Gastric bypass has better outcomes than gastric b and procedures for long-term weight loss , type 2 diabetes control and remission , hypertension , and hyperlipidemia .
Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections
IMPORTANCE Bariatric surgery is an accepted treatment for obesity .
Despite extensive literature , few studies report long-term follow-up in cohorts with adequate retention rates .
OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss , type 2 diabetes , hypertension , and hyperlipidemia in severely obese adults .
A Prospective Comparison of Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass in a Non-Superobese Population
Background : In the non-superobese population , consensus is currently unavailable in bariatric surgery . We report the results of a prospect i ve comparison of vertical b and ed gastroplasty ( VBG ) and Roux-en-Y gastric bypass ( RYGBP ) in a non-superobese population . Methods : From 1994 to 2000 , 179 patients with clinical ly severe obesity underwent various surgical procedures in our department . During this time a prospect i ve study was undertaken in order to compare VBG with RYGBP in morbidly obese patients with a BMI < 50 kg/m2 . Based on specific criteria including eating behavior , 68 patients were selected to undergo RYGBP and 35 VBG . All patients have undergone complete follow-up evaluation at 1 , 3 , 6 , and 12 months postoperatively and every year thereafter . Results : All patients have now completed their 5th postoperative year . Mean follow-up period to date is 96.5±12.2 months for VBG and 67.6±11.3 months for RYGBP . 3 patients ( 8.6 % ) in the VBG group and 9 patients ( 13.2 % ) in the RYGBP group are lost to follow-up . Mean excess weight loss ( EWL ) was always better in the RYGBP group ( P=0.0013 ) . The percentage of failure , defined as EWL < 25 % , was not significantly different between the two procedures . No statistically significant differences were observed between the 2 groups in the total number of non-metabolic complications , and the only statistically significant difference observed in metabolic complications was vitamin B12 deficiency after RYGBP . Frequency of vomiting was significantly less and quality of eating significantly better in RYGBP than in VBG patients . Conclusion : This prospect i ve long-term study , with nearly complete follow-up , suggests that in the non-superobese population , preoperative eating habits may play a role in choosing the most appropriate bariatric operation for each patient . Although RYGBP is associated with better mean weight loss outcomes , the percentage of patients who achieved and maintained ≥50 % EWL after VBG in this pre-selected patient population was not significantly different . Each type of operation has advantages and disadvantages , and , if properly chosen , a purely restrictive procedure can be successful for some patients . Therefore , it can be said that the decision regarding which bariatric procedure to perform in non-superobese patients must be based on in-depth preoperative evaluation as well as the patients ' own preferences and outcome expectations
Gastric bypass has better outcomes than gastric b and procedures for long-term weight loss , type 2 diabetes control and remission , hypertension , and hyperlipidemia .
Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections
IMPORTANCE Bariatric surgery is an accepted treatment for obesity .
Despite extensive literature , few studies report long-term follow-up in cohorts with adequate retention rates .
OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss , type 2 diabetes , hypertension , and hyperlipidemia in severely obese adults .