Roux-en-Y Gastric Bypass vs. Sleeve Gastrectomy vs. Gastric Banding: The First Multicenter Retrospective Comparative Cohort Study in Obese Korean Patients
Yonsei Medical Journal 2016³â 57±Ç 4È£ p.956 ~ p.962
ÀÌ»ó±Ç(Lee Sang-Kuon) - Catholic University College of Medicine Department of Surgery
ÇãÀ±¼®(Heo Yoon-Seok) - Inha University College of Medicine Department of Surgery
¹ÚÁß¹Î(Park Joong-Min) - Chung-Ang University College of Medicine Department of Surgery
±è¿ëÁø(Kim Yong-Jin) - Soonchunhyang University College of Medicine Soonchunhyang University Hospital Department of Surgery
±è¼º¹Î(Kim Seong-Min) - Gachon University of Medicine and Science Gil Medical Center Department of Surgery
¹ÚµµÁß(Park Do-Joong) - Seoul National University Bundang Hospital Department of Surgery
ÇÑ»ó¹®(Han Sang-Moon) - CHA University School of Medicine Gangnam CHA Medical Center Department of Surgery
½É°æ¿ø(Shim Kyung-Won) - Ewha Womans University School of Medicine Department of Family Medicine
ÀÌ¿¬Áö(Lee Yeon-Ji) - Inha University School of Medicine Department of Family Medicine
ÀÌÀÚ¿¬(Lee Ja-Youn) - National Evidence-Based Healthcare Collaborating Agency
±ÇÁø¿ø(Kwon Jin-Won) - Kyungpook National University College of Pharmacy
Abstract
Purpose: Bariatric surgery is relatively new in Korea, and studies comparing different bariatric procedures in Koreans are lacking. This study aimed to compare the clinical outcomes of laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) for treating morbidly obese Korean adults.
Materials and Methods: In this multicenter retrospective cohort study, we reviewed the medical records of 261 obese patients who underwent different bariatric procedures. Clinical outcomes were measured in terms of weight loss and resolution of comorbidities, such as diabetes, hypertension, and dyslipidemia. Safety profiles for the procedures were also evaluated.
Results: In terms of weight loss, the three procedures showed similar results at 18 months (weight loss in 52.1% for SG, 61.0% for LAGB, and 69.2% for RYGB). Remission of diabetes, hypertension, and dyslipidemia was more frequent in patients who underwent RYGB (65.9%, 63.6%, and 100% of patients, respectively). Safety profiles were similar among groups. Early complications occurred in 26 patients (9.9%) and late complications in 32 (12.3%). In the LAGB group, five bands (6.9%) were removed. Among all patients, one death (1/261=0.38%) occurred in the RYGB group due to aspiration pneumonia.
Conclusion: The three bariatric procedures were comparable in regards to weight-loss outcomes; nevertheless, RYGB showed a higher rate of comorbidity resolution. Bariatric surgery is effective and relatively safe; however, due to complications, some bands had to be removed in the LAGB group and a relatively high rate of reoperations was observed in the RYGB group.
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Morbid obesity, bariatric surgery, outcomes, comparative study, Koreans
KMID :
0311120160570040956
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À¯È¿¼º°á°ú(Recomendation)
This study reported that all three bariatric procedures were comparably effective in terms of weight loss, with quite effective resolution of comorbidities. Complications were more severe in the RYGB group; however, LAGB was associated with a higher rate of late complications.