Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: 5-year outcomes of merged data from two randomized clinical trials (SLEEVEPASS and SM-BOSS)

• Published in: British journal of surgery 2021-01, Vol.108 (1), p.49-57
• Main Authors: Wölnerhanssen, B K, Peterli, R, Hurme, S, Bueter, M, Helmiö, M, Juuti, A, Meyer-Gerspach, A C, Slawik, M, Peromaa-Haavisto, P, Nuutila, P, Salminen, P
• Format: Article
• Language: English
• Subjects: Female; Gastrectomy - methods; Gastric Bypass - methods; Humans; Laparoscopy - methods; Male; Middle Aged; Obesity, Morbid - surgery; Treatment Outcome; Weight Loss
• ISSN: 1365-2168
• DOI: 10.1093/bjs/znaa011

Laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) are both effective surgical procedures to achieve weight reduction in patients with obesity. The trial objective was to merge individual-patient data from two RCTs to compare outcomes after LSG and LRYGB. Five-year outcomes of the Finnish SLEEVEPASS and Swiss SM-BOSS RCTs comparing LSG with LRYGB were analysed. Both original trials were designed to evaluate weight loss. Additional patient-level data on type 2 diabetes (T2DM), obstructive sleep apnoea, and complications were retrieved. The primary outcome was percentage excess BMI loss (%EBMIL). Secondary predefined outcomes in both trials included total weight loss, remission of co-morbidities, improvement in quality of life (QoL), and overall morbidity. At baseline, 228 LSG and 229 LRYGB procedures were performed. Five-year follow-up was available for 199 of 228 patients (87.3 per cent) after LSG and 199 of 229 (87.1 per cent) after LRYGB. Model-based mean estimate of %EBMIL was 7.0 (95 per cent c.i. 3.5 to 10.5) percentage points better after LRYGB than after LSG  (62.7 versus 55.5 per cent respectively; P