J-M Catheline1, M Fysekidis2, Y Bendacha3, J-J Portal4, N Huten5, E Chouillard6, J Gugenheim7, G Fourtanier8, K Arapis9, S Msika10, J M Fabre11, M Sodji12, E Vicaut13, R Dbouk14, J Roussel15, R Cohen16. 1. Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: jmcatheline@orange.fr. 2. Department of endocrinology, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93000 Bobigny, France. Electronic address: fisekidis_marinos@hotmail.com. 3. Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: yasmina.bendacha@ch-stdenis.fr. 4. Clinical research unit, hôpital Fernand-Widal, AP-HP, 200, rue du Faubourg-Saint-Denis, 75475 Paris, France. Electronic address: jean-jacques.portal@aphp.fr. 5. Department of digestive surgery, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France. Electronic address: huten@med.univ-tours.fr. 6. Department of digestive surgery, CHI de Poissy, 10, rue du Champ-Gaillard, 78303 Poissy, France. Electronic address: chouillard@yahoo.com. 7. Department of digestive surgery, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, 06202 Nice, France. Electronic address: gugenheim.j@chu-nice.fr. 8. Department of digestive surgery, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, 31400 Toulouse, France. Electronic address: gilles@fourtanier.com. 9. Department of digestive surgery, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75877 Paris, France. Electronic address: konstantinos.arapis@bch.aphp.fr. 10. Department of digestive surgery, hôpital Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France. Electronic address: simon.msika@aphp.fr. 11. Department of digestive surgery, CHU de Montpellier, 80, avenue Augustin-Fiche, 34000 Montpellier, France. Electronic address: jm-fabre@chu-montpellier.fr. 12. Department of digestive surgery, clinique des Émailleurs, 1, rue Victor-Schoelcher, 87000 Limoges, France. Electronic address: maximesodji87@gmail.com. 13. Clinical research unit, hôpital Fernand-Widal, AP-HP, 200, rue du Faubourg-Saint-Denis, 75475 Paris, France. Electronic address: eric.vicaut@aphp.fr. 14. Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: rami.dbouk@ch-stdenis.fr. 15. Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: jyroussel@gmail.com. 16. Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: regis.cohen@ch-stdenis.fr.
Abstract
BACKGROUND:Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-enY gastric bypass (LRYGB) are commonly performed, but few studies have shown superiority of one strategy over the other. OBJECTIVE: Simultaneously compare LSG and LRYGB in terms of weight loss and morbimortality over a 36-month follow-up period. SETTING:University hospital and bariatric surgery centers, France. METHODS: Prospective, comparative study between LSG and RYGBP. The primary endpoint of this study was a joint hypothesis during the 36-month follow-up: the first primary outcome pertained to the frequency of patients with an excess weight loss (EWL) greater than 50% (% EWL>50%) after LSG or RYGB; the second primary outcome was defined as a composite endpoint of at least one major complication. Secondary objectives were regression of comorbidities and improvement in quality of life. RESULTS:Two hundred and seventy-seven patients were included (91 RYGBP, 186 LSG). The mean age was 41.1±11.1 years, and average preoperative body mass index of 45.3±5.5kg/m2. After 36months, the %EWL>50% was not inferior in the case of LSG (82.2%) relative to LRYGB (82.1%); while major complications rates were significantly higher in LRYGB (15.4%) vs. LSG (5.4%, P=0.005). After 36months, all secondary objectives were comparable between groups while only gastroesophageal reflux disease (GERD) increased in LSG group and decreased in LRYGB group. CONCLUSIONS:LSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up. But GERD increased in LSG group and decreased in LRYGB group.
RCT Entities:
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en Y gastric bypass (LRYGB) are commonly performed, but few studies have shown superiority of one strategy over the other. OBJECTIVE: Simultaneously compare LSG and LRYGB in terms of weight loss and morbimortality over a 36-month follow-up period. SETTING: University hospital and bariatric surgery centers, France. METHODS: Prospective, comparative study between LSG and RYGBP. The primary endpoint of this study was a joint hypothesis during the 36-month follow-up: the first primary outcome pertained to the frequency of patients with an excess weight loss (EWL) greater than 50% (% EWL>50%) after LSG or RYGB; the second primary outcome was defined as a composite endpoint of at least one major complication. Secondary objectives were regression of comorbidities and improvement in quality of life. RESULTS: Two hundred and seventy-seven patients were included (91 RYGBP, 186 LSG). The mean age was 41.1±11.1 years, and average preoperative body mass index of 45.3±5.5kg/m2. After 36months, the %EWL>50% was not inferior in the case of LSG (82.2%) relative to LRYGB (82.1%); while major complications rates were significantly higher in LRYGB (15.4%) vs. LSG (5.4%, P=0.005). After 36months, all secondary objectives were comparable between groups while only gastroesophageal reflux disease (GERD) increased in LSG group and decreased in LRYGB group. CONCLUSIONS: LSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up. But GERD increased in LSG group and decreased in LRYGB group.
Authors: Piotr Małczak; Magdalena Mizera; Yung Lee; Magdalena Pisarska-Adamczyk; Michał Wysocki; Małgorzata M Bała; Jan Witowski; Mateusz Rubinkiewicz; Alicja Dudek; Tomasz Stefura; Grzegorz Torbicz; Piotr Tylec; Natalia Gajewska; Tanawat Vongsurbchart; Michael Su; Piotr Major; Michał Pędziwiatr Journal: Obes Surg Date: 2021-10-11 Impact factor: 4.129