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Comparative Study
. 2011 Sep;254(3):410-20; discussion 420-2.
doi: 10.1097/SLA.0b013e31822c9dac.

First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass

Matthew M Hutter  1 , Bruce D Schirmer, Daniel B Jones, Clifford Y Ko, Mark E Cohen, Ryan P Merkow, Ninh T Nguyen
Affiliations
Comparative Study

First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass

Matthew M Hutter et al. Ann Surg. 2011 Sep.

Abstract

Objective: To assess the safety and effectiveness of the laparoscopic sleeve gastrectomy (LSG) as compared to the laparoscopic adjustable gastric band (LAGB), the laparoscopic Roux-en-Y gastric bypass (LRYGB) and the open Roux-en-Y gastric bypass (ORYGB) for the treatment of obesity and obesity-related diseases.

Background: LSG is a newer procedure being done with increasing frequency. However, limited data are currently available comparing LSG to the other established procedures. We present the first prospective, multiinstitutional, nationwide, clinically rich, bariatric-specific data comparing sleeve gastrectomy to the adjustable gastric band, and the gastric bypass.

Methods: This is the initial report analyzing data from the American College of Surgeons-Bariatric Surgery Center Network accreditation program, and its prospective, longitudinal, data collection system based on standardized definitions and collected by trained data reviewers. Univariate and multivariate analyses compare 30-day, 6-month, and 1-year outcomes including morbidity and mortality, readmissions, and reoperations as well as reduction in body mass index (BMI) and weight-related comorbidities.

Results: One hundred nine hospitals submitted data for 28,616 patients, from July, 2007 to September, 2010. The LSG has higher risk-adjusted morbidity, readmission and reoperation/intervention rates compared to the LAGB, but lower reoperation/intervention rates compared to the LRYGB and ORYGB. There were no differences in mortality. Reduction in BMI and most of the weight-related comorbidities after the LSG also lies between those of the LAGB and the LRYGB/ORYGB.

Conclusion: LSG has morbidity and effectiveness positioned between the LAGB and the LRYGB/ORYGB for data up to 1 year. As obesity is a lifelong disease, longer term comparative effectiveness data are most critical, and are yet to be determined.

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Figures

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Figure 1
Increasing incidence of Sleeve Gastrectomy.
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Reduction in Obesity Related Diseases
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Reduction in Obesity Related Diseases
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Reduction in Obesity Related Diseases
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Figure 3
Reduction in Obesity Related Diseases
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Figure 3
Reduction in Obesity Related Diseases
See this image and copyright information in PMC

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