Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the treatment of morbid obesity. a prospective study with 5 years of follow-up.

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) is becoming increasingly popular. The aim of this study was to compare mid-term results of both procedures.

METHODS: From January 2008 to December 2008, 117 obese patients were assigned by patient choice after informed consent to either a LRYGB procedure (n=75) or a LSG procedure (n=42). We determined operative time, length of stay, morbidity, comorbidity outcomes, failures, and excess weight loss at 5 years.

RESULTS: Both groups were comparable in demographic characteristics and comorbidities at baseline. No significant statistical differences were found in length of stay and early major morbidity, but mean operative time was shorter in LSG group, p<0.05. Follow-up was achieved in 74 patients (63.2 %) at 5 years, and major complications (early and late) were 10 (21.2 %) for the LRYGB group and 3 (11.1 %) for the LSG group, p>0.05. Five years after surgery, the percentage of excess weight loss was similar in both groups (69.8 % for LRYGB and 67.3 % for LSG, p>0.05). Failures were more common for LSG group, 22.2 versus 12.7 % for LRYGB group, but this difference was not significant, p>0.05.

CONCLUSIONS: Both techniques are comparable regarding safety and effectiveness after 5 years of follow-up, so not one procedure is clearly superior to the other.