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Comparative study of outcomes following laparoscopic roux-en-y gastric bypass and sleeve gastrectomy in morbidly obese patients: A case control study

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World Journal of Gastrointestinal endoscopy 2017年第4期9卷 162-170页

作者： Harshit Garg Pratyusha Priyadarshini Sandeep Aggarwal Samagra Agarwal Rachna Chaudhary Department of Surgical Disciplines All India Institute of Medical Sciences Department of Medicine All India Institute of Medical Sciences

To compare the impact of laparoscopic roux-en-y gastric bypass (LRyGB) and laparoscopic sleeve gastrectomy (LSG) on weight loss and obesity related comorbidities over two year follow-up via case control study design. METHODSForty patients undergoing LRyGB, who completed their two year follow-up were matched with 40 patients undergoing LSG for age, gender, body mass index and presence of type 2 diabetes mellitus (T2DM). Data of these patients was retrospectively reviewed to compare the outcome in terms of weight loss and improvement in comorbidities, i.e., T2DM, hypertension (HTN), obstructive sleep apnea syndrome (OSAS), hypothyroidism and gastroesophageal reflux disease (GERD). RESULTSPercentage excess weight loss (EWL%) was similar in LRyGB and LSG groups at one year follow-up (70.5% vs 66.5%, P = 0.36) while it was significantly greater for LRyGB group after two years as compared to LSG group (76.5% vs 67.9%, P = 0.04). The complication rate after LRyGB and LSG was similar (10% vs 7.5%, P = 0.99). The median duration of T2DM and mean number of oral hypoglycemic agents were higher in LRyGB group than LSG group (7 years vs 5 years and 2.2 vs 1.8 respectively, P yGB and LSG had significant but similar improvement in T2DM, HTN, OSAS and hypothyroidism. However, GERD resolved in all patients undergoing LRyGB while it resolved in only 50% cases with LSG. Eight point three percent patients developed new-onset GERD after LSG. CONCLUSIONLRyGB has better outcomes in terms of weight loss two years after surgery as compared to LSG. The impact of LRyGB and LSG on T2DM, HTN, OSAS and hypothyroidism is similar. However, LRyGB has significant resolution of GERD as compared to LSG.

关键词： Bariatric surgery laparoscopic sleeve gastrectomy laparoscopic roux-en-y gastric bypass Weight loss Comorbidities

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Surgical outcome of laparoscopic sleeve gastrectomy and roux-en-y gastric bypass for resolution of type 2 diabetes mellitus:A systematic review and meta-analysis

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World Journal of Gastroenterology 2020年第8期26卷 865-876页

作者： Salman yousuf Guraya Tim Strate Clinical Sciences Department College of MedicineUniversity of SharjahSharjah 27272United Arab Emirates Department of Surgery Reinbek HospitalAcademic Teaching Hospital of the University of HamburgReinbek D-21465Germany

BACKGROUND Bariatric procedures are considered superior to medical therapies in managing type 2 diabetes mellitus(T2DM).laparoscopic roux-en-y gastric bypass(LRyGB)and laparoscopic sleeve gastrectomy(LSG)are the most commonly used procedures for weight loss and comorbidity resolution ***,it is not yet known whether the degree of T2DM is influenced by the choice of bariatric *** To quantitatively compare T2DM resolution over 1-5 years follow-up by LRyGB and LSG in morbidly obese *** We searched the selected databases for full-text english language clinical studies that compared the effectiveness of LRyGB and LSG for T2DM *** manager 5.3 was used for data analysis,and the overall effect summary was represented in a forest *** From 1,650 titles retrieved by an initial search,we selected nine studies for this *** found insignificant differences for T2DM resolution by LRyGB and LSG,with an odds ratio of 0.93(95%CI:0.64-1.35,Z statistics=0.38,P=0.71).Additionally,subset analyses for T2DM resolution showed insignificant differences after 24 mo(χ^2=1.24,df=4,P=0.87,overall Z effect=0.23),36 mo(χ^2=0.41,df=2,P=0.81,overall Z effect=0.51),and 60 mo(χ^2=4.75,df=3,P=0.19,overall Z effect=1.20)by LRyGB and *** study reports a T2DM remission rate of 82.3%by LRyGB and 80.7%by *** This study reports similar T2DM resolution rates by both LRyGB and LSG during 1-5 years of ***,long-term follow-up of 10 years is needed to further substantiate these findings.

关键词： Morbid obesity Type 2 diabetes mellitus laparoscopic sleeve gastrectomy laparoscopic roux-en-y gastric bypass

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Excessive Weight Loss Following laparoscopic gastric Mini bypass or roux-en-y gastric bypass Surgery

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International Journal of Clinical Medicine 2016年第7期7卷 445-449页

作者： Abdolreza Pazouki Sima Karbalaei Esmaeili Assistant Professor Minimally Invasive Surgery Research Center Iran University of Medical Sciences Tehran Iran Surgery Resident Iran University of Medical Sciences Tehran Iran

Background: More than 90 percent of obesity surgery is done using a laparoscope. This method is superior to open surgery and lead to fewer complications, shorter hospital stay and faster recovery. This study compared course of weight loss following laparoscopic gastric Mini bypass or roux-en-y gastric bypass surgery, after one year of follow up. Materials and Methods: This randomized clinical trial was conducted among obese patients admitted to Rasoul Akram Hospital Obesity Clinic, Half underwent laparoscopic roux-en-y gastric bypass and the rest were undergoing laparoscopic Mini gastric bypass. The amount of weight loss during the first year after surgery will be discussed. Results: In this study, 75 obese patients were studied. Most of the participants were female (82.7%). Participants aged between 18 and 59 years old (average = 36.8 ± 9.8 y/o). Before the surgery, there was no significant difference in weight between the two groups. Excessive weight loss after one month, six months nine months and one year between the two groups was significant and was more in Mini gastric bypass (p enefits of Mini gastric bypass compared to the roux-en-y gastric bypass technique, it is suggested for patients with morbid obesity.

