Randomized trial of Roux-en-Y gastric bypass versus sleeve gastrectomy in achieving excess weight loss
| Autor: | Silvana Perretta, A D'Urso, Michel Vix, Didier Mutter, Jacques Marescaux, Mihaela Ignat, I Imad |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy Adolescent medicine.medical_treatment Gastric Bypass 030209 endocrinology & metabolism Patient Readmission Preoperative care law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial Gastrectomy Weight loss law Weight Loss Health Status Indicators Humans Medicine Laparoscopy medicine.diagnostic_test business.industry Middle Aged Roux-en-Y anastomosis Obesity Morbid Surgery Treatment Outcome Quality of Life Female 030211 gastroenterology & hepatology medicine.symptom business Follow-Up Studies |
| Zdroj: | British Journal of Surgery. 104:248-256 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1002/bjs.10400 |
| Popis: | Background Robust data on quality of life (QoL) after different techniques of bariatric surgery are sparse. This RCT compared excess weight loss (EWL) and QoL after sleeve gastrectomy versus Roux-en-Y gastric bypass (RYGB). Methods Obese patients were assigned randomly to RYGB or sleeve gastrectomy. The primary outcome measure was EWL. Secondary outcomes included QoL, co-morbidity, adverse events, vitamin and glycolipid status. QoL was assessed before and annually after surgery, using the Moorehead–Ardelt Quality of Life Questionnaire II (M-A-QoLQII) and Gastrointestinal Quality of Life Index (GIQLI). Results One hundred patients were enrolled, 45 in the RYGB group and 55 in the sleeve gastrectomy group. Mean postoperative EWL at 1, 2, 3 and 5 years was 80·4, 79·8, 83·0 and 74·8 per cent respectively after RYGB, and 83·0, 77·8, 66·3 and 65·1 per cent after sleeve gastrectomy (P = 0·017). Mean M-A-QoLQII score before surgery and at 1, 2, 3 and 5 years after operation was 0·5, 1·6, 1·7, 2·1 and 1·4 respectively after RYGB, and 0·3, 1·7, 1·5, 1·5 and 1·2 after sleeve gastrectomy. Mean GIQLI score before and at 1, 2, 3, 5 years after RYGB was 96·4, 113·8, 113·3, 113·4, 111·7, compared with 90·7, 113·9, 114·5, 113·1 and 113·0 for sleeve gastrectomy. The improvement was significant compared with preoperative values (P < 0·001 for M-A-QoLQII and GIQLI), with no difference between groups (P = 0·418 and P = 0·323 respectively). RYGB resulted in higher readmission rates (P = 0·002) and length of hospital stay (P = 0·006) than sleeve gastrectomy. Conclusion RYGB and sleeve gastrectomy resulted in equivalent, long-standing QoL improvement. RYGB resulted in more stable weight loss but was associated with higher readmission rates. Registration number: NCT02475590. |
| Databáze: | OpenAIRE |
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