Recent research has found that, over 10 years, Roux-en-Y gastric bypass (RYGB) leads to greater excess body mass index (BMI) loss than sleeve gastrectomy in patients with severe obesity, with the latter procedure being associated with higher conversion rates to different bariatric procedures and an increased risk for gastroesophageal reflux disease (GERD).
Since 2014, sleeve gastrectomy has surpassed RYGB as the most frequently performed bariatric metabolic procedure globally; however, recent long-term studies have indicated significant rates of recurrent weight gain, new-onset GERD, and need for reoperations after sleeve gastrectomy.
Researchers from the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS) trial compared long-term weight and metabolic outcomes in 217 patients with severe obesity, with 107 undergoing laparoscopic sleeve gastrectomy and 110 RYGB.
Among patients who completed weight-related assessments 10 years after the surgery without undergoing any treatment changes prior to the assessments, RYBG led to greater excess BMI loss than sleeve gastrectomy. Those who underwent sleeve gastrectomy vs RYBG had significantly higher conversion rates to different bariatric procedures, primarily due to insufficient weight reduction or reflux. GERD occurred in significantly more patients after sleeve gastrectomy than RYGB.
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