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Reduction in obesity-related comorbidities: is gastric bypass better than sleeve gastrectomy?

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Abstract

Background

Bariatric surgery is currently the most effective treatment for morbid obesity. It provides not only substantial weight loss, but also resolution of obesity-related comorbidities. Laparoscopic sleeve gastrectomy (LSG) has rapidly been gaining in popularity. However, there are limited data on the reduction of obesity-related comorbidities for LSG compared to laparoscopic Roux-en-Y gastric bypass (LRYGB). The aim of this study was to assess the effectiveness of laparoscopic LSG versus LRYGB for the treatment of obesity-related comorbidities.

Methods

A total of 558 patients who underwent either LSG or LRYGB for morbid obesity at the Westchester Medical Center between April 2008 and September 2010 were included. Data were collected prospectively into a computerized database and reviewed for this study. Fisher’s exact test analyses compared 30-day, 6-month, and 1-year outcomes of obesity-related comorbidities.

Results

A total of 558 patients were included in the analysis of obesity-related comorbidity resolution; 200 underwent LSG and 358 underwent LRYGB. After 1 year, 86.2 % of the LSG patients had one or more comorbidities in remission compared to 83.1 % LRYGB patients (P = 0.688). With the exception of GERD (−0.09 vs. 50 %; P < 0.001), similar comorbidity remission rates were observed between LSG and LRYGB for sleep apnea (91.2 vs. 82.8 %; P = 0.338), hyperlipidemia (63 vs. 55.8 %; P = 0.633), hypertension (38.8 vs. 52.9 %; P = 0.062), diabetes (58.6 vs. 65.5 %; P = 0.638), and musculoskeletal disease (66.7 vs. 79.4 %; P = 0.472).

Conclusions

Laparoscopic sleeve gastrectomy markedly improves most obesity-related comorbidities. Compared to LRYGB, LSG may have equal in reducing sleep apnea, hyperlipidemia, hypertension, diabetes, and musculoskeletal disease. LRYGB appears to be more effective at GERD resolution than LSG.

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Acknowledgments

We thank Nancy Nolan, RN, who worked on the data collection system and provided the detailed data for statistical analysis.

Disclosures

Niu Zhang, Anthony Maffei, Thomas Cerabona, Juan Omana, Anil Pahuja and Ashutosh Kaul have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Westchester Medical Center, 100 Woods Road, Valhalla, NY, 10595, USA

    Niu Zhang, Anthony Maffei, Thomas Cerabona, Anil Pahuja, Juan Omana & Ashutosh Kaul

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  1. Niu Zhang
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  2. Anthony Maffei
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  3. Thomas Cerabona
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Correspondence to Ashutosh Kaul.

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Zhang, N., Maffei, A., Cerabona, T. et al. Reduction in obesity-related comorbidities: is gastric bypass better than sleeve gastrectomy?. Surg Endosc 27, 1273–1280 (2013). https://doi.org/10.1007/s00464-012-2595-7

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  • DOI: https://doi.org/10.1007/s00464-012-2595-7

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