Vanessa Boudreau, MD, Karen Barlow, HonsBSc, Scott Gmora, MD, Dennis Hong, MD, Mehran Anvari, MD, PhD. Center for Minimal Access Surgery, McMaster University, Ontario, Canada
Introduction: Vertical Sleeve Gastrectomy (VSG) is becoming an increasingly popular surgical treatment for morbid obesity compared to Roux-en-Y Gastric Bypass (RYGB) in North America.
Methods: Data collected in Ontario Bariatric Registry between 2010–2018 was used to compare long term outcomes of patients undergoing VSG or RYGB (currently the gold standard). Intention to treat analysis was performed. Results include conversions and revisions.
Results: Of the 18 431 patients that underwent surgical treatment, 15,379 (81.4%) had RYGB (baseline BMI 48.2; age 44.3 years; 84.3% female) and 2572 (13.6%) had VSG (baseline BMI 53.3, age 48.2 years; 75.4% female). Surgical complications were reported in 5.6% of RYGB patients and in 2.8% of VSG patients. There were 50 VSG patients that required a conversion due to weight regain/ineffective weight loss compared to 4 RYGB patients. The follow-up data were available for 2384 RUGB at 3 years and 569 at 5 years. For VSG, 236 patients had 3 year follow-up and 40 patients had 5 year follow-up.
| RYGB | VSG | p-value | ||
| Conversion |
3 year 5 year |
0.2% 1.5% |
36.0% 47.5% |
<0.05 <0.05 |
| %EWL |
3 year 5 year |
68.8% 62.3% |
49.3% 46.4% |
<0.05 <0.05 |
| Improvement in GERD |
3 year 5 year |
46.9% 45.7% |
-3.9% -6.0% |
<0.05 <0.05 |
| Improvement in Diabetes |
3 year 5 year |
56.0% 41.5% |
39.7% 40.9% |
NS NS |
| Improvement in OSA |
3 year 5 year |
27.3% 48.9% |
6.6% 27.1% |
<0.05 <0.05 |
| Improvement in musculoskeletal pain |
3 year 5 year |
38.0% 34.3% |
22.3% 7.0% |
<0.05 <0.05 |
Conclusion: RYGB results in more favorable weight loss and reduced weight regain as well as better resolution of GERD, musculoskeletal pain and OSA symptoms and has a significantly less likelihood for conversion due to weight regain or side effects at 5 years.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93997
Program Number: P144
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster