title: First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass.
abstract: OBJECTIVE
  To assess the safety and effectiveness of the laparoscopic sleeve gastrectomy (LSG) as compared to the laparoscopic adjustable gastric band (LAGB), the laparoscopic Roux-en-Y gastric bypass (LRYGB) and the open Roux-en-Y gastric bypass (ORYGB) for the treatment of obesity and obesity-related diseases.
  
  
  BACKGROUND
  LSG is a newer procedure being done with increasing frequency. However, limited data are currently available comparing LSG to the other established procedures. We present the first prospective, multiinstitutional, nationwide, clinically rich, bariatric-specific data comparing sleeve gastrectomy to the adjustable gastric band, and the gastric bypass.
  
  
  METHODS
  This is the initial report analyzing data from the American College of Surgeons-Bariatric Surgery Center Network accreditation program, and its prospective, longitudinal, data collection system based on standardized definitions and collected by trained data reviewers. Univariate and multivariate analyses compare 30-day, 6-month, and 1-year outcomes including morbidity and mortality, readmissions, and reoperations as well as reduction in body mass index (BMI) and weight-related comorbidities.
  
  
  RESULTS
  One hundred nine hospitals submitted data for 28,616 patients, from July, 2007 to September, 2010. The LSG has higher risk-adjusted morbidity, readmission and reoperation/intervention rates compared to the LAGB, but lower reoperation/intervention rates compared to the LRYGB and ORYGB. There were no differences in mortality. Reduction in BMI and most of the weight-related comorbidities after the LSG also lies between those of the LAGB and the LRYGB/ORYGB.
  
  
  CONCLUSIONS
  LSG has morbidity and effectiveness positioned between the LAGB and the LRYGB/ORYGB for data up to 1 year. As obesity is a lifelong disease, longer term comparative effectiveness data are most critical, and are yet to be determined.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, MA 02114, USA. mhutter@partners.org
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hutter
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Schirmer
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jones
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Ko
authors.forename: Mark E
authors.initials: ME
authors.lastname: Cohen
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Merkow
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
mesh_terms: D000068:Accreditation; D000704:Analysis of Variance; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012955:Societies, Medical; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss