Laparoscopic Sleeve Gastrectomy and Roux-en-y Gastric Bypass: Weight Results After Surgery

E Raga, A Molina, F Sabench, M Paris, M Hernandez, A Sanchez, S Blanco, A Munoz, E Homs, J Sanchez, Ml Pinana, Daniel Del Castilo. Hospital Universitari Sant Joan de Reus. Universitat Rovira i Virgili

OBJECTIVES: To describe the weight evolution along three years after surgery in patients undergoing Laparoscopic Sleeve Gastrectomy (LSG) and Roux-Y gastric Bypass (RYGB ) in our center.

MATERIAL AND METHODS: Retrospective review of patients treated between 2005 and 2010. Weight evolution was assessed by the following indicators: total weight (kg), body mass index and percentage of excess BMI lost (PEBMIL).

RESULTS: 297 patients (23.6%?, 76.4 % ?), mean age 46.5 years, mean weight 127.2 kg and mean BMI 48.1 kg/m2. A total of 175 LSG and 122 RYGB were performed. Before surgery in LSG group: mean weight 132.1 kg (95% CI 128.3-135.8) and mean BMI 49.7 kg/m2 (95% CI 48.4-51.0). One year after surgery: mean weight 93.6 kg (CI 90.5-96.7), mean BMI 35.5 kg/m2 (CI 34.4-36.5) and a PEBMIL 56,3% (CI 50.5-62.1). Two years after surgery: mean weight 92.3 kg (CI 88.5 to 96.0), mean BMI 35.2 kg/m2 (CI 33.9-36.5) and the PEBMIL 56.6 % (CI 47.8-65.5). Three years after surgery: mean weight 93.5 kg (95% CI 89.5-97.5), mean BMI 35.9 kg/m2 (CI 34.4-37.4) and 47.0% PEBMIL (CI: 30.2-63.7). Before surgery in RYGB group: mean weight 120.3 kg (CI 117.4-123.1) and mean BMI 45.8 kg/m2 (CI 44.9-46.7). One year after surgery: mean weight 81.7 kg (CI 79.1-84.3), mean BMI 31.3 kg/m2 (CI 30.5-32.2) and a PEBMIL 70,6% (CI 66.8-74.3). Two years after surgery: mean weight 78.7 kg (CI 75.8-81.6), mean BMI 30.2 kg/m2 (CI 29.2-31.2) and PEBMIL 76.9 % (CI 72.9-81.0). Three years after surgery: mean weight 80.2 kg (CI 77.1-83.4), mean BMI 30.9 kg/m2 (CI 29.7-32.1) and 73.5 % PEBMIL (CI: 68.6-78.4). Comparing the two techniques according PEBMIL, a significant differences at year, two years and three years were found (p<0.05).

CONCLUSIONS: Patients undergoing RYGB have better weight evolution valued according PEBMIL and BMI during the 3 years analyzed, and the maximum peak was recorded two years after surgery. PEBMIL in LSG is smaller although the results remain within quality standards. This is because LSG is performed as a first surgical step in most cases.