关键词： Morbid Obesity laparoscopic Mini gastric bypass laparoscopic roux-en-y gastric bypass

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Analysis of long-term outcome of modified gastric bypass for type 2 diabetes mellitus in Chinese patients

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World Journal of Clinical Cases 2024年第25期12卷 5697-5705页

作者： ying Xing Ri-Xing Bai you-Guo Li Jun Xu Zhi-Qiang Zhong Ming yan Wen-Mao yan Department of General Surgery Beijing Tiantan HospitalBeijing 100170China

BACKGROUND Bariatric and metabolic surgery have been routinely performed following the rapid increase in obesity and metabolic diseases *** all evolving procedures,roux-en-y gastric bypass(RyGB)is considered the gold standard for surgical treatment of patients with type 2 diabetes mellitus(T2DM)and *** was introduced in China nearly 20 years ago,but the number of RyGB surgeries only accounts for 3.1%of the total number of weight loss and metabolic surgeries in China,it’s effect on Chinese people still needs further *** To investigate the effect and safety of a modified gastric bypass performed in Chinese patients with *** Patients with obesity and T2DM who underwent modified gastric bypass,with>5-year follow-up data,were *** All 37 patients underwent uneventful laparoscopic surgery,no patient was switched to laparotomy during the surgery,and no severe complications were *** weight and body mass index of the patients reduced from 84.6±17.3(60.0–140.0)kg and 30.9±5.0(24.7–46.2)kg/m2 to 67.1±12.2(24.7–46.2)kg and 24.6±3.9(17.7–36.5)kg/m2,respectively,and fasting plasma glucose and glycated hemoglobin decreased from 7.4±3.4 mmol/L and 8.2%±1.7%preoperatively to 6.5±1.3 mmol/L and 6.5%±0.9%5-years postoperatively,*** 29.7%(11/37)of the patients used hypoglycemic drugs 5-years postoperatively,and the complete remission rate of T2DM was 29.7%(11/37).Triglyceride level reduced significantly but high-density lipoprotein increased significantly(both Penal function improved significantly postoperatively,and binary logistic regression analysis revealed that the patients’preoperative history of T2DM and fasting C-peptide were significant prognostic factors influencing complete T2DM remission after RyGB(P=0.006 and 0.012,respectively).CONCLUSION The modified gastric bypass is a safe and feasible procedure for Chinese patients with obesity an

关键词： laparoscopic roux-en-y gastric bypass Chinese patients Metabolic surgery Bariatric surgery Type 2 diabetes mellitus

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roux-en-y gastric bypass or sleeve gastrectomy for obstructive sleep apnea:A systematic review and meta-analysis

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laparoscopic, endoscopic and Robotic Surgery 2019年第3期2卷 53-58页

作者： Hussein Al-Rubaye Emma Rose McGlone Borna Farzaneh Livyar Mustafa Mae Johnson Ajit Kayal Caroline-Louise english Vasha Kaur Myutan Kalendran Marcus Reddy Omar A.Khan St George's University of LondonLondonSW170REUK Department of Metabolic and Investigative Medicine Hammersmith Hospital CampusImperial College LondonLondonW120HSUK Department of Anaesthetic St George's HospitalLondonSW170QTUK St George's Hospital LondonSW170QTUK Department of Upper Gastrointestinal and Bariatric Surgery St George's HospitalLondonSW170QTUK Population Health Research Institute St George'sUniversity of LondonLondonSW170REUK

Objective:Bariatric surgery has been shown to be an effective method of treatment for obstructive sleep apnea(OSA)with long-term benefits,however,the mechanisms of action and the optimum operative procedure remains *** aim of this systemic review was to compare the efficacy of laparoscopic sleeve gastrectomy(LSG)and roux-en-y gastric bypass(RyGB)in resolving ***:A comprehensive search of MEDLINE,Pubmed,Embase,and OVID was *** that reported OSA resolution in obese patients with BMI>30 kg/m2 were included in the ***,comparative prospective and matched cohort studies comparing RyGB with LSG were considered for this ***:Five studies(309 participants)were included:4 cohort studies and 1 RCT;all with low risk of *** 12 months follow-up,there was a trend towards improved resolution of OSA with LSG(OR 0.47,95%CI[0.20 to 1.06];p=0.07)when compared to *** contrast,there was a trend to poorer weight loss in the LSG group(SMD 3.83,95%CI[-1.82 to 9.48];p=0.18).Similarly,at 36 months follow-up,there was a trend towards better resolution of OSA with LSG(OR 0.52,95%CI[0.16 to 1.71];p=0.28)and a significantly poorer weight loss in LSG when compared to RyGB(SMD 8.25,95%CI[2.91 to 13.58];p=0.002).Conclusion:Despite poorer weight loss following LSG,there is a trend towards increased resolution of sleep apnea *** findings suggest the possibility of weight loss independent factors causing OSA resolution,which should be further ***:PROSPERO:CRD42018090367.

关键词： Obesity laparoscopic sleeve gastrectomy laparoscopic roux-en-y gastric bypass Obstructive sleep apnea Meta-analysis

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