SHORT- AND LONG-TERM OUTCOMES OF SLEEVE GASTRECTOMY VS. ROUX-EN-Y GASTRIC BYPASS IN BARIATRIC SURGERY
Main Article Content
Keywords
Sleeve Gastrectomy, , bariatric surgery, Roux-en-Y Gastric Bypass, weight loss, complications, , co-morbidities, , quality of life, nutritional deficiencies
Abstract
Global obesity has become an epidemic, responsible in part for the soaring tide of chronic conditions like type 2 diabetes, high blood pressure and cardiovascular disease. Sleeve Gastrectomy (SG) and Roux en Y Gastric Bypass (RYGB) are the two most commonly performed types of bariatric surgery. Both of these procedures result in massive weight loss and amelioration of obesity co-morbidities, however they have very different long term outcomes, complications, and effects on quality of life. This review, then, aims to compare the clinical outcomes of SG and RYGB, and to contrast side of key issues including loss in weight, resolution of co-morbidities, complications, nutritional deficiencies and patient satisfaction. The intent is to instruct the clinician to guide the best bariatric surgery option for the patient. Database such as PubMed, Cochrane Library, and Google Scholar were used for conducting of a comprehensive search of literature. This review includes studies of adult patients who have undergone either SG or RYGB and involve randomized controlled trials (RCTs), cohort studies, and meta analyses. Weight loss (% excess weight loss) resolution of co-morbidities (diabetes, hypertension) complications, nutritional deficiencies, and quality of life were key outcomes evaluted. Significant weight loss was seen with both SG and RYGB but RYGB has superior, long term weight loss and co-morbidity resolution, especially with diabetes. The short term complication rates were lower and there were fewer risks for malnutrition with SG. But SG patients were more likely to have gastroesophageal reflux disease (GERD). We found that RYGB was more associated with metabolic outcomes and less nutritional deficiencies. However, both SG and RYGB are effective solutions for severe obesity, with SG itself a simpler procedure and having a better safety profile in the short term and RYGB with additional long term metabolic benefits. Repeat treatments were provided if indicated by clinical characteristics or long term goals that are applicable to individual patients.
References
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2. Adler, D., Bailly, S., Benmerad, M., Joyeux-Faure, M., Jullian-Desayes, I., Soccal, P. M., ... & Pépin, J. L. (2020). Clinical presentation and co-morbidities of obstructive sleep apnea-COPD overlap syndrome. PloS one, 15(7), e0235331.
3. Anbara, T. (2023). What to do after Bariatric Surgery: Developing a Comprehensive Roadmap for Surgeons and Patients. Saudi J Med, 8(6), 338-348.
4. Angioni, S., Saponara, S., D'Ancona, G., Sicilia, G., D'Alterio, M. N., & Vitale, S. G. (2024). Safety, Efficacy, and Cost-effectiveness of Organ Suspension in Laparoscopic Gynecologic Surgery. A Retrospective Cohort Study to Validate an Innovative Technique: Laparoscopic Organ Suspension sec. Angioni. Gynecologic and Obstetric Investigation, 1-1.
5. Argyrakopoulou, G., Konstantinidou, S. K., Dalamaga, M., & Kokkinos, A. (2022). Nutritional deficiencies before and after bariatric surgery: prevention and treatment. Current Nutrition Reports, 11(2), 95-101.
6. Auge, M., Menahem, B., Savey, V., Bion, A. L., & Alves, A. (2022). Long-term complications after gastric bypass and sleeve gastrectomy: What information to give to patients and practitioners, and why?. Journal of visceral surgery, 159(4), 298-308.
7. Brozek, J. L., Canelo-Aybar, C., Akl, E. A., Bowen, J. M., Bucher, J., Chiu, W. A., ... & GRADE Working Group. (2021). GRADE Guidelines 30: the GRADE approach to assessing the certainty of modeled evidence—An overview in the context of health decision-making. Journal of clinical epidemiology, 129, 138-150.
8. Cancello, R., Brunani, A., Brenna, E., Soranna, D., Bertoli, S., Zambon, A., ... & Capodaglio, P. (2023). Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment. Reviews in Endocrine and Metabolic Disorders, 24(3), 451-464.
