Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study.
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a procedure for the treatment of morbid obesity. Its indications and long-term results are currently under evaluation. Initially started as a first-stage procedure for superobese patients, it is now emerging as a standalone procedure in Asia and other parts of the world. Early results suggest that, at the end of 1 year, weight loss and resolution of comorbidities with LSG is comparable to laparoscopic Roux-en-Y gastric bypass (LRYGB). Whether LSG alone can replace LRYGB as a standard bariatric procedure is questionable. The aim of this study is to compare the results, resolution of comorbidities, and complications between LSG and LRYGB.


METHODS
A retrospective comparative analysis was done of 50 patients in each arm who underwent LSG and LRYGB from October 2007 to March 2008. Both groups were matched for age, sex, and body mass index. The resolution of comorbidities, percentage of excess weight loss (EWL), and complications were studied at 6 months and 1 year in our study.


RESULTS
It was seen that resolution of most comorbidities such as type 2 diabetes, hypertension, dyslipidemia, sleep apnea, joint pains, and percentage of EWL in both groups was comparable at the end of 6 months and 1 year. Though early resolution of type 2 diabetes was seen to be better in the LRYGB group, the results matched up at 1 year. There was increased incidence of gastroesophageal reflux disease in LSG patients. On comparison, it was also observed that the Asian studies have shown better results with LSG when compared to studies done in a largely Caucasian population.


CONCLUSIONS
Long-term studies are needed to evaluate the efficacy of LSG alone as a procedure for the treatment of morbid obesity and its comorbidities.
Center for Obesity and Diabetes Support and Department of Minimally Invasive Surgery, Saifee Hospital, Mumbai, India.
Muffazal A
MA
Lakdawala
Aparna
A
Bhasker
Dheeraj
D
Mulchandani
Sunita
S
Goel
Sneha
S
Jain
D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007194:India; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D016896:Treatment Outcome; D015431:Weight Loss