Surgery results in greater improvement in weight loss outcomes and weight associated comorbidities compared with non-surgical interventions , regardless of the type of procedures used .
When compared with each other , certain procedures result ed in greater weight loss and improvements in comorbidities than others .
Outcomes were similar between RYGB and sleeve gastrectomy , and both of these procedures had better outcomes than adjustable gastric b and ing .
For people with very high BMI , biliopancreatic diversion with duodenal switch result ed in greater weight loss than RYGB .
Isolated sleeve gastrectomy led to better weight-loss outcomes than adjustable gastric b and ing after three years follow-up .
BACKGROUND Bariatric ( weight loss ) surgery for obesity is considered when other treatments have failed .
The effects of the available bariatric procedures compared with medical management and with each other are uncertain .
This is an up date of a Cochrane review first published in 2003 and most recently up date d in 2009 .
OBJECTIVES To assess the effects of bariatric surgery for overweight and obesity , including the control of comorbidities .
A Prospective Randomized Study Between Laparoscopic Gastric Banding and Laparoscopic Isolated Sleeve Gastrectomy: Results after 1 and 3 Years
Background : Laparoscopic adjustable gastric b and ing ( GB ) is the most popular restrictive procedure for obesity in Europe . Isolated sleeve gastrectomy ( SG ) , is less common , but more invasive and with a higher learning curve . The aim of this prospect i ve r and omized study was to compare the results of GB and SG after 1 and 3 years of surgery . Methods : 80 patient c and i date s for laparoscopic restrictive surgery were operated consecutively and r and omly , between January and December 31 , 2002 , by GB ( 7 M , 33F ) or by SG ( 9 M , 31F ) ( NS ) . Median age was 36 ( 20 - 61 ) for GB versus 40 ( 22 - 65 ) for SG ( NS ) . Median BMI was 37 ( 30 - 47 ) for GB versus 39 ( 30 - 53 ) for SG ( NS ) . After 1 and 3 years : weight loss , feeling of hunger , sweet eating , gastroesophageal reflux disease ( GERD ) , complications and re-operations were recorded in both groups . Results : Median weight loss after 1 year was 14 kg ( −5 to + 38 ) for GB and 26 kg ( 0 to 46 ) for SG ( P<0.0001 ) ; and after 3 years was 17 kg ( 0 to 40 ) for GB and 29.5 kg ( 1 to 48 ) for SG ( P<0.0001 ) . Median decrease in BMI after 1 year was 15.5 kg/m 2 ( 5 to 39 ) after GB and 25 kg/m2 ( 0 to 45 ) after SG ( P<0.0001 ) ; and after 3 years was 18 kg/m2 ( 0 to 39 ) after GB and 27.5 kg/m 2 ( 0 to 48 ) after SG ( P=0.0004 ) . Median % EWL at 1 year was 41.4 % ( −11.8 to + 130.5 ) after GB and 57.7 % ( 0 to 125.5 ) after SG ( P=0.0004 ) ; and at 3 years was 48 % ( 0 to 124.8 ) after GB and 66 % ( −3.1 to + 152.4 ) after SG ( P=0.0025 ) . Loss of feeling of hunger after 1 year was registered in 42.5 % of patients with GB and in 75 % of patients with SG ( P=0.003 ) ; and after 3 years in 2.9 % of patients with GB and 46.7 % of patients with SG ( P<0.0001 ) . Loss of craving for sweets after 1 year was achieved in 35 % of patients with GB and 50 % of patients with SG ( NS ) ; and after 3 years in 2.9 % of patients with GB and 23 % of patients with SG ( NS ) . GERD appeared de novo after 1 year in 8.8 % of patients with GB and 21.8 % of patients with SG ( NS ) ; and after 3 years in 20.5 % of patients with GB and 3.1 % of patients with SG ( NS ) . Postoperative complications requiring re-operation were necessary for 2 patients after SG . Late complications requiring re-operation after GB included 3 pouch dilations treated by b and removal in 2 and 1 laparoscopic conversion to Roux-en-Y gastric bypass  ( RYGBP ) , 1 gastric erosion treated by conversion to RYGBP , and 3 disconnections of the system treated by reconnection . Inefficacy affected 2 patients after GB , treated by conversion into RYGBP and 2 patients after SG treated by conversion to duodenal switch . Conclusion : Weight loss and loss of feeling of hunger after 1 year and 3 years are better after SG than GB . GERD is more frequent at 1 year after SG and at 3 years after GB . The number of re-operations is important in both groups , but the severity of complications appears higher in SG
Surgery results in greater improvement in weight loss outcomes and weight associated comorbidities compared with non-surgical interventions , regardless of the type of procedures used .
When compared with each other , certain procedures result ed in greater weight loss and improvements in comorbidities than others .
Outcomes were similar between RYGB and sleeve gastrectomy , and both of these procedures had better outcomes than adjustable gastric b and ing .
For people with very high BMI , biliopancreatic diversion with duodenal switch result ed in greater weight loss than RYGB .
Isolated sleeve gastrectomy led to better weight-loss outcomes than adjustable gastric b and ing after three years follow-up .
BACKGROUND Bariatric ( weight loss ) surgery for obesity is considered when other treatments have failed .
The effects of the available bariatric procedures compared with medical management and with each other are uncertain .
This is an up date of a Cochrane review first published in 2003 and most recently up date d in 2009 .
OBJECTIVES To assess the effects of bariatric surgery for overweight and obesity , including the control of comorbidities .