9. Castro, M. J., Jimenez, J. M., Carbajo, M. A., Lopez, M., Cao, M. J., Garcia, S., & Ruiz-Tovar, J. (2020). Long-term weight loss results, remission of co-morbidities and nutritional deficiencies of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB) on type 2 diabetic (T2D) patients. International Journal of Environmental Research and Public Health, 17(20), 7644.
10. Chiarello, M. M., Fransvea, P., Cariati, M., Adams, N. J., Bianchi, V., & Brisinda, G. (2022). Anastomotic leakage in colorectal cancer surgery. Surgical oncology, 40, 101708.
11. Courcoulas, A. P., Johnson, E., Arterburn, D. E., Haneuse, S., Herrinton, L. J., Fisher, D. P., ... & Coleman, K. J. (2023). Reduction in long-term mortality after sleeve gastrectomy and gastric bypass compared to non-surgical patients with severe obesity. Annals of surgery, 277(3), 442-448.
12. Davies, N. K. (2020). Clinical, metabolic, and microbial responses to sleeve gastrectomy and Roux-en-Y gastric bypass: results from a randomised clinical trial (Doctoral dissertation, ResearchSpace@ Auckland).
13. Der Schueren, B. (2022). Compliance and patients’ perspectives towards nutritional supplementation following bariatric surgery. Obesity Surgery, 32(6), 1804-1813.
14. El Ansari, W., & Elhag, W. (2021). Weight regain and insufficient weight loss after bariatric surgery: definitions, prevalence, mechanisms, predictors, prevention and management strategies, and knowledge gaps—a scoping review. Obesity surgery, 31, 1755-1766.
15. Farooqi, S., Montrief, T., Koyfman, A., & Long, B. (2024). High risk and low incidence diseases: Bariatric surgery complications. The American Journal of Emergency Medicine.
16. Ghanem, O. M., Abi Mosleh, K., Kerbage, A., Lu, L., Hage, K., & Dayyeh, B. K. A. (2023). Continued diabetes remission despite weight recurrence: gastric bypass long-term metabolic benefit. Journal of the American College of Surgeons, 10-1097.
17. Gjeorgjievski, M., Imam, Z., Cappell, M. S., Jamil, L. H., & Kahaleh, M. (2021). A comprehensive review of endoscopic management of sleeve gastrectomy leaks. Journal of Clinical Gastroenterology, 55(7), 551-576.
18. Gomes-Rocha, S. R., Costa-Pinho, A. M., Pais-Neto, C. C., de Araújo Pereira, A., Nogueiro, J. P. M., Carneiro, S. P. R., ... & CRI-O Group. (2022). Roux-en-Y gastric bypass vs sleeve gastrectomy in super obesity: a systematic review and meta-analysis. Obesity surgery, 1-16.
19. Gusenbauer, M., & Haddaway, N. R. (2020). Which academic search systems are suitable for systematic reviews or meta‐analyses? Evaluating retrieval qualities of Google Scholar, PubMed, and 26 other resources. Research synthesis methods, 11(2), 181-217.
20. Haththotuwa, R. N., Wijeyaratne, C. N., & Senarath, U. (2020). Worldwide epidemic of obesity. In Obesity and obstetrics (pp. 3-8). Elsevier.
21. Hecker, J., Freijer, K., Hiligsmann, M., & Evers, S. M. A. A. (2022). Burden of disease study of overweight and obesity; the societal impact in terms of cost-of-illness and health-related quality of life. BMC Public Health, 22, 1-13.
22. Janssen, J. A. (2021). Hyperinsulinemia and its pivotal role in aging, obesity, type 2 diabetes, cardiovascular disease and cancer. International journal of molecular sciences, 22(15), 7797.
23. Järvholm, K., Olbers, T., & Engström, M. (2021). Patients’ views of long-term results of bariatric surgery for super-obesity: sustained effects, but continuing struggles. Surgery for Obesity and Related Diseases, 17(6), 1152-1164.
