Background

Although there is extensive literature on the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), debate continues regarding their long-term effects on comorbidities and weight development. Therefore, both interventions continue to be the subject of scientific studies.

Methods

Weight changes, obesity-related diseases, and perioperative events are compared after both procedures. Patient data were entered into the German Bariatric Surgery Registry (GBSR). A follow-up of three years was performed. Any P value≤ 0.05 indicates a significant difference.

Results

Seven thousand seven hundred fifty-five patients were followed for three years (SG= 3791, RYGB= 3964). Excess weight loss was 61.9 in SG and 69.5 in RYGB (P< 0.001). BMI reduction was not significantly different (P= 0.638) between the two groups. RYGB was significantly associated with remission of non-insulin-dependent diabetes mellitus (P= 0.024), insulin-dependent diabetes mellitus (P= 0.002), hypertension (P< 0.001), sleep apnea (P< 0.001) and reflux disease (GERD)(P< 0.001), and a lower incidence of bleeding requiring surgical intervention (P< 0.001). The SG was associated with a lower incidence of anastomotic stenosis and ileus (P= 0.006 and< 0.001, respectively).

Conclusions

Both SG and RYGB reduce comorbidity and weight. However, RYGB is associated with a higher% EWL and remission rate of obesity-associated diseases than SG. However, it remains to be seen whether the outcomes of the two interventions are similar after a more extended follow-up period.