Copyright
©The Author(s) 2015.
World J Gastroenterol. Nov 7, 2015; 21(41): 11804-11814
Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11804
Published online Nov 7, 2015. doi: 10.3748/wjg.v21.i41.11804
Ref. | Country | Follow-up(mo) | Intervention groups | Preoperative BMI (kg/m2) | Weight loss | T2DM | T2DM remission | T2DM remision criteria |
Langer et al[53] | Austria | 6 | SG (10) | 48.3 | 61.4%EWL | 10% | NR | |
LAGB (10) | 46.7 | 28.7%EWL | 30% | |||||
Himpens et al[54] | Belgium | 36 | SG (40) | 39.0 | 66%EWL | NR | ||
LAGB (40) | 37.0 | 48%EWL | ||||||
Lee et al[55] | Taiwan | 12 | SG (30) | 30.3 | 76.3%EWL | 100% | 93% | FG < 126 mg/dL and A1c < 6.5% without hypoglycemic therapy |
RYGB (30) | 94.4%EWL | 47% | ||||||
Karamanakos et al[56] | Greece | 12 | SG (16) | 45.1 | 69.7%EWL | |||
RYG (16) | 46.6 | 60.5%EWL | ||||||
Kehagias et al[57] | Greece | 36 | SG (30) | 44.9 | 68.5%EWL | 16.7% | 80% | FG < 126 mg/dL without hypoglycemic therapy |
RYGB (30) | 45.8 | 62.1%EWL | 16.7% | 80% | ||||
Peterli et al[58] | Switzerland | 12 | SG (11) | 44.7 | 65.6%EWL | 0% | ||
RYGB (12) | 46.7 | 77.0%EWL | 0% | |||||
Schauer et al[59] | USA | 36 | SG (50) | 36.2 | 81%EWL | 100% | 26.5% | A1c < 6.0% without hypoglycemic therapy |
RYGB (50) | 37.0 | 88%EWL | 42% | |||||
Medical therapy (50) | 36.8 | 13%EWL | ||||||
Schauer et al[60] | USA | 12 | SG (50) | 36.2 | 21.1%TWL | 100% | 29% | A1c < 6.0% without hypoglycemic therapy |
RYGB (50) | 37.0 | 24.5%TWL | 46% | |||||
Medical therapy (50) | 36.8 | 4.2%TWL | 0% | |||||
Paluszkiewicz et al[61] | Poland | 12 | SG (36) | 46.1 | 67.6%EWL | 27.8% | 40% | FG < 100 mg/dL and A1c < 6.0% without hypoglycemic therapy |
RYGB (36) | 48.6 | 64.2%EWL | 38.9% | 64.3% | ||||
Ramón et al[28] | Spain | 12 | SG (8) | 43.5 | NR | 25.0% | 100% | NR |
RYGB (7) | 44.2 | 28.6% | 100% | |||||
Vix et al[62] | USA | 12 | SG (45) | 45.5 | 82.9%EWL | 8.9% | NR | |
RYGB (45) | 47.0 | 80.3%EWL | 8.9% |
Extreme obesity (BMI > 50 kg/m2): first-step procedure |
ASA IV morbidly-obese patient |
Absence of hypercholesterolemia |
To avoid drug malabsorption |
Extreme ages |
BMI of 35-40 kg/m2 with comorbidity |
Class I obesity |
Crohn’s disease |
Prevent potential consequences of hypoglycemia in specific occupations |
SG | RYGB | |
Weight loss | No differences with RYGB | No differences with SG |
67.1 %EWL at 12 mo[63] | 68.9% EWL at 12 mo[63] | |
Type 2 diabetes mellitus remission | Early improvement before significant weight loss | Slightly more effective than SG. HR 1.49, 95%CI: 1.04-2.12 for type 2 diabetes mellitus remission in favor of RYGB[63] |
More effective than other restrictive techniques | ||
Hypertension remission | Greater efficacy than other restrictive techniques | More effective than SG |
69% (55-82) Hypertension remission for SG and 45% (27-56) for LAGB[72] | HR of 1.47, 95%CI: 1.115-1.86 for Hypertension remission in favor of RYGB[63] | |
Dyslipidemia remission | Same as other malabsorptive techniques, no hypercholesterolemia improvement | Clearly more effective than SG. HR = 2.41, 95%CI: 1.87-3.11 for Dyslipidemia remission in favor of RYGB[63] |
Mortality | No differences (detailed in table 2) | No differences |
Surgical complications | Less surgical time, lowest 30-d morbidity, 30-d readmission and 30-d reoperation. (detailed in table 2) | Increased risk of nutritional deficiencies |
Characteristic complications: staple line leaks (2.7%[86]; < 1% in expert hands[87]) | Characteristic complications: severe hypoglycemia | |
Long-term results | Limited evidence | Effective and safe in the long term |
Other advantages | Possibility of conversion to a malabsorptive surgery |
- Citation: Benaiges D, Más-Lorenzo A, Goday A, Ramon JM, Chillarón JJ, Pedro-Botet J, Roux JAFL. Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure? World J Gastroenterol 2015; 21(41): 11804-11814
- URL: https://www.wjgnet.com/1007-9327/full/v21/i41/11804.htm
- DOI: https://dx.doi.org/10.3748/wjg.v21.i41.11804