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

Affiliations
  • 1Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 2Department of Surgery, School of Medicine, Inha University, Incheon, Korea. gshur@inha.ac.kr
  • 3National Evidence-based Healthcare Collaborating Agency, Seoul, Korea. jylee@neca.re.kr
  • 4Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.
  • 5Department of Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea.
  • 6Department of Surgery, Gachon University College of Medicine, Incheon, Korea.
  • 7Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 8Department of Surgery, CHA University School of Medicine, Seoul, Korea.
  • 9Department of Family Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • 10Department of Family Medicine, School of Medicine, Inha University, Incheon, Korea.
  • 11College of Pharmacy, Kyungpook National University, Daegu, Korea.

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
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