24. Jin, Z. L., & Liu, W. (2021). Progress in treatment of type 2 diabetes by bariatric surgery. World Journal of Diabetes, 12(8), 1187.
25. Jung, H. K., Tae, C. H., Song, K. H., Kang, S. J., Park, J. K., Gong, E. J., ... & Lee, K. J. (2021). 2020 Seoul consensus on the diagnosis and management of gastroesophageal reflux disease. Journal of neurogastroenterology and motility, 27(4), 453.
26. Lefere, S., Onghena, L., Vanlander, A., Van Nieuwenhove, Y., Devisscher, L., & Geerts, A. (2021). Bariatric surgery and the liver—Mechanisms, benefits, and risks. Obesity Reviews, 22(9), e13294.
27. Lei, Y., Lei, X., Chen, G., Wang, Z., Song, H., Feng, X., ... & Tian, Y. (2024). Update on comparison of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: A systematic review and meta-analysis of weight loss, co-morbidities, and quality of life at 5 years. BMC surgery, 24(1), 219.
28. Leowattana, W., & Leowattana, T. (2022). Potassium-competitive acid blockers and gastroesophageal reflux disease. World journal of gastroenterology, 28(28), 3608.
29. Liao, J., Wen, Y., Yin, Y., Qin, Y., & Zhang, G. (2024). Factors Impacting One-year Follow-up Visit Adherence after Bariatric Surgery in West China: A Mixed Methods Study. Obesity Surgery, 1-9.
30. Lombardo, M., Franchi, A., Biolcati Rinaldi, R., Rizzo, G., D’Adamo, M., Guglielmi, V., ... & Sbraccia, P. (2021). Long-term iron and vitamin B12 deficiency are present after bariatric surgery, despite the widespread use of supplements. International Journal of Environmental Research and Public Health, 18(9), 4541.
31. Matheson, B. (2024). Changes in body composition over 5 years after Roux-en-Y Gastric Bypass and Sleeve Gastrectomy (Doctoral dissertation, ResearchSpace@ Auckland).
32. McCarty, T. R., Jirapinyo, P., & Thompson, C. C. (2020). Effect of sleeve gastrectomy on ghrelin, GLP-1, PYY, and GIP gut hormones: a systematic review and meta-analysis. Annals of surgery, 272(1), 72-80.
33. Meneses, E., Zagales, I., Fanfan, D., Zagales, R., McKenney, M., & Elkbuli, A. (2021). Surgical, metabolic, and prognostic outcomes for Roux-en-Y gastric bypass versus sleeve gastrectomy: a systematic review. Surgery for Obesity and Related Diseases, 17(12), 2097-2106.
34. Mohajan, D., & Mohajan, H. K. (2023). Obesity and its related diseases: a new escalating alarming in global health. Journal of Innovations in Medical Research, 2(3), 12-23.
35. Moradi, M., Kabir, A., Khalili, D., Lakeh, M. M., Dodaran, M. S., Pazouki, A., ... & Baradaran, H. R. (2022). Type 2 diabetes remission after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one anastomosis gastric bypass (OAGB): results of the longitudinal assessment of bariatric surgery study. BMC Endocrine Disorders, 22(1), 260.
36. Naguib, S. M., Sarhan, A. M. A., Negm, M., Abdulraheem, N. S., & Ali, W. A. E. (2022). Review of Sleeve operation and Complications. NeuroQuantology, 20(10), 7175.
37. Nijland, L. M., Noordman, P. C., Boehlé, L., van Veen, R. N., Bonjer, H. J., & de Castro, S. M. (2023). A decision aid to help patients make informed choices between the laparoscopic gastric bypass or sleeve gastrectomy. Obesity Surgery, 33(2), 562-569.
38. Papakonstantinou, E., Oikonomou, C., Nychas, G., & Dimitriadis, G. D. (2022). Effects of diet, lifestyle, chrononutrition and alternative dietary interventions on postprandial glycemia and insulin resistance. Nutrients, 14(4), 823.
