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. 2021 Aug;35(8):4691-4699.
doi: 10.1007/s00464-020-07933-6. Epub 2020 Sep 9.

Factors influencing the choice between laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

Hassan Nasser  1 , Tommy Ivanics  2 , Arthur M Carlin  2
Affiliations

Factors influencing the choice between laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

Hassan Nasser et al. Surg Endosc. 2021 Aug.

Abstract

Background: While laparoscopic sleeve gastrectomy (LSG) continues to be the most commonly performed bariatric operation, several variables influence surgeons' practice patterns and patients' decision-making in the type of bariatric procedure to perform. The aim of this study was to evaluate patient factors that influence the decision between laparoscopic Roux-en-Y gastric bypass (LRYGB) versus LSG.

Methods: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried for patients undergoing LSG and LRYGB between 2015 and 2017. Univariate analysis and multivariate logistic regression were used to evaluate factors associated with performing LRYGB compared to LSG.

Results: A total of 252,117 (72.3%) LSG and 96,677 (27.7%) LRYGB cases were identified. Patients undergoing LSG were younger (44.3 ± 12.0 vs 45.2 ± 11.8 years; p < 0.01) and had a lower body mass index (BMI; 45.1 ± 7.8 vs 46.2 ± 8.1 kg/m2; p < 0.01). Most of the patients were females (79.4%), white (73.0%), with an American Society of Anesthesiology (ASA) class ≤ 3 (96.4%). The factors associated with undergoing LRYGB compared to LSG were diabetes mellitus, gastroesophageal reflux disease, BMI ≥ 50 kg/m2, ASA class > 3, obstructive sleep apnea, hypertension, and hyperlipidemia. However, patients with kidney disease, black race, chronic steroid use, age ≥ 60 years, recent smoking history, chronic obstructive pulmonary disease, and coronary artery disease were more likely to undergo LSG.

Conclusions: The decision to perform LRYGB is primarily driven by obesity-associated comorbidities and higher BMI, whereas LSG is more likely to be performed in higher risk patients.

Keywords: Bariatric surgery; Body mass index; Comorbidities; Procedure choice; Roux-en-Y gastric bypass; Sleeve gastrectomy.

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References

    1. English WJ, DeMaria EJ, Hutter MM, Kothari SN, Mattar SG, Brethauer SA, Morton JM (2020) American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis 16:457–463. https://doi.org/10.1016/j.soard.2019.12.022 - DOI - PubMed
    1. El Chaar M, Lundberg P, Stoltzfus J (2018) Thirty-day outcomes of sleeve gastrectomy versus Roux-en-Y gastric bypass : first report based on Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis 14:545–553. https://doi.org/10.1016/j.soard.2018.01.011 - DOI - PubMed
    1. Osland E, Yunus RM, Khan S, Alodat T, Memon B, Memon MA (2016) Postoperative early major and minor complications in laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures: a meta-Analysis and systematic review. Obes Surg 26:2273–2284. https://doi.org/10.1007/s11695-016-2101-8 - DOI - PubMed
    1. Peterli R, Wolnerhanssen BK, Peters T, Vetter D, Kroll D, Borbely Y, Schultes B, Beglinger C, Drewe J, Schiesser M, Nett P, Bueter M (2018) Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial. JAMA 319:255–265. https://doi.org/10.1001/jama.2017.20897 - DOI - PubMed - PMC
    1. Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, Hurme S, Soinio M, Nuutila P, Victorzon M (2018) Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial. JAMA. https://doi.org/10.1001/jama.2017.20313 - DOI - PubMed - PMC

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