title: Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies.
abstract: OBJECTIVE
  This study aimed to compare midterm and long-term weight loss and resolution of co-morbidity with laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG).
  
  
  CONCLUSIONS
  LRYGB and LSG are the most common procedures performed in bariatric surgery. However, their weight loss efficacy in the midterm and long-term has not been well compared.
  
  
  METHODS
  A meta-analysis was performed by systematically identifying comparative studies conducted until the end of June 2016 that investigated weight loss outcome and resolution of co-morbidities (type 2 diabetes mellitus, hypertension, hyperlipidemia, hypertriglyceridemia, and obstructive sleep apnea) with LRYGB and LSG in the midterm (3-5 years) and long term (≥5 years). The primary endpoint was weight loss after LRYGB versus LSG. The secondary endpoint was resolution of co-morbidities after these procedures.
  
  
  RESULTS
  Fourteen studies comprising 5264 patients were eligible. Follow-up ranged from 36 months to 75.8±8.4 months. The pooled result for weight loss outcomes did not show any significant difference in midterm weight loss (standardized mean difference = -0.03; 95% confidence interval (CI), -0.38-.33; P = .88) but a significant difference in the long-term weight loss outcome favoring LRYGB (standardized mean difference = .17; 95% CI, .05-.28; P= .005). The pooled results demonstrated no significant difference for resolution of type 2 diabetes mellitus, hypertension, hyperlipidemia, and hypertriglyceridemia.
  
  
  CONCLUSIONS
  Despite the insignificant difference between LRYGB and LSG in midterm weight loss, LRYGB produced better weight loss in the long-term. There was no significant difference between the 2 procedures for co-morbidity resolution.
authors.affiliation: Department of Metabolic and Bariatric Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY. Electronic address: saber6231@gmail.com.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.affiliation: Department of Metabolic and Bariatric Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY.
authors.forename: Alan A
authors.initials: AA
authors.lastname: Saber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000601:surgery; D006973:Hypertension / Q000150:complications / Q000601:surgery; D015228:Hypertriglyceridemia / Q000150:complications / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000150:complications; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
keywords: Bariatric surgery; LRYGB; LSG; Laparoscopic Roux-en-Y gastric bypass; Laparoscopic sleeve gastrectomy; Meta-analysis; Weight loss