Gender Influence in Bariatric Surgery Outcomes: Sleeve Gastrectomy and Gastric Bypass

Martin A Berducci, MD, Jorge Nefa, Alberto Gallo, MD, Magali Sanchez, MD, Natalia Pampillon, Lic, Viviana Lasagni, Lic, Cecilia Penutto, Sonia Omelanczuk, Mariela Abaurre, Lic, Romina Palma, Lic, Alejandra Ojeda, MD, Pablo E Omelanczuk, MD. Clinica Quirurgica

Introduction

The long-term ef?cacy of laparoscopic Roux-en-Y gastric bypass (RYGB) in the treatment of morbid obesity has been proven both as a first-stage for super-obese patients and as a definitive procedure. Nonetheless, laparoscopic sleeve gastrectomy (LSG) is becoming the favorite bariatric procedure worldwide.

The effect of gender on weight loss after bariatric surgery has not been well established in the literature despite being noted in every day practice. The aim of this study was to assess whether gender influences on long-term weight loss after bariatric surgery.

Methods

A retrospective, comparative analysis was performed of 632 patients who underwent RYGB and LSG between 2005 and 2014 at Hospital Italiano, Mendoza, Argentina. Patients were then divided into groups based on type of surgical procedure and gender. Demographics, perioperative data, early (<30 days) and late (>30 days) complications, re-interventions, mortality and %EWL at 12 and 24 months were compared.

Results

We included 343 LSG patients (72.8% female) and 289 RYGB patients (80.2% female). The mean age and initial BMI were similar in LSG and RYGB groups (46.6 ± 11.7 and 45.4 ± 8.8, and 41.1 ± 9.1 and 45.9 ± 6.4, respectively). The operating time was signi?cantly shorter in the LSG group than for RYGB group (92.7 ± 21.2 min vs. 174.4 ± 31 min, p<0.001). The conversion rate was 0% in both groups. There were 3 (1.03%) major complications following LSG and 7 (2.42%) after RYGB (p=0.999). All required laparoscopic reoperations. There was one death in the RYGB group. In the female group, %EWL after 12 and 24 months was better in RYGB group than LSG group (12 months: 66.5 vs. 60.2, p=0.012; 24 months: 65.7 vs. 54.3, p=0.016, respectively). In contrast, in the male group the %EWL was not significantly different between RYGB and LSG (12 months: 66.4 vs. 67.8; 24 months: 67.5 vs. 62.1, respectively) (table 1).

Females Males
LSG RYGB p Value LSG RYGB p Value
Initial BMi 43.8 45.3 NS 48.3 47.4 NS
%EWL 12 M 60.2 66.5 0.012 67.8 66.4 NS
%EWL 24 M 54.3 65.7 0.016 62.1 67.5 NS

Table 1. Percentage of EWL in males and females at 12 and 24 months

Conclusion

RYGB is more effective than LSG in terms of weight loss in the female population. Interestingly, this difference was not observed in the male group. We believe that RYGB should be considered as the primary bariatric procedure for obese female patients seeking weight loss surgery.

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