Yonsei Med J.  2016 Jul;57(4):956-962. 10.3349/ymj.2016.57.4.956.

Roux-en-Y Gastric Bypass vs. Sleeve Gastrectomy vs. Gastric Banding: The First Multicenter Retrospective Comparative Cohort Study in Obese Korean Patients

• Lee SK
• Heo Y
• Park JM
• Kim YJ
• Kim SM
• Park DJ
• Han SM
• Shim KW
• Lee YJ
• Lee JY
• Kwon JW

• KMID: 2374129
• DOI: http://doi.org/10.3349/ymj.2016.57.4.956

Abstract

PURPOSE
Bariatric surgery is relatively new in Korea, and studies comparing different bariatric procedures in Koreans are lacking. This study aimed to compare the clinical outcomes of laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) for treating morbidly obese Korean adults.
MATERIALS AND METHODS
In this multicenter retrospective cohort study, we reviewed the medical records of 261 obese patients who underwent different bariatric procedures. Clinical outcomes were measured in terms of weight loss and resolution of comorbidities, such as diabetes, hypertension, and dyslipidemia. Safety profiles for the procedures were also evaluated.
RESULTS
In terms of weight loss, the three procedures showed similar results at 18 months (weight loss in 52.1% for SG, 61.0% for LAGB, and 69.2% for RYGB). Remission of diabetes, hypertension, and dyslipidemia was more frequent in patients who underwent RYGB (65.9%, 63.6%, and 100% of patients, respectively). Safety profiles were similar among groups. Early complications occurred in 26 patients (9.9%) and late complications in 32 (12.3%). In the LAGB group, five bands (6.9%) were removed. Among all patients, one death (1/261=0.38%) occurred in the RYGB group due to aspiration pneumonia.
CONCLUSION
The three bariatric procedures were comparable in regards to weight-loss outcomes; nevertheless, RYGB showed a higher rate of comorbidity resolution. Bariatric surgery is effective and relatively safe; however, due to complications, some bands had to be removed in the LAGB group and a relatively high rate of reoperations was observed in the RYGB group.

Keyword

Morbid obesity; bariatric surgery; outcomes; comparative study; Koreans

MeSH Terms

Adult
Cohort Studies
Comorbidity
Female
*Gastrectomy/adverse effects
*Gastric Bypass/adverse effects
Humans
Male
Obesity, Morbid/epidemiology/*surgery
Republic of Korea
Retrospective Studies
Treatment Outcome
Weight Loss

Figure

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  Fig. 1 (A) Comparison of percentage of weight loss (%WL) over an 18-month follow-up. (B) Comparison of percentage of excess weight loss (%EWL) over an 18-month follow-up. %WL, percentage of weight loss; %EWL, percentage of excess weight loss; LAGB, laparoscopic adjustable gastric banding; RYGB, Roux-en-Y gastric bypass; SG, sleeve gastrectomy.

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