Prospective, multicentric, comparative study between sleeve gastrectomy and Roux-en-Y gastric bypass, 277 patients, 3 years follow-up.

Autor: Catheline JM; Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: jmcatheline@orange.fr., Fysekidis M; Department of endocrinology, hôpital Avicenne, AP-HP, 125, rue de Stalingrad, 93000 Bobigny, France. Electronic address: fisekidis_marinos@hotmail.com., Bendacha Y; Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: yasmina.bendacha@ch-stdenis.fr., Portal JJ; Clinical research unit, hôpital Fernand-Widal, AP-HP, 200, rue du Faubourg-Saint-Denis, 75475 Paris, France. Electronic address: jean-jacques.portal@aphp.fr., Huten N; Department of digestive surgery, CHU de Tours, 2, boulevard Tonnellé, 37000 Tours, France. Electronic address: huten@med.univ-tours.fr., Chouillard E; Department of digestive surgery, CHI de Poissy, 10, rue du Champ-Gaillard, 78303 Poissy, France. Electronic address: chouillard@yahoo.com., Gugenheim J; Department of digestive surgery, CHU de Nice, 151, route Saint-Antoine-de-Ginestière, 06202 Nice, France. Electronic address: gugenheim.j@chu-nice.fr., Fourtanier G; Department of digestive surgery, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, 31400 Toulouse, France. Electronic address: gilles@fourtanier.com., Arapis K; Department of digestive surgery, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75877 Paris, France. Electronic address: konstantinos.arapis@bch.aphp.fr., Msika S; Department of digestive surgery, hôpital Louis-Mourier, AP-HP, 178, rue des Renouillers, 92700 Colombes, France. Electronic address: simon.msika@aphp.fr., Fabre JM; Department of digestive surgery, CHU de Montpellier, 80, avenue Augustin-Fiche, 34000 Montpellier, France. Electronic address: jm-fabre@chu-montpellier.fr., Sodji M; Department of digestive surgery, clinique des Émailleurs, 1, rue Victor-Schoelcher, 87000 Limoges, France. Electronic address: maximesodji87@gmail.com., Vicaut E; Clinical research unit, hôpital Fernand-Widal, AP-HP, 200, rue du Faubourg-Saint-Denis, 75475 Paris, France. Electronic address: eric.vicaut@aphp.fr., Dbouk R; Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: rami.dbouk@ch-stdenis.fr., Roussel J; Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: jyroussel@gmail.com., Cohen R; Department of digestive surgery, centre hospitalier de Saint-Denis, 2, rue du Docteur-Delafontaine, 93205 Saint-Denis, France. Electronic address: regis.cohen@ch-stdenis.fr.
Jazyk: angličtina
Zdroj: Journal of visceral surgery [J Visc Surg] 2019 Dec; Vol. 156 (6), pp. 497-506. Date of Electronic Publication: 2019 May 15.
DOI: 10.1016/j.jviscsurg.2019.04.013
Abstrakt: Background: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en Y gastric bypass (LRYGB) are commonly performed, but few studies have shown superiority of one strategy over the other.
Objective: Simultaneously compare LSG and LRYGB in terms of weight loss and morbimortality over a 36-month follow-up period.
Setting: University hospital and bariatric surgery centers, France.
Methods: Prospective, comparative study between LSG and RYGBP. The primary endpoint of this study was a joint hypothesis during the 36-month follow-up: the first primary outcome pertained to the frequency of patients with an excess weight loss (EWL) greater than 50% (% EWL>50%) after LSG or RYGB; the second primary outcome was defined as a composite endpoint of at least one major complication. Secondary objectives were regression of comorbidities and improvement in quality of life.
Results: Two hundred and seventy-seven patients were included (91 RYGBP, 186 LSG). The mean age was 41.1±11.1 years, and average preoperative body mass index of 45.3±5.5kg/m 2 . After 36months, the %EWL>50% was not inferior in the case of LSG (82.2%) relative to LRYGB (82.1%); while major complications rates were significantly higher in LRYGB (15.4%) vs. LSG (5.4%, P=0.005). After 36months, all secondary objectives were comparable between groups while only gastroesophageal reflux disease (GERD) increased in LSG group and decreased in LRYGB group.
Conclusions: LSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up. But GERD increased in LSG group and decreased in LRYGB group.
(Copyright © 2019. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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