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 18 February 2018

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News

Laparoscopic Roux-en-Y vs mini-gastric bypass for obesity

Research in the most recent issue of Annals of Surgery shows that laparoscopic mini-gastric bypass is a simpler and safer procedure that has no disadvantage compared with laparoscopic Roux-en-Y gastric bypass.

News image

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Dr Lee and colleagues conducted a prospective, randomized trial to compare treatments of morbid obesity.

The research team compared the safety and effectiveness of laparoscopic Roux-en-Y gastric bypass and laparoscopic mini-gastric bypass in the treatment of morbid obesity.

Laparoscopic Roux-en-Y gastric bypass has been the gold standard for the treatment of morbid obesity.

Operative morbidity rate was higher in the laparoscopic Roux-en-Y gastric bypass group
Annals of Surgery

While laparoscopic mini-gastric bypass has been reported to be a simple and effective treatment, the team report that data from a randomized trial are lacking.

The researchers recrtuited 80 patients who met the National Institute of Health criteria.

The team randomized 40 patients to receive laparoscopic Roux-en-Y gastric bypass and 40 to laparoscopic mini-gastric bypass.

The research team reported that the minimum postoperative follow-up was 2 years and that perioperative data were assessed.

The researchers determined late complication, excess weight loss, body mass index, quality of life, and comorbidities.

Changes in quality of life were assessed using the Gastro-Intestinal Quality of Life Index.

The researchers found 1 conversion in the laparoscopic Roux-en-Y gastric bypass group.

Operation time was shorter in laparoscopic mini-gastric bypass group and there was no mortality in each group.

The team observed that the operative morbidity rate was higher in the laparoscopic Roux-en-Y gastric bypass group, at 20% versus 8%.

The late complications rate was the same in the 2 groups at 8% with no reoperation.

The team noted that weight loss was 59% and 60% at 1 and 2 years, respectively, in the laparoscopic Roux-en-Y gastric bypass group.

The team noted that percentage weight loss in the group was 65% and 64% in the laparoscopic mini-gastric bypass group.

Residual excess weight of less than 50% at 2 years postoperatively was achieved in 75% of patients in the laparoscopic Roux-en-Y gastric bypass group.

In comparison, the researchers found that residual excess weight loss at 2 years in the laparoscopic mini-gastric bypass group was 95%.

A significant improvement of obesity-related clinical parameters and complete resolution of metabolic syndrome in both groups were noted.

In addition, the researchers observed that gastrointestinal quality of life increased significantly without any significant difference between the groups.

Dr Lee's team concludes, “Both laparoscopic Roux-en-Y gastric bypass and laparoscopic mini-gastric bypass are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life.”

“Laparoscopic mini-gastric bypass is a simpler and safer procedure that has no disadvantage compared with laparoscopic Roux-en-Y gastric bypass at 2 years of follow-up.”

Ann Surg 2005: 242(1): 20-8
30 June 2005

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