In a recent paper published in the BMC Obesity journal entitled “The Sleeve Bypass Trial: a multicentre randomized controlled trial comparing the long term outcome of laparoscopic sleeve gastrectomy and gastric bypass for morbid obesity in terms of excess BMI loss percentage and quality of life,” clinicians from the Netherlands are evaluating the long term efficiency of two bariatric surgery techniques in the treatment of obesity.
Obesity is a condition in which body fat accumulates to yield a body mass exceeding 30 kg/m2. Patients suffering from obesity usually have reduced life expectancy, and accumulated body fat may negatively affect health-yielding complications like type 2 diabetes, heart problems, and certain types of cancer. The disease can be caused by a variety of factors like diet, genetics, lifestyle, infection agents, and medical conditions like eating disorders and growth hormone deficiency. It is worth noting that obesity is considered as one of the leading preventable causes of death worldwide.
Obesity can be managed by change in diet, physical exercise and use of anti-obesity medications. However, the outcomes of these methods are not altogether effective and medications can lead to side effects. By contrast, bariatric surgery is demonstrated to be the most efficient treatment for obesity. With respect to this, Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) in which the stomach is surgically divided into two parts then small intestine is rearranged to connect to both, is considered a gold standard surgical technique. On the other hand, Laparoscopic Sleeve Gastrectomy (LSG) in which the stomach is surgically reduced to about 25% of its original size, is a new, promising procedure with the advantage of maintaining an intact gastrointestinal tract. With respect to which methods is best to treat obesity, so far only few results concerning short-term outcomes recorded with small groups of patients are available. Consequently, the recent study conducted in the Netherlands aimed to figure out long term evaluation of both surgical methods using large number of participants.
The study started on November 24th, 2012 and aimed to compare the results obtained with both methods for a period of five years. A total of 620 morbidly obese patients were enrolled in the study. The primary endpoint of the comparison relied on weight loss and the secondary endpoints looked for complications, resolution of obesity related comorbidity, revision bariatric surgery and quality of life evaluated by questionnaires. So far, the results illustrate that long-term weight loss is in favor of LRYGB, but recorded data throughout the world show similar results of weight loss in both methods.
The clinicians concluded that if weight loss is comparable for both surgical methods, other parameters like quality of life and complications after surgery should count when deciding on which surgical method should be selected by patients in the future.