title: Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) has been gaining acceptance because it has shown good short- and mid-term results as a single procedure for morbid obesity. The aim of this study was to compare short- and mid-term results between laparoscopic Roux-en-Y gastric bypass (LRYGB) and LSG.
  
  
  METHODS
  Observational retrospective study from a prospective database of patients undergoing LRYGB and LSG between 2004 and 2011, where 249 patients (mean age 44.7 years) were included. Patients were followed at 1, 3, 6, 12, and 18 months, and annually thereafter. Short- and mid-term weight loss, comorbidity improvement or resolution, postoperative complications, re-interventions, and mortality were evaluated.
  
  
  RESULTS
  One hundred thirty-five LRYGB and 114 LSG were included. Significant statistical differences between LRYGB and LSG were found in operative time (153 vs. 93 min. p < 0.001), minor postoperative complications (21.5 % vs. 4.4 %, p = 0.005), blood transfusions (8.8 % vs. 1.7 %, p = 0.015), and length of hospital stay (4 vs. 3 days, p < 0.001). There were no differences regarding major complications and re-interventions. There was no surgery-related mortality. The percentage of excess weight loss up to 4 years was similar in both groups (66 ± 13.7 vs. 65 ± 14.9 %). Both techniques showed similar results in comorbidities improvement or resolution at 1 year.
  
  
  CONCLUSIONS
  There is a similar short- and mid-term weight loss and 1-year comorbidity improvement or resolution between LRYGB and LSG, although minor complication rate is higher for LRYGB. Results of LSG as a single procedure need to be confirmed after a long-term follow-up.
authors.affiliation: Section of Gastrointestinal Surgery, Hospital Universitario del Mar, IMIM (Hospital del Mar Institut d'Investigacions Mèdiques), Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Vidal
authors.forename: José M
authors.initials: JM
authors.lastname: Ramón
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.forename: David
authors.initials: D
authors.lastname: Benaiges
authors.forename: Lourdes
authors.initials: L
authors.lastname: Trillo
authors.forename: Alejandra
authors.initials: A
authors.lastname: Parri
authors.forename: Susana
authors.initials: S
authors.lastname: González
authors.forename: Manuel
authors.initials: M
authors.lastname: Pera
authors.forename: Luís
authors.initials: L
authors.lastname: Grande
mesh_terms: D000293:Adolescent; D000328:Adult; D001177:Arthropathy, Neurogenic / Q000209:etiology; D015992:Body Mass Index; D015897:Comorbidity; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D012074:Remission Induction; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000209:etiology; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss