OBJECTIVE: To compare the long-term risks of reintervention following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in a large surgical cohort. BACKGROUND: The use of SG has increased dramatically relative to RYGB for the treatment of obesity. However, long-term risks following SG compared with RYGB have not been adequately defined in a large population-based study. METHODS: A retrospective longitudinal cohort study of all adult health-plan members undergoing SG or RYGB for obesity in a multistate integrated health care system from January 2005 through September 2015. The risks of nutritional, endoscopic, radiologic, and surgical reintervention as well as the overall risk of any reinterventions at 1, 3, and 5 years were identified using diagnosis and procedure codes from comprehensive electronic medical records. RESULTS: The study included 15,319 patients who underwent SG and 19,954 patients who underwent RYGB with a follow-up of 79.2%. The overall risk of any reintervention at 5 years was 21.3% for SG and 28.3% for RYGB (P < 0.0001). After adjustment, SG was associated with fewer reinterventions through 5 years than RYGB (hazard ratio, 0.78; 95% confidence interval, 0.74-0.84). When comparing subcategories, SG also had a lower risk of nutritional, endoscopic, radiologic, and surgical reinterventions when examined versus RYGB. The findings for risks of reinterventions were consistent across clinical subgroups. CONCLUSION: SG has significantly lower risk of reintervention in all categories studied when compared with RYGB at 5-year follow-up. The long-term safety profile of LSG compared with RYGB should be an essential part of the discussion in patient-centered decision making when choosing between bariatric procedure options.
OBJECTIVE: To compare the long-term risks of reintervention following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in a large surgical cohort. BACKGROUND: The use of SG has increased dramatically relative to RYGB for the treatment of obesity. However, long-term risks following SG compared with RYGB have not been adequately defined in a large population-based study. METHODS: A retrospective longitudinal cohort study of all adult health-plan members undergoing SG or RYGB for obesity in a multistate integrated health care system from January 2005 through September 2015. The risks of nutritional, endoscopic, radiologic, and surgical reintervention as well as the overall risk of any reinterventions at 1, 3, and 5 years were identified using diagnosis and procedure codes from comprehensive electronic medical records. RESULTS: The study included 15,319 patients who underwent SG and 19,954 patients who underwent RYGB with a follow-up of 79.2%. The overall risk of any reintervention at 5 years was 21.3% for SG and 28.3% for RYGB (P < 0.0001). After adjustment, SG was associated with fewer reinterventions through 5 years than RYGB (hazard ratio, 0.78; 95% confidence interval, 0.74-0.84). When comparing subcategories, SG also had a lower risk of nutritional, endoscopic, radiologic, and surgical reinterventions when examined versus RYGB. The findings for risks of reinterventions were consistent across clinical subgroups. CONCLUSION: SG has significantly lower risk of reintervention in all categories studied when compared with RYGB at 5-year follow-up. The long-term safety profile of LSG compared with RYGB should be an essential part of the discussion in patient-centered decision making when choosing between bariatric procedure options.
Authors: Anita Courcoulas; R Yates Coley; Jeanne M Clark; Corrigan L McBride; Elizabeth Cirelli; Kathleen McTigue; David Arterburn; Karen J Coleman; Robert Wellman; Jane Anau; Sengwee Toh; Cheri D Janning; Andrea J Cook; Neely Williams; Jessica L Sturtevant; Casie Horgan; Ali Tavakkoli Journal: JAMA Surg Date: 2020-03-01 Impact factor: 14.766
Authors: Anita P Courcoulas; Eric Johnson; David E Arterburn; Sebastien Haneuse; Lisa J Herrinton; David P Fisher; Robert A Li; Mary Kay Theis; Liyan Liu; Brianna Taylor; Julie Cooper; Philip L Chin; Gary G Grinberg; Anirban Gupta; Shireesh Saurabh; Scott S Um; Panduranga R Yenumula; Jorge L Zelada; Karen J Coleman Journal: Ann Surg Date: 2021-08-13 Impact factor: 12.969
Authors: Jean-Eric Tarride; Aristithes G Doumouras; Dennis Hong; J Michael Paterson; Semra Tibebu; Francis Nguyen; Richard Perez; Valerie H Taylor; Feng Xie; Vanessa Boudreau; Eleanor Pullenayegum; David R Urbach; Mehran Anvari Journal: JAMA Netw Open Date: 2021-09-01
Authors: Karen J Coleman; Anirban Basu; Lee J Barton; Heidi Fischer; David E Arterburn; Douglas Barthold; Anita Courcoulas; Cecelia L Crawford; Benjamin B Kim; Peter N Fedorka; Edward C Mun; Sameer B Murali; Kristi Reynolds; Robert E Zane; Sami Alskaf Journal: JAMA Netw Open Date: 2022-09-01