Chris G Smith, Dr1, Fatima Haggar, Dr2, Joe Mamazza, Dr2, Bryan Curtis, Dr1, Michael Hogan, Dr1, Dave Pace, Dr1, Darrell Boone, Dr1, Lisa Bacque, Dr1, Dimitry Terterov, Dr1, Priscille Cyr, Dr1, Aryan Modasi, Dr1, Erin Mayo, Dr1, Vanessa Falk, Dr1, Hensley Mariathas, Dr1. 1Memorial University of Newfoundland, 2University of Ottawa
Background: Bariatric surgery has been shown to be safe and effective for the treatment of morbid obesity and related comorbidities. The goal of the current study is to explore the role of surgery in patients with moderate obesity or body mass index (BMI) < 35.
Methods: Systematic review and Meta analysis was performed focusing solely on patients with BMI < 35 who underwent laparoscopic roux en y gastric bypass (REYGB), sleeve gastrectomy (LSG), or adjustable gastric banding (AGB). Data were limited to randomized controlled trials and prospective cohort studies. Primary outcome measure was fasting plasma glucose (FPG). Secondary outcome measures included hemoglobin A1c (HbA1c), and other obesity related comorbidities.
Results: 13 studies were included in the analysis. Surgery was associated with significantly improved FPG compared to medical therapy (WMD -3.24, 95% CI -4.45; -2.02). Surgery was also associated with improved HbA1c, body weight, BMI loss, waist circumference, and resolution of hypertension and dyslipidemia. Improvements were also seen with respect to obstructive sleep apnea, osteoarthritis, gastroesophageal reflux, infertility, urinary stress incontinence, and venous stasis. These results were consistent across each surgical procedure. 2 randomized controlled trials compared REYGB to LSG and subgroup analysis was performed which revealed no difference with respect to glucose metabolism however REYGB was associated with greater BMI loss and decreased waist circumference. Perioperative complications were comparable to morbidly obese subjects.
Conclusion: REYGB, LSG and AGB appear to be safe and effective in the treatment of obesity and related comorbidities in patients with BMI < 35. REYGB and LSG have similar effects on FPG and HbA1c however REYGB appears to have improved results with respect to waist circumference and BMI.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93419
Program Number: P142
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
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