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 comparison of 399 open and 568 laparoscopic gastric bypasses performed during a 4-year period
Background Laparoscopic Roux-en-Y gastric bypass surgery ( RYGB ) was introduced at the authors ’ institution 5 years ago . The authors analyzed the short- and long-term results of this procedure compared with those for the same procedure using the laparotomy approach over the same period . Methods Retrospective analysis of a prospect ively collected bariatric data base used the outcome end points used by the American Society of Bariatric Surgery ( ASBS ) and the American College of Surgeons ( ACS ) in their center of excellence programs . Results From January 2001 to July 2005 , 568 laparoscopic and 399 open gastric bypasses were performed at V and erbilt University . The patients were from the same bariatric surgery program and therefore received the same pre- and postoperative care . The hospital length of stay in the laparoscopic group was significantly shorter ( 2.5 ± 2.4 days ) than in the open group ( 3.7 ± 3.7 days ; p = 0.001 ) . The procedure time was significantly shorter in the laparoscopic group ( 164 ± 50 min ) than in the open group ( 195 ± 50 min ; p = 0.0001 ) . The follow-up assessment response at 2 years was 76.6 % . At 2 years , the excess weight loss ( EWL ) was significantly greater in the laparoscopic group ( 71.3 % ± 18.4 % ) than in the open group ( 67.3 % ± 15.3 % ; p = 0.03 ) . The wound infection rate was significantly higher in open group ( 9.2 % ) than in the laparoscopic group ( 1.7 % ; p = 0.001 ) . There was no significant difference in 30-day mortality : open ( 0.50 % ) versus laparoscopic ( 0.17 % ; p = 0.371 ) . There was no significant difference in the 30-day reoperation rate between the open ( 2.4 % ) and laparoscopic ( 2.6 % ; p = 0.705 ) groups . The 30-day readmission rate was similar in the open ( 5.0 % ) and laparoscopic ( 5.2 % ; p = 0.852 ) groups , as was the rate of leakage from the gastrojejunostomy in the open ( 0.50 % ) and laparoscopic ( 0.35 % ; p = 0.127 ) groups . The conversion rate from laparoscopic procedure to laparotomy was 1.7 % . Conclusion In the authors ’ institution , a laparoscopic bariatric surgery program with a very low rate of morbidity and mortality has been introduced . Operative time , hospital stay , and wound complications are reduced with the laparoscopic approach . The laparoscopic and open procedures are equally safe , with equivalent 30-day mortality , readmission , reoperation , and gastrojejunostomy leakage rates
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 .