title: Comparison of laparoscopic sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass for morbid obesity in a military institution.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance in the bariatric community as a definitive weight loss procedure; however, longitudinal data remain limited. The objective of this study was to compare weight loss results of LSG with laparoscopic Roux-en-Y gastric bypass (LRYGB) up to 5 years postoperatively using anthropometric measurements.
  
  
  METHODS
  Prospectively collected bariatric database at the Naval Medical Center San Diego was retrospectively reviewed from 2005-2011 . Anthropometric factors, including weight and hip circumference were measured during standard yearly follow-up appointments. Surgical outcomes were tested by the Student t test and demographic variables by Fisher's exact and Wilcoxon rank-sum tests.
  
  
  RESULTS
  Follow-up was achieved in 147/226 LRYGB versus 130/208 LSG at year 1, 92/195 versus 81/151 at year 2, 64/145 versus 50/100 at year 3, 32/81 versus 18/54 at year 4, and 12/42 versus 14/15 at year 5. The excess weight loss (EWL) for LRYGB versus LSG was 72% versus 64.7% at 1 year (P = .002), 71.3% versus 65.5% at 2 years (P = .113), and 68.3% versus 57.4% at 5 years (P = .252), respectively. Similarly, the body mass index (BMI) decrease was statistically significant at 1 year (P = .001) but not on subsequent annual visits. Mean percent body adiposity index (BAI) decrease was 28.4% for LRYGB versus 26.8% for LSG at 1 year (P = .679) and 21.8% versus 29.8% at 2 years (P = .134), respectively. Weight loss measured in terms of %EWL and decrease in BMI and BAI did not show significance between LRYGB and LSG 2 years after surgery.
  
  
  CONCLUSIONS
  Our study provides similar long-term weight loss between LSG and LRYGB, and therefore, LSG is a viable option as a definitive bariatric procedure.
authors.affiliation: Department of General Surgery, Naval Medical Center San Diego, San Diego, California. Electronic address: gwisbach@gmail.com.
authors.forename: David M
authors.initials: DM
authors.lastname: Lim
authors.affiliation: Department of General Surgery, Naval Medical Center San Diego, San Diego, California.
authors.forename: Janos
authors.initials: J
authors.lastname: Taller
authors.affiliation: Department of General Surgery, Naval Medical Center San Diego, San Diego, California.
authors.forename: William
authors.initials: W
authors.lastname: Bertucci
authors.affiliation: Clinical Investigation Department, Naval Medical Center San Diego, San Diego, California.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Riffenburgh
authors.affiliation: Department of General Surgery, Naval Medical Center San Diego, San Diego, California.
authors.forename: Jack
authors.initials: J
authors.lastname: O'Leary
authors.affiliation: Department of General Surgery, Naval Medical Center San Diego, San Diego, California.
authors.forename: Gordon
authors.initials: G
authors.lastname: Wisbach
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006772:Hospitals, Military; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult