• Annals of surgery · Apr 2021

    Multicenter Study Comparative Study

    Five-year Longitudinal Cohort Study of Reinterventions After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass.

    • Robert A Li, Liyan Liu, David Arterburn, Karen J Coleman, Anita P Courcoulas, David Fisher, Sebastien Haneuse, Eric Johnson, Mary Kay Theis, Tae K Yoon, Heidi Fisher, James R Fraser, and Lisa J Herrinton.
    • Kaiser Permanente Northern California, Oakland, CA.
    • Ann. Surg. 2021 Apr 1; 273 (4): 758-765.

    ObjectiveTo compare the long-term risks of reintervention following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in a large surgical cohort.BackgroundThe use of SG has increased dramatically relative to RYGB for the treatment of obesity. However, long-term risks following SG compared with RYGB have not been adequately defined in a large population-based study.MethodsA retrospective longitudinal cohort study of all adult health-plan members undergoing SG or RYGB for obesity in a multistate integrated health care system from January 2005 through September 2015. The risks of nutritional, endoscopic, radiologic, and surgical reintervention as well as the overall risk of any reinterventions at 1, 3, and 5 years were identified using diagnosis and procedure codes from comprehensive electronic medical records.ResultsThe study included 15,319 patients who underwent SG and 19,954 patients who underwent RYGB with a follow-up of 79.2%. The overall risk of any reintervention at 5 years was 21.3% for SG and 28.3% for RYGB (P < 0.0001). After adjustment, SG was associated with fewer reinterventions through 5 years than RYGB (hazard ratio, 0.78; 95% confidence interval, 0.74-0.84). When comparing subcategories, SG also had a lower risk of nutritional, endoscopic, radiologic, and surgical reinterventions when examined versus RYGB. The findings for risks of reinterventions were consistent across clinical subgroups.ConclusionSG has significantly lower risk of reintervention in all categories studied when compared with RYGB at 5-year follow-up. The long-term safety profile of LSG compared with RYGB should be an essential part of the discussion in patient-centered decision making when choosing between bariatric procedure options.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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