A Comparison of the Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Body Mass Composition as Measured by Air Displacement Plethysmography.

BACKGROUND: The laparoscopic sleeve gastrectomy (LSG) is now the most commonly performed bariatric surgery in the world. Multiple studies have demonstrated the equivalence between the LSG and Roux-en-Y gastric bypass (RYGB) with regard to weight loss and comorbidity resolution. Few studies have examined the differences in body mass composition change between the two procedures.
METHODS: Sixty-three patients undergoing either LSG or RYGB underwent calculation of total body mass, ideal body mass, lean mass, and fat mass by air displacement plethysmography (BodPodtm) prior to surgery and at 12 months postoperatively. Calculations of excess body weight, % excess weight loss, change in % fat mass, and change in % lean mass were then performed at each time interval.
RESULTS: Thirty-three patients underwent LSG and 30 patients underwent RYGB. Mean percent excess weight loss in the LSG and RYGB group was 47.2% and 53.4% respectively (p = 0.165, 95% CI - 14.8-2.6). Mean percent change in fat mass for the LSG group and RYGB group was 9.2% and 10.51% respectively (p = 0.249, 95% CI - 0.86-3.2). Mean percent change in lean mass for the LSG group and RYGB group was 9.4% and 10.49% respectively (p = 0.383, 95% CI 2.85-1.13).
CONCLUSION: The LSG and RYGB both impart dramatic meaningful loss in excess body weight. In addition, both the LSG and RYGB impart dramatic reductions in fat mass. However, both procedures induce loss of lean mass and there appears to be no difference between the two procedures in this regard despite their anatomic and physiologic differences.