Saeed Shoar1, Zhamak Khorgami2, Stacy A Brethauer3, Ali Aminian4. 1. ScientificWriting Corporation, Houston, Texas. 2. Department of Surgery, University of Oklahoma, College of Medicine, Tulsa, Oklahoma. 3. Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. 4. Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address: aminiaa@ccf.org.
Abstract
BACKGROUND: Bariatric surgery is remarkably effective in achieving weight loss and improving obesity-related co-morbidities; however, efforts still continue to improve its long-term outcomes. Particularly, banded Roux-en-Y gastric bypass (RYGB) has been scrutinized in comparison to standard (nonbanded) RYGB in terms of benefits and postoperative complications. OBJECTIVES: This study aims to compare the safety and efficacy of banded versus nonbanded RYGB. SETTING: Meta-analysis of randomized controlled trials (RCTs). METHODS: A meta-analysis of high-quality studies that compared banded and nonbanded RYGB was conducted through February 2019 by systematically searching multiple electronic databases. Published RCTs comparing these 2 procedures were included to pool the data on excess weight loss, food tolerability, and postoperative complications. RESULTS: Three RCTs were eligible to be included in this meta-analysis, comprising a total of 494 patients (247 in each group). Two of the RCTs provided 2-year postoperative data, and 1 study reported 5-year outcome. Age ranged from 21 to 50 years, and body mass index ranged from 42 to 65 kg/m2. Percentage of excess weight loss was significantly greater with banded RYGB than with nonbanded RYGB (mean difference 5.63%; 95% CI 3.26-8.00; P < .05). Postoperative food intolerance, emesis, and dysphagia were more common after banded RYGB (odds ratio 3.76; 95% CI 2.27-6.24; P < .001). Nevertheless, major postoperative complications did not significantly differ between the 2 groups. CONCLUSION: Findings of this meta-analysis of RCTs indicate that in a medium-term follow-up, excess weight loss with banded RYGB would be 5% greater than that with the nonbanded RYGB (about 1 point difference in body mass index) at the expense of more food intolerance and postoperative vomiting; however, the frequency of postoperative complications would not be significantly different.
BACKGROUND: Bariatric surgery is remarkably effective in achieving weight loss and improving obesity-related co-morbidities; however, efforts still continue to improve its long-term outcomes. Particularly, banded Roux-en-Y gastric bypass (RYGB) has been scrutinized in comparison to standard (nonbanded) RYGB in terms of benefits and postoperative complications. OBJECTIVES: This study aims to compare the safety and efficacy of banded versus nonbanded RYGB. SETTING: Meta-analysis of randomized controlled trials (RCTs). METHODS: A meta-analysis of high-quality studies that compared banded and nonbanded RYGB was conducted through February 2019 by systematically searching multiple electronic databases. Published RCTs comparing these 2 procedures were included to pool the data on excess weight loss, food tolerability, and postoperative complications. RESULTS: Three RCTs were eligible to be included in this meta-analysis, comprising a total of 494 patients (247 in each group). Two of the RCTs provided 2-year postoperative data, and 1 study reported 5-year outcome. Age ranged from 21 to 50 years, and body mass index ranged from 42 to 65 kg/m2. Percentage of excess weight loss was significantly greater with banded RYGB than with nonbanded RYGB (mean difference 5.63%; 95% CI 3.26-8.00; P < .05). Postoperative food intolerance, emesis, and dysphagia were more common after banded RYGB (odds ratio 3.76; 95% CI 2.27-6.24; P < .001). Nevertheless, major postoperative complications did not significantly differ between the 2 groups. CONCLUSION: Findings of this meta-analysis of RCTs indicate that in a medium-term follow-up, excess weight loss with banded RYGB would be 5% greater than that with the nonbanded RYGB (about 1 point difference in body mass index) at the expense of more food intolerance and postoperative vomiting; however, the frequency of postoperative complications would not be significantly different.
Authors: Rinki Murphy; Lindsay D Plank; Michael G Clarke; Nicholas J Evennett; James Tan; David D W Kim; Richard Cutfield; Michael W C Booth Journal: Diabetes Care Date: 2022-07-07 Impact factor: 17.152
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