39. Paul, M. A., Opyrchał, J., Knakiewicz, M., Jaremków, P., Duda-Barcik, Ł., Ibrahim, A. M., & Lin, S. J. (2020). The long-term effect of body contouring procedures on the quality of life in morbidly obese patients after bariatric surgery. Plos one, 15(2), e0229138.
40. Pequeno, N. P. F., Cabral, N. L. D. A., Marchioni, D. M., Lima, S. C. V. C., & Lyra, C. D. O. (2020). Quality of life assessment instruments for adults: a systematic review of population-based studies. Health and quality of life outcomes, 18, 1-13.
41. Peristeri, D. V., & Rowdhwal, S. S. S. (2024). Persistent Gastroesophageal Reflux Disease After RYGB: What Shall we do Next?. Surgical Innovation, 15533506241292707.
42. Rose, S. M., & Ahmed, A. R. (2023). Laparoscopic Roux-en-Y Gastric Bypass: Complications–Diagnosis and Management. In Obesity, Bariatric and Metabolic Surgery: A Comprehensive Guide (pp. 347-376). Cham: Springer International Publishing.
43. Shenoy, A., & Schulman, A. R. (2024). Endoscopic Management of Bariatric Surgery Complications: Fistulas, Leaks, and Ulcers. Gastrointestinal Endoscopy Clinics, 34(4), 655-669.
44. Stenberg, E., dos Reis Falcao, L. F., O’Kane, M., Liem, R., Pournaras, D. J., Salminen, P., ... & Thorell, A. (2022). Guidelines for perioperative care in bariatric surgery: enhanced recovery after surgery (ERAS) society recommendations: a 2021 update. World journal of surgery, 46(4), 729-751.
45. Syn, N. L., Cummings, D. E., Wang, L. Z., Lin, D. J., Zhao, J. J., Loh, M., ... & Shabbir, A. (2021). Association of metabolic–bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants. The Lancet, 397(10287), 1830-1841.
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Published
Nov 25, 2024
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How to Cite
Nabaa shakir mahmood, Roda Rashid Bin Sultan Alshamsi, Meera Ahmed Mohamed Othman Ali, Hanadi Mohamad Al Hussami, Shahad Mohammed Al-Mashjari, Judy Al Hussami, Aisha Rashid Mohamed Binsultan Alshamsi, Mahra Salem Mubarak Albreiki, & Meera Mohamed Al Yazeedi. (2024). SHORT- AND LONG-TERM OUTCOMES OF SLEEVE GASTRECTOMY VS. ROUX-EN-Y GASTRIC BYPASS IN BARIATRIC SURGERY. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 778-796. https://doi.org/10.53555/0av7pv86
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Author Biographies
Nabaa shakir mahmood
Medical college: University of Sharjah, College of Medicine,
Roda Rashid Bin Sultan Alshamsi
Medical college: University of Sharjah, College of Medicine,
Meera Ahmed Mohamed Othman Ali
Medical college: University of Sharjah, College of Medicine,
Hanadi Mohamad Al Hussami
Medical college: University of Sharjah, College of Medicine,
Shahad Mohammed Al-Mashjari
Medical college: University of Sharjah,
Judy Al Hussami
Medical college: Gulf Medical University, College of Medicine
Aisha Rashid Mohamed Binsultan Alshamsi
Medical college: Gulf Medical University, College of Medicine,
Mahra Salem Mubarak Albreiki
Medical college: University of Sharjah, College of Medicine,
Meera Mohamed Al Yazeedi
Medical college: Ilia State University, College of Medicine
How to Cite
Nabaa shakir mahmood, Roda Rashid Bin Sultan Alshamsi, Meera Ahmed Mohamed Othman Ali, Hanadi Mohamad Al Hussami, Shahad Mohammed Al-Mashjari, Judy Al Hussami, Aisha Rashid Mohamed Binsultan Alshamsi, Mahra Salem Mubarak Albreiki, & Meera Mohamed Al Yazeedi. (2024). SHORT- AND LONG-TERM OUTCOMES OF SLEEVE GASTRECTOMY VS. ROUX-EN-Y GASTRIC BYPASS IN BARIATRIC SURGERY. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 778-796. https://doi.org/10.53555/0av7pv86