title: Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for treating morbid obesity is becoming more popular. We compared both techniques to evaluate their efficacy in treating morbid obesity or type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  We searched the Cochrane Controlled Trials Register databases, Medline, Embase, ISI databases and the Chinese Biomedical Literature Database to identify randomized controlled trials (RCTs) of LRYGB and LSG for morbid obesity or T2DM published in any language. Statistical analyses were carried out using RevMan software.
  
  
  RESULTS
  Five worldwide RCTs with 196 patients in the LRYGB group and 200 in the LSG group were included in our analysis. Compared with patients who had LSG, those who had LRYGB had a higher remission rate of T2MD, lost more weight and had lower low-density lipoprotein, triglycerides, homeostasis model assessment index and insulin levels. There was no difference in the reoperation rate between the groups. However, patients treated with LRYGB had a higher incidence of complication than those treated with LSG.
  
  
  CONCLUSIONS
  Our meta-analysis demonstrates that LRYGB is more effective than LSG for the surgical treatment of T2DM and control of metabolic syndrome. However, LSG is safer and has a reduced rate of complications. Further high-quality RCTs with long follow-up periods are needed to provide more reliable evidence.
authors.affiliation: From the Department of Gastrointestinal Surgery, the First People's Hospital of Xiaoshan, Hangzhou Normal University, Hangzhou City, China.
authors.forename: Jian-Fang
authors.initials: JF
authors.lastname: Li
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Lai
authors.forename: Bin
authors.initials: B
authors.lastname: Ni
authors.forename: Kuan-Xue
authors.initials: KX
authors.lastname: Sun
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic