Zhamak Khorgami1, Saeed Shoar, MD2, Philip R Schauer, MD2, Stacy A Brethauer, MD2, Ali Aminain, MD2. 1University of Oklahoma, College of Medicine, Tulsa, OK, 2Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, OH
Introduction: While sleeve gastrectomy (SG) is the most common bariatric procedure worldwide, single anastomosis (mini) gastric bypass (SAGB) is rapidly gaining acceptance. As mid- to long-term effects of SAGB on weight and obesity-related comorbidities become available, a systematic review of the literature to summarize the available high quality data is required to direct future investigations and clinical practice.
Methods: A systematic literature review was conducted in PubMed/Medline and Cochrane Database through September 2018 to identify RCTs which compared weight loss outcome, diabetes mellitus (DM) and hypertension (HTN) remission, and postoperative complications between SAGB and SG.
Results: 3 RCTs encompassing 595 patients (297 SAGB patients and 298 LSG patients) were eligible to be enrolled into this meta-analysis. The longest follow-up was 5 years for 2 RCTs and 3 years for 1 RCT. Weight loss outcome was pooled based on percentage of total weight loss in 2 studies (significant in favor of SAGB) and percent excess weight loss in 2 studies (not significantly different). Moreover, while SAGB had a mild superiority in DM remission (effect size = 0.16, p = 0.02), the difference was not significant for HTN resolution (effect size = 0.17, p = 0.06). Postoperative adverse events were comparable between the 2 procedures (odds ratio = 0.80, p = 0.42).
Conclusion: Findings of this meta-analysis suggest that SAGB is associated with more weight loss compared with SG. Furthermore, while SG has remarkable effects on DM and HTN, SAGB is associated with about 15% higher chance of remission for both comorbidities. Both procedures are comparably safe.
Figure. Comparison of weight loss outcome (above: %weight loss and % excess weight loss), resolution of comorbid diabetes mellitus and hypertension (middle), and postoperative adverse events (below)
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 96053
Program Number: P072
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster