Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: Results from a meta-analysis of randomized controlled trials.

Background: Laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass (LRYGB) are 2 widely used procedures performed in bariatric surgery. However, their long-term weight loss effects have not been well compared.

Objectives: To evaluate the long-term outcome of 2 procedures for treating morbid obesity.

Setting: The gastrointestinal surgery center, Eastern Hospital, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital.

Methods: Three electronic databases, PubMed, CNKI, and EMBASE, were searched ending in September 2018. Eligible studies were prospective randomized controlled trials.

Results: Of 15 randomized controlled trials studies, 1381 cases were included, 697 were randomly divided into the laparoscopic sleeve gastrectomy group and 684 to the LRYGB group. A statistically significant percent excess weight loss reduction in weighted mean difference was observed in LRYGB group at 5 years (weighted mean difference = -8.9, 95% confidence interval [CI] = -13.08 to -4.73, P < .0001), and at 3 years (weighted mean difference = -11.96, 95% CI = -17.62 to -6.30, P < .0001). However, there was not any statistically difference between the 2 procedures in <3 years. The total complication of the LSC group were less than that of the LRYGB groups (odds ratio = .52, 95%CI = .35-.76, P = .0007). This meta-analysis showed that the LRYGB procedure could reduce gastrointestinal reflux disease (odds ratio = .26, 95%CI = .11-.61, P = .002); however, no statistically significant differences were found in type 2 diabetes, hypertension, dyslipidemia, and sleep apnea.

Conclusions: This meta-analysis showed that significantly greater in percent excess weight loss after 5 years of LRYGB treatment; however, it seems to have a higher incidence of total complications.