-7 year results - a retrospective cohort study. Int J Surg. 2017;48:201–9.CrossRef
32.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.CrossRef Livhits M, Mercado C, Yermilov I, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.CrossRef
33.
Zurück zum Zitat Sugerman HJ. Gastric bypass surgery for severe obesity. Semin Laparosc Surg. 2002;9:79–85.CrossRef Sugerman HJ. Gastric bypass surgery for severe obesity. Semin Laparosc Surg. 2002;9:79–85.CrossRef
34.
Zurück zum Zitat Alexandrides KT, Skroubis G, Kalfarentzos F. Resolution of diabetes mellitus and metabolic syndrome following Roux-en-Y gastric bypass and a variant of biliopancreatic diversion in patients with morbid obesity. Obes Surg. 2007;17:176–84.CrossRef Alexandrides KT, Skroubis G, Kalfarentzos F. Resolution of diabetes mellitus and metabolic syndrome following Roux-en-Y gastric bypass and a variant of biliopancreatic diversion in patients with morbid obesity. Obes Surg. 2007;17:176–84.CrossRef
35.
Zurück zum Zitat Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-y gastric bypass: 10-year follow up. Surg Obes Relat Dis. 2011;7:516–25.CrossRef Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-y gastric bypass: 10-year follow up. Surg Obes Relat Dis. 2011;7:516–25.CrossRef
Metadaten
Titel
Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy for Super Super Obese and Super Obese: Systematic Review and Meta-analysis of Weight Results, Comorbidity Resolution
verfasst von
Yong Wang
Ying-han Song
Jing Chen
Rui Zhao
Lin Xia
Ya-ping Cui
Zhi-yong Rao
Yong Zhou
Xiao-ting Wu
Publikationsdatum
05.04.2019
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 6/2019
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-03817-4

Weitere Artikel der Ausgabe 6/2019

Obesity Surgery 6/2019 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.