Chike Okolocha1, Sitembile Lee1, Aliu Sanni, MD, FACS2. 1Philadelphia College of Osteopathic Medicine – Georgia Campus, 2Eastside Bariatric and General Surgery
INTRODUCTION: Morbid obesity has become a growing health risk in the United States with up to 40% of Americans suffering with Obesity. Bariatric surgery remains the best treatment for morbid obesity. The recent use of laparoscopic sleeve gastrectomy (LSG) as a single stage procedure has met with great success because of its quick learning curve and minimal postoperative complication rates. However, there are concerns if the LSG is an effective procedure for long-term weight loss. Although criticized at first, the mini-gastric bypass (MGB) surgery has become a great option for morbidly obese patients because of the ability to lose weight with minimal post-op complications. The aim of this review is to assess the outcomes of LSG as it compares to MGB for the management of morbid obesity.
METHODS/MATERIALS: A systematic review was conducted through PubMed to identify relevant publications from 2006 to 2016 with comparative studies on LSG vs MGB for weight loss in morbidly obese patients. The primary outcome analysed was the percentage of excess weight loss (%EWL). Other outcomes include body mass index (BMI), operative time, postoperative complication rates and remission of diabetes. Results were expressed as standard difference in means with standard error. Statistical analysis was done using fixed-effects meta-analysis to compare the mean value of the two groups and percentage of patients affected by complications or had remission of diabetes to the sample size. (Comprehensive Meta-Analysis Version 3.3.070 software; Biostat Inc., Englewood, NJ).
RESULTS: Six out of 52 studies were quantitatively assessed and included for this meta-analysis. Among the six studies, 522 patients underwent LSG and 526 patients underwent MGB. The %EWL (0.399 ± 0.066; p <0.001) in the MGB group was significantly higher when compared to the LSG group. Postoperative BMI (-0.408 ± 0.065; p < 0.0001) and the operative time (-0.850 ± 0.096; p < 0.0001) were significantly lower in the MGB group. The rate of diabetes remission (-0.480 ± 0.122; p < 0.0001) was higher in MGB patients. Postoperative complication rates (0.079 ± 0.161; p = 0.624) were similar amongst both groups.
CONCLUSION: Mini gastric bypass is more effective in the management of morbid obesity when compared to the sleeve gastrectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86703
Program Number: P567
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster