Gastric Bypass Versus Sleeve Gastrectomy: Patient Selection and Short-term Outcome of 47, 101 Primary Operations From the Swedish, Norwegian, and Dutch National Quality Registries. Issue 2 (August 2020)

• Record Type: Journal Article
• Authors: Poelemeijer, Youri Q. M.; Liem, Ronald S. L.; Våge, Villy; Mala, Tom; Sundbom, Magnus; Ottosson, Johan; Nienhuijs, Simon W.
• Is Part Of: Annals of surgery. Volume 272:Issue 2(2020)
• Publication Date: 2020-08
• Subjects: %TWL -- bariatric -- comparison -- complications -- DATO -- DICA -- Dutch -- gastrectomy -- gastric bypass -- LTFU -- Netherlands -- Norway -- Norwegian -- outcome -- outcomes -- quality -- readmission -- Roux-en-Y -- RYGB -- SG -- sleeve -- SOReg -- surgery -- Sweden -- Swedish -- total weight loss -- TWL; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000003279
• Languages: English
• ISSNs: 0003-4932

Abstract

Abstract : Objective: The aim of this study was to compare the use and short-term outcome of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Sweden, Norway, and the Netherlands. Background: Although bariatric surgery is performed in high volumes worldwide, no consensus exists regarding the choice of bariatric procedure for specific groups of patients. Methods: Data from 3 national registries for bariatric surgery were used. Patient selection, perioperative data (severe complications, mortality, and rate of readmissions within 30 days), and 1-year results (follow-up rate and weight loss) were studied. Results: A total of 47, 101 primary operations were registered, 33, 029 (70.1%) RYGB and 14, 072 (29.9%) SG. Patients receiving RYGB met international guidelines for having bariatric surgery more often than those receiving SG (91.9% vs 83, 0%, P < 0.001). The 2 procedures did not differ in the rate of severe complications (2.6% vs 2.4%, P = 0.382), nor 30-day mortality (0.04% vs 0.03%, P = 0.821). Readmission rates were higher after RYGB (4.3% vs 3.4%, P < 0.001). One-year post surgery, less RYGB-patients were lost-to follow-up (12.1% vs 16.5%, P < 0.001) and RYGB resulted in a higher rate of patients with total weight loss of more than 20% (95.8% vs 84.6%, P < 0.001). While the weight-loss after RYGB was similar between hospitals, there was a great variation in weight loss after SG. Conclusion: This study reflects the pragmatic use and short-term outcome of RYGB and SG in 3 countries in North-Western Europe. Both procedures were safe, with RYGB having higher weight loss and follow-up rates at the cost of a slightly higher 30-day readmission rate.