Comparative Outcomes of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass

Although Sleeve Gastrectomy (SG) is the most frequently performed bariatric surgery today, research with follow up of more than five years demonstrated that patients who undergo this procedure experience less weight loss in contrast to those who have Roux-en-Y gastric bypass (RYGB). This study aimed to investigate the differences in weight loss and the occurrence of weight regain between SG and RYGB over an eight-year period post-surgery.

This retrospective analysis included adult patients who underwent SG or RYGB between 2015 and 2018. The study assessed weight progression and the pre- and postoperative management of type 2 diabetes (T2D), hypertension, and dyslipidemia. 

The findings revealed:

• Out of 591 patients (average age 40, baseline body mass index 41.7; 83% female), 327 underwent RYGB (55%) and 264 SG (45%). 
• Before surgery, 14% had T2D, 40% had hypertension, and 53% had dyslipidemia.
• After eight years, the average total percentage of weight loss was significantly greater in the RYGB group at 32%, compared to 19% in the SG group (a difference of 13%).
• Additionally, weight regain was lower in the RYGB group (23%) than in the SG group (39%).
• Five years post-surgery, the remission rates for T2D, hypertension, and dyslipidemia were 63%, 42%, and 51%, respectively, among patients who continued their follow-up.

To summarize, patients who underwent RYGB experienced more weight loss and reduced weight regain eight years after the procedure compared to those who had SG.

Source: Lins de Souza Salerno M, Garcia Soares Leães Rech C, Bortoluzzi Escobar da Silva P, Weston AC, de Carli LA, Pereira-Lima JF. Eight Year Follow-Up After Gastric Bypass and Sleeve Gastrectomy in a Brazilian Cohort: Weight Trajectory and Health Outcomes. Obes Surg. 2024 Dec;34(12):4452-4458. doi: 10.1007/s11695-024-07557-y. Epub 2024 Oct 26. PMID: 39461936.