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Meta-Analysis
. 2023 Nov 1;109(11):3541-3554.
doi: 10.1097/JS9.0000000000000629.

Comparing the safety and efficacy of sleeve gastrectomy versus Roux-en-Y gastric bypass in elderly (>60 years) with severe obesity: an umbrella systematic review and meta-analysis

Mohammad Kermansaravi  1   2 , Antonio Vitiello  3 , Rohollah Valizadeh  4 , Shahab Shahabi Shahmiri  1   2 , Mario Musella  3
Affiliations
Meta-Analysis

Comparing the safety and efficacy of sleeve gastrectomy versus Roux-en-Y gastric bypass in elderly (>60 years) with severe obesity: an umbrella systematic review and meta-analysis

Mohammad Kermansaravi et al. Int J Surg. .

Abstract

Background: Today, bariatric surgeons face the challenge of treating older adults with class III obesity. The indications and outcomes of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) also constitute a controversy.

Methods: PubMed, Web of Science and Scopus were searched to retrieve systematic reviews/meta-analyses published by 1 March 2022. The selected articles were qualitatively evaluated using A Measurement Tool to Assess systematic Reviews (AMSTAR).

Results: An umbrella review included six meta-analyses retrieved from the literature. The risk of early-emerging and late-emerging complications decreased by 55% and 41% in the patients underwent SG than in those receiving RYGB, respectively. The chance of the remission of hypertension and obstructive sleep apnoea, respectively increased by 43% and 6%, but type-2 diabetes mellitus decreased by 4% in the patients underwent RYGB than in those receiving SG. RYGB also increased excess weight loss by 15.23% in the patients underwent RYGB than in those receiving SG.

Conclusion: Lower levels of mortality and early-emerging and late-emerging complications were observed in the older adults undergoing SG than in those receiving RYGB, which was, however, more efficient in term of weight loss outcomes and recurrence of obesity-related diseases.

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Conflict of interest statement

None.

Sponsorships or competing interests that maybe relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Flowchart of the umberella review.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 3
Figure 3
Forest plot to show risk of early complications for sleeve gastrectomy vs. Roux-en-Y gastric bypass in elderly. OR, odds ratio; OSA, Obstructive sleep apnea.
Figure 4
Figure 4
Forest plot to show risk of late complications for sleeve gastrectomy vs. Roux-en-Y gastric bypass in elderly. OR, odds ratio.
Figure 5
Figure 5
Forest plot to show risk of mortality for sleeve gastrectomy vs. Roux-en-Y gastric bypass in elderly. OR, odds ratio.
Figure 6
Figure 6
Forest plot to show chance of OSA remission for sleeve gastrectomy vs. Roux-en-Y gastric bypass in elderly. OR, odds ratio.
Figure 7
Figure 7
Forest plot to show chance of hypertension remission for sleeve gastrectomy vs. Roux-en-Y gastric bypass in elderly. OR, odds ratio.
Figure 8
Figure 8
Forest plot to show chance of type-2 diabetes mellitus remission after sleeve gastrectomy vs. Roux-en-Y gastric bypass in elderly. OR, odds ratio.
Figure 9
Figure 9
Forest plot to show total complications after Roux-en-Y gastric bypass in elderly compared to youngers than 60 years. OR, odds ratio.
Figure 10
Figure 10
Forest plot to show hypertension remission after Roux-en-Y gastric bypass in elderly compared to youngers than 60 years. OR, odds ratio.
Figure 11
Figure 11
Forest plot to show mortality after Roux-en-Y gastric bypass in elderly compared to youngers than 60 years. OR, odds ratio.
Figure 12
Figure 12
Forest plot to show type-2 diabetes mellitus remission after Roux-en-Y gastric bypass in elderly compared to Youngers than 60 years. OR, odds ratio.
Figure 13
Figure 13
Forest plot to show total complications after sleeve gastrectomy in elderly compared to youngers than 60 years. OR, odds ratio.
Figure 14
Figure 14
Forest plot to show OSA remission after sleeve gastrectomy in elderly compared to youngers than 60 years. OR, odds ratio; OSA, Obstructive sleep apnea.
Figure 15
Figure 15
Forest plot to show %excess weight loss mean difference following Roux-en-Y gastric bypass in youngers than 60 years compared to elderly.
Figure 16
Figure 16
Forest plot to show %excess weight loss mean difference following sleeve gastrectomy in youngers than 60 years compared to elderly.
Figure 17
Figure 17
Forest plot to show %excess weight loss mean difference in elderly following sleeve gastrectomy vs. Roux-en-Y gastric bypass.
Figure 18
Figure 18
List of meta-analyses reporting outcomes related to only sleeve gastrectomy (SG), only Roux-en-Y gastric bypass (RYGB) and comparing SG vs. RYGB.
See this image and copyright information in PMC

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