Page 48 - WJOLS - Journal of Laparoscopic Surgery

WJOL S
WJOLS

10.5005/jp-journals-10033-1320
LSG vs LRYGB Surgery in Obese and Morbidly Obese Patients
RevieW ARticLe

Laparoscopic Sleeve Gastrectomy vs Laparoscopic

Roux-en-Y Gastric Bypass Surgery in Obese and
Morbidly Obese Patients

Shalmali Alva

ABSTRACT dealt with on a mammoth footing. In the current scenario,
The review article deals with the comparison between the bariatric surgery is the only effective means of long-term
procedures of laparoscopic sleeve gastrectomy (LSG) vs lapa- weight loss in the morbidly obese and also to reduce and/
roscopic Roux-en-Y gastric bypass (LRYGB) in the morbidly or remove the concomitant comorbidities arising as a result
obese/obese patient subset. Given that the bariatric surgery
deals not only with the weight loss of the patient, but also the of the grossly elevated body mass index (BMI).
accompanying myriad systemic and metabolic manifesta- Given that the patient’s BMI is > 40 or BMI is >35, but
tions, this comparison was made to look into any prominent with comorbidities, and patient is found to be compliant
differences in the outcome of patients including postoperative with nutritional advice and is psychologically competent
sequelae. The studies were taken from reputed institutes across
the world that were sourced from Medline and Cochrane Central to withstand and understand this process of weight loss,
and PubMed, which compared these two procedures on their various surgical options are presented to give the best
patient groups and also followed up to a maximum period of possible outcome to the patient.
5 years for improvement on overall health parameters. The two
procedures have shown fairly comparable results with regard In this article, we will review LSG vs LRYGB as a
to improvement in metabolic and hormonal parameters and surgical procedure offered to patients, their outcomes in
LRYGB as better than LSG in long-term excessive weight loss the various studies, and also their effect on the comorbidi-
in the follow-up phase of up to 5 years. ties of the patients. Laparoscopic sleeve gastrectomy is
Keywords: Excessive weight loss, Laparoscopic Roux-en-Y a restrictive component surgery, whereas LRYGB entails
gastric bypass, Laparoscopic sleeve gastrectomy, Morbid obesity.
both a restrictive and malabsorptive component. The fol-
How to cite this article: Alva S. Laparoscopic Sleeve lowing studies have been conducted in reputed hospitals
Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass
Surgery in Obese and Morbidly Obese Patients. World J Lap and medical universities across the world.
Surg 2017;10(3):129-132.
Source of support: Nil AIM
Conflict of interest: Nil The aim of this article is to compare LSG vs LRYGB
surgery and evaluate if there is any difference in the

INTRODUCTION patient weight loss and/or reduction in comorbidities
or if there is prevalence of any increased postoperative
Over the last three decades, the prevalence of obesity sequelae following any one of the procedures.
and morbid obesity has steadily increased in populations
across the world, affecting all age groups from pediatric MATERIALS AND METHODS
to geriatric. The widespread prevalence of obesity has its
implications as it gives rise to several comorbidities in the The studies included in the review article include ten
patient, affecting all the organ systems. The conditions randomized controlled trials and nonrandomized pro-
more commonly encountered in this patient category spective and retrospective studies and meta-analysis
range from Type II diabetes mellitus, hypertension, taken from reputed institutes across the world, published
asthma, obstructive sleep apnea, to degenerative bone dis- during the period from 2010 to 2017. Research material for
eases and Infertility issues. The wide ramifications on the the review article was sourced from Medline, PubMed,
overall quality-of-life of the patient irrespective of gender and Cochrane central.
and age make morbid obesity and obesity a challenge to be
OBSERvATION
The observations are presented in Table 1. 1-40
Consultant
Private Dental Clinic, Bengaluru, Karnataka, India DISCUSSION

Corresponding Author: Shalmali Alva, Consultant, Private This review article covered the above 10 articles
Dental Clinic, Bengaluru, Karnataka, India, e-mail: shalalva@ (prospective, retrospective randomized controlled trials,
gmail.com
and meta-analysis) after short listing them from extensive
World Journal of Laparoscopic Surgery, September-December 2017;10(3):129-132 129