Roux‐en‐Y gastric bypass, sleeve gastrectomy, or one‐anastomosis gastric bypass? A systematic review and meta‐analysis of randomized‐controlled trials

• Published in: Obesity (Silver Spring, Md.) Vol. 30; no. 3; pp. 614 - 627
• Main Authors: Uhe, Isabelle, Douissard, Jonathan, Podetta, Michele, Chevallay, Mickael, Toso, Christian, Jung, Minoa Karin, Meyer, Jeremy
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2022; John Wiley and Sons Inc
• Subjects: Diabetes; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - surgery; Disease; Gastrectomy - methods; Gastric Bypass - methods; Gastroesophageal reflux; Gastrointestinal surgery; Humans; Meta-analysis; Obesity; Obesity, Morbid - surgery; Original; ORIGINAL ARTICLES; Randomized Controlled Trials as Topic; Remission (Medicine); Retrospective Studies; Software reviews; Systematic review; Treatment Outcome; Weight control; Weight Loss
• ISSN: 1930-7381; 1930-739X
• DOI: 10.1002/oby.23338

Objective This study aimed to determine which bariatric procedure allows patients to obtain the best weight‐loss outcomes and a remission of type 2 diabetes. Methods Databases were searched for randomized‐controlled trials comparing Roux‐en‐Y gastric bypass (RYGB) with sleeve gastrectomy (SG) or one‐anastomosis gastric bypass (OAGB). The mean difference (MD) or the relative risk was determined. Results Twenty‐five randomized‐controlled trials were analyzed. Excess weight loss (EWL, percentage) was greater for RYGB patients at 3 years (MD: 11.93, p < 0.00001) and 5 years (MD: 13.11, p = 0.0004). Higher excess BMI loss (percentage) was found in RYGB at 1 year (MD: 11.66, p = 0.01). Total weight loss (percentage) was greater for RYGB patients after 3 months (MD: 2.41, p = 0.02), 6 months (MD: 3.83, p < 0.00001), 1 year (MD: 6.35, p < 0.00001), and 5 years (MD: 3.90, p = 0.005). No difference in terms of remission of type 2 diabetes was seen between RYGB and SG. EWL was significantly more important after OAGB than after RYGB after 1 year (MD: −10.82, p = 0.003). Conclusions RYGB is more efficient than SG in the midterm. OAGB offers greater EWL than RYGB after 1 year, but further evidence is needed to confirm this result.