Late (>= 5 y) complications of laparoscopic vertical sleeve gastrectomy (LVSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB): A systematic review and meta-analysis of randomized controlled trials
Document Type
Article
Publication Date
8-1-2022
Abstract
Background: There is a paucity of data that compares the relative complication profiles of laparoscopic vertical sleeve gastrectomy (LVSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) at 5 years. Objectives: The aim was to compare late complications of LVSG and LRYGB. Methods: We updated our previous systematic review and meta-analysis of randomized controlled trials of primary LVSG and LRYGB procedures in adults, to review late (5 years) complication outcomes (PROSPERO 112054). Electronic databases were searched from January 2015 to July 2021 for publications meeting inclusion criteria. The Hartung-Knapp-Sidik-Jonkman random effects model was utilized to estimate weighted mean differences where meta-analysis was possible. Bias and certainty of evidence was assessed using the Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development and Evaluations. Results: Four randomized controlled trials met the inclusion criteria (n=531; LVSG=272, LRYGB=259). No late treatment-related mortality was reported with either procedure. A significant reduction in surgical reoperations (odds ratio: 0.47, 95% confidence interval: 0.27-0.82, P=0.01) and endoscopic interventions (odds ratio: 0.29, 95% confidence interval: 0.12-0.71, P=0.02) were reported at 5 years post-LVSG relative to LRYGB. Reoperations were more frequently performed for reflux management in LVSG and for internal hernia repairs in LRYGB. Complications requiring medical management were common following both procedures. Limitations included few eligible studies for inclusion, and varying definitions of medically managed complications. Conclusions: LRYGB is associated with a higher proportion of surgical and endoscopic interventions at 5 years compared with LVSG. More high-quality, long-term studies are required to further elucidate both surgical and nutritional long-term outcomes post these procedures.
Keywords
Meta-analysis, Systematic review, Sleeve gastrectomy, Roux-en-Y gastric bypass, Long-term, Late complications
Divisions
MathematicalSciences
Funders
None
Publication Title
Surgical Laparoscopy Endoscopy & Percutaneous Techniques
Volume
32
Issue
4
Publisher
Lippincott Williams & Wilkins
Publisher Location
TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA