Clinical Outcomes of Resectional Roux-en-Y Gastric Bypass, Compared to Sleeve Gastrectomy for Severe Obesity (original) (raw)

Abstract

Purpose

Resectional Roux-en-Y gastric bypass (RRYGB) is considered an alternative bariatric surgery in countries with a high incidence of stomach cancer because there is no excluded stomach after RRYGB. This study aimed to evaluate the efficacy and safety of RRYGB.

Materials and Methods

This study included patients who underwent RRYGB and sleeve gastrectomy (SG) between 2011 and 2021. Surgical complications and metabolic and nutritional profiles were compared between the patients preoperatively and at 1, 6, and 12 months after surgery.

Results

Twenty and seventy-six patients underwent RRYGB and SG, respectively; 7 in the SG group were lost to follow-up within 1 year. Surgical complications and baseline characteristics were comparable between two groups, except for diabetes (90.0% vs. 44.7%, p < 0.001). The decrease of HbA1c levels and incidence of reflux esophagitis were lower in the RRYGB group compared to that of SG at 1-year postoperative (-3.0% vs. -1.8%, p = 0.014; 0% vs. 26.7%, p = 0.027). The percentage of total weight loss at 1- year postoperative and incidence of dumping syndrome were comparable between the two groups. The RRYGB group had significantly lower total cholesterol level (161.9 mg/dl vs. 196.4 mg/dl, p < 0.001), but higher incidence of vitamin B12 deficiency (30.0% vs. 3.6%, p = 0.003) at 1 year postoperative compared to those of the SG group.

Conclusions

The RRYGB group had better postoperative outcomes for diabetes and dyslipidemia without increasing surgical complications compared to that of the SG group. Thus, RRYGB can be considered a safe and effective alternative in areas where gastric cancer is prevalent.

Graphical Abstract

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Data Availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This study was supported by grants from National Evidence-based Healthcare Collaborating Agency (grant number: HC21C0099) funded by the Ministry of Health & Welfare, Republic of Korea. The funder had no role in study design, data collection, analysis and interpretation or manuscript preparation.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
    Yo-Seok Cho, Ji-Hyeon Park, JeeSun Kim, Sa-Hong Kim, Min Kyu Kang, Yeon-Ju Huh, Yun-Suhk Suh, Seong-Ho Kong, Do-Joong Park, Han-Kwang Yang & Hyuk-Joon Lee
  2. Department of Surgery, Gachon University Gil Medical Center, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea
    Ji-Hyeon Park
  3. Office of Medical Education, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
    Yeon-Ju Huh
  4. Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-guGyeonggi-do, Seongnam-si, 13620, Republic of Korea
    Yun-Suhk Suh
  5. Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
    Seong-Ho Kong, Do-Joong Park, Han-Kwang Yang & Hyuk-Joon Lee
  6. Department of Family Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
    Minseon Park
  7. Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
    Young Min Cho
  8. Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 110-744, Korea
    Hyuk-Joon Lee

Authors

  1. Yo-Seok Cho
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  2. Ji-Hyeon Park
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  3. JeeSun Kim
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  4. Sa-Hong Kim
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  5. Min Kyu Kang
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  6. Yeon-Ju Huh
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  7. Yun-Suhk Suh
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  8. Seong-Ho Kong
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  9. Do-Joong Park
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  10. Han-Kwang Yang
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  11. Minseon Park
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  12. Young Min Cho
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  13. Hyuk-Joon Lee
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Corresponding author

Correspondence toHyuk-Joon Lee.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cho, YS., Park, JH., Kim, J. et al. Clinical Outcomes of Resectional Roux-en-Y Gastric Bypass, Compared to Sleeve Gastrectomy for Severe Obesity.OBES SURG 33, 1338–1346 (2023). https://doi.org/10.1007/s11695-023-06544-z

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