Pondech Vichajarn, MD, Narong Boonyagard, MD, Pakkavuth Chansawangphuvana, MD, Krit Kittisin, MD, Suppa-ut Pungpapong, MD, Chadin Tharavej, MD, Patpong Navicharern, MD, Suthep Udomsawaengsup, MD. Chulalongkorn University
Many of studies showed effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) in excess weight loss (EWL) for morbid obesity patients but there were few studies in super obese patients. The comparison between effectiveness of LRYGB and laparoscopic sleeve gastrectomy (LSG) also had limit data.
This study was designed to compare effectiveness of reduction of excess weight after bariatric surgery between LRYGB and LSG in super obese patients.
Medical records of morbid obesity patients with BMI 50 kg/m2 or more who underwent LRYGB or LSG at least 12 month previously were retrospectively reviewed. Baseline characteristics, body mass index (BMI), comorbidities, complications were observed. Percent of EWL at 1,3,6,9 and 12 months of both groups were compared as the primary end point.
Ninety two patients with BMI 50 kg/m2 or more were retrospectively reviewed. Forty one patients were performed LRYGB and 51 were performed LSG. There was no difference in baseline characteristics of both groups. Mean age was nearly 33 years old. Patients who were performed LSG have tend to be female more than in LRYGB group (58.82%vs41.46%) but it was not significantly different. Average BMI was comparable in both groups (58.09±8.07 for LRYGB and 61.0 ±9.80 for LSG). There was no conversion to open surgery in this study. At one year follow up mean percent EWL were 63.07±13.79 for LRYGB and 53.12±14.74 for LSG, the difference reached statistical significance (p=0.007). Significant difference of percent EWL had been showed at the first three months of follow up (32.69±9.77 for LRYGB vs 27.89±8.89 for LSG, p=0.032). There was no fatal complication in this study. Three major postoperative complications were found, one was bleeding from staple line after performed LSG, the other one was bleeding at gastrojejunostomy anastomosis and the last one was edematous of anastomosis that caused acute postoperative obstruction in LRYGB groups.
Both LRYGB and LSG are safe and effective procedure for reduce excessive weight in super obese patients. However LRYGB can provide percent EWL better than LSG at one year follow up.