Weight Loss Outcomes in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) Versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) Procedures: A Meta-Analysis and Systematic Review of Randomized Controlled Trials.
OBJECTIVE
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage morbid obesity. The aim of this meta-analysis was to compare the postoperative weight loss outcomes reported in randomized control trials (RCTs) for LVSG versus LRYGB procedures.


METHODS
RCTs comparing the weight loss outcomes following LVSG and LRYGB in adult population between January 2000 and November 2015 were selected from PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane database. The review was prepared in accordance with Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA).


RESULTS
Nine unique RCTs described over 10 publications involving a total of 865 patients (LVSG, n=437; LRYGB, n=428) were analyzed. Postoperative follow-up ranged from 3 months to 5 years. Twelve-month excess weight loss (EWL) for LVSG ranged from 69.7% to 83%, and for LRYGB, ranged from 60.5% to 86.4%. A number of studies reported slow weight gain between the second and third years of postoperative follow-up ranging from 1.4% to 4.2%EWL. This trend was seen to continue to 5 years postoperatively (8% to 10%EWL) for both procedures.


CONCLUSIONS
In conclusion, LRYGB and LVSG are comparable with regards to the weight loss outcomes in the short term, with LRYGB achieving slightly greater weight loss. Slow weight recidivism is observed after the first postoperative year following both procedures. Long-term reporting of outcomes obtained from well-designed studies using intention-to-treat analyses are identified as a major gap in the literature at present.
*Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston †Department of Human Movements and Nutrition ¶Mayne Medical School, School of Medicine, University of Queensland, Brisbane §School of Agricultural, Computational and Environmental Sciences, International Centre for Applied Climate Sciences and Centre for Health Sciences Research, University of Southern Queensland, Toowoomba ∥Sunnybank Obesity Centre, South & East Queensland Surgery (SEQS), Sunnybank #Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia ‡Institute of Mathematical Sciences, University of Malaya, Kuala Lumpur, Malaysia **Faculty of Health and Social Science, Bolton University, Bolton, Lancashire, UK.
Emma
E
Osland
Rossita M
RM
Yunus
Shahjahan
S
Khan
Breda
B
Memon
Muhammed A
MA
Memon
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult