Tuesday, July 21, 2009

Laparoscopic Mini-Gastric Bypass Versus Roux-En-Y Gastric Bypass: 5-Year Results and Final Report of a Randomized Trial

Presenter: W. J. Lee (Min-Sheng General Hospital, Taoyuan, Taiwan)
Co-authors: J. Chen1, K. Ser1
1Min-Sheng General Hospital, Taoyuan, Taiwan

Background We had previously reported a randomized study evaluated the surgical morbidity and 2-year results of laparoscopic mini-gastric bypass (LMGBP) versus laparoscopic Roux-en-Y gastric bypass (LRYGBP). We now reported the final result after 5-year follow-up.

Methods 282 patients received LMGBP for the treatment of morbid obesity were recruited from our comprehensive obesity surgery center and compared with 40 patients received LRYGBP who were included in the previous randomized trial. Minimum follow-up was 5 years (from 5 to 8 years). The changes in body weight loss, BMI, quality of life and late complication were determined at follow-up. . Changes in quality of life were assessed using the Gastro-Intestinal Quality of Life Index (GIQLI).

Result There was no difference in preoperative clinical parameters between the two groups. All procedures were successfully carried out with no deaths in either group.

Surgical time was significantly longer for LRYGBP (205 minutes vs. 148 minutes for LMGBP, p < 0.05).

The complication rate was higher for LRYGBP (20% vs. 7.5%, p < 0.05).

Excess weight loss and mean BMI at 5 years for LRYGBP and LMGB were 60.1% vs. 72.1%, p = 0.072) and (29.2 vs. 27.1, p = 0.30) separately.

Post-operative GQILI increased significantly after operation in both groups without difference.

Late complications and revision rates were similar in the two groups.

Follow-up study disclosed an improvement of obesity-related clinical parameters in both groups without significant difference.

Conclusion This study demonstrates that LMGBP is an effective treatment for morbid obesity and can improve quality of life similar to LRYGBP. LMGBP is simpler and safer procedure than LRYGBP and no proven disadvantage after five year follow-up. LMGBP can be regarded as a simpler and safer alternative surgical procedure to LRYGBP.

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