Remission of comorbidities, weight loss, and adverse events after Sleeve Gastrectomy and Roux-en-Y gastric bypass in patients with obesity

Background: Despite the extensive literature on the outcome and impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on comorbidities and weight loss, clear evidence is still lacking. Our study aims to compare the short- and long-term efficacy and safety of the two procedures in patients with obesity. Methods: The primary endpoint of this retrospective registry study is to examine the adverse events after surgery, weight loss, and remission rate of comorbidities 12 months after surgery. Any result with a p-value of 5% corresponds to a significant outcome. Results: 27,882 patients had completed a one-year follow-up. 14,399 patients after SG and 13,483 after RYGB. The overall rate of intraoperative and postoperative complications was not significantly different between the two groups (overall p>5%). The %EWL was 62.4% in the SG group vs. 69.2% in the RYGB group; p<0.001. BMI reduction and mean weight loss were significantly different between the two groups in favor of SG. The RYGB group achieved significantly better remission of diabetes mellitus (T2DM; p<0.001), hypertension (28.8% vs. 23.5%; p < 0.001) and reflux 22.3% vs. 7.8%; p<0.001). Sleep apnea remission was similar between the two groups (10.2%; p<0.001). Conclusion: SG and RYGB are effective methods in the treatment of obesity. RYGB achieved better results in terms of remission of comorbidities and %EWL. However, further studies are needed to investigate the sustainability of weight loss and remission of comorbidities after both procedures.