Reoperations were common in all groups .
Reoperation rate was initially high but reduced markedly with improved b and and surgical and aftercare techniques .
Conclusion All current procedures are associated with substantial and durable weight loss .
More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy  .
Reoperation is likely to remain common across all procedures
Introduction Durability is a key requirement for the broad acceptance of bariatric surgery .
Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass.
BACKGROUND  Laparoscopic Roux-en-Y gastric bypass ( LRYGB )  has been the " gold st and ard " for weight loss surgery . Long-term data are limited , and reporting methods for LRYGB outcomes vary in the literature . In addition , follow-up compliance within bariatric centers is poor due to insurance and access to care issues , making long-term follow-up evaluation difficult . OBJECTIVE Evaluate long-term LRYGB outcomes using st and ard outcome reporting definitions . SETTING Integrated multispecialty health system . METHODS A retrospective review of our institution 's prospect i ve bariatric surgery registry and integrated multispecialty electronic medical record system was completed for patients who underwent LRYGB from 2001 to 2015 . Data were defined according to the 2015 St and ards for Outcome Reporting . RESULTS During the study period , 1402 patients underwent primary LRYGB ; mean age and preoperative body mass index were 44.5±10.3 years and 47.5±6.2 kg/m2 , respectively . Early complications included anastomotic leak ( 0.2 % ) , venous thromboembolism ( 0.6 % ) , surgical site infections ( 1.4 % ) , and urinary tract infections ( 1.6 % ) . The 30-day readmission rate was 3.5 % . There were no 30-day mortalities . Follow-up weight data were available for>70 % of eligible patients through 12 years postoperative . The highest mean percent excess weight loss and lowest body mass index were reached at 18 months postoperative at 79 % and 30.1 kg/m2 , respectively . Remission of diabetes , dyslipidemia , and hypertension were observed through 8 years postoperatively . CONCLUSION This is the first report of long-term ( > 10-year ) outcomes from a single integrated health system using the 2015 St and ards for Outcome Reporting . LRYGB results in significant , sustained weight loss and durable improvement and remission of obesity-related co-morbidities . Integrated healthcare systems provide an optimal environment for data collection and long-term follow-up
Reoperations were common in all groups .
Reoperation rate was initially high but reduced markedly with improved b and and surgical and aftercare techniques .
Conclusion All current procedures are associated with substantial and durable weight loss .
More long-term data are needed for one-anastomosis gastric bypass and sleeve gastrectomy  .
Reoperation is likely to remain common across all procedures
Introduction Durability is a key requirement for the broad acceptance of bariatric surgery .