Ten-year outcomes after Roux-en-Y gastric bypass and sleeve gastrectomy: an observational nonrandomized cohort study

Background: Sleeve gastrectomy (SG) has replaced Roux-en-Y gastric bypass (RYGB) as the most commonly performed bariatric surgery procedure. Data on the long-term (up to 10 yr) outcomes after SG is scarce. No previous study has compared the long-term outcomes between RYGB and SG. Objective: To compare 10-year weight lost and 10-year remission rates of type 2 diabetes, hypertension, and dyslipidemia between RYGB and SG. Setting: University hospital, Spain. Methods: Nonrandomized cohort study including all patients that underwent RYGB or SG at our institution between January 2005 and March 2008. Participants were followed yearly after bariatric surgery. Data obtained at the 10-year evaluation after RYGB or SG (between January 2015 and March 2018) was analyzed. Main study outcomes were 10-year percentage of total weight lost and percentage of excess weight lost. Secondary outcomes included 10-year remission rates of type 2 diabetes, hypertension, and dyslipidemia. Between-groups differences in 10-year percentage of total weight lost and percentage of excess weight lost were evaluated using analysis of covariance. Association between type of surgery and remission rates of obesity-related co-morbidities were evaluated using logistic regression analyses. Results: Five hundred four patients were included in the study, 390 underwent RYGB and 134 SG. Follow-up rate was 84.5%. Mean 10-year percentage of total weight lost and percentage of excess weight lost were 25.3 +/- 11.2% and 56.0 +/- 25.6% in the RYGB group, and 27.5 +/- 13.5% and 53.2 +/- 25.1% in the SG group (P = .853 and P = .746, respectively). In logistic regression analyses RYGB was superior to SG in achieving 10-year hypertension and dyslipidemia remission. Conclusions: This study suggested comparable effectiveness between SG and RYGB on weight loss. (C) 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.