Table 4. Details of some studies comparing LRYGB and LSG from different regions.
| Characteristic | Our series | Zhang et al. [10] | Yang et al. [11] | Peterli et al. [12] | Lim et al. [9] | Boza et al. [4] | Thomas et al. [13] | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LRYGB (n=63) | LSG (n=63) | LRYGB (n=32) | LSG (n=32) | LRYGB (n=32) | LSG (n=32) | LRYGB (n=110) | LSG (n=107) | LRYGB (n=237) | LSG (n=248) | LRYGB (n=786) | LSG (n=811) | LRYGB (n=11) | LSG (n=11) | |
| Country | China | China | China | Switzerland | America | Chile | New Zealand | |||||||
| Region | Asia | Asia | Asia | Europe | North America | South America | Oceania | |||||||
| Publication year | - | 2014 | 2015 | 2013 | 2014 | 2012 | 2016 | |||||||
| Study type | 1:1 matched cohort study | RCT | RCT | RCT | Retrospective study | Case-control study | Cross-sectional study | |||||||
| Study design | Patients were matched for gender, age (±8 years), and BMI (±1.5 kg/m2). | Computer-generated random numbers were used to allocate the type of procedure (LRYGB or LSG). | A computer generated variable block schedule was used for randomization. Allocation to treatments was not concealed. | A computer-based randomization with sealed envelopes was used to assign patients to receive either LSG or LRYGB. | The hospital database was reviewed to identify eligible patients who had undergone bariatric surgery. | Patients who underwent LSG were randomly matched by age, gender, preoperative weight, and BMI to patients undergoing LRYGB. | Patients with T2DM scheduled for either LRYGB or LSG between August 2010 and March 2012 were recruited for the study. | |||||||
| Study aim | Effect on weight loss | Effect on weight loss | Effect on T2DM | Effect on weight loss and comorbidities | Effect on weight loss | Effect on weight loss and comorbidities | Effect on T2DM | |||||||
| Gender (M/F) | 21/42 | 21/42 | 14/18 | 12/20 | 13/19 | 9/23 | 31/79 | 30/77 | 18/219 | 24/224 | 184/602 | 193/618 | 1/10 | 3/8 |
| Age (years) | 33.9±10.1 | 34.6±10.4 | 32.2±9.2 | 29.3±9.8 | 41.4±9.3 | 40.4±9.3 | 42.1±11.2 | 43.0±11.1 | 54(M), 40(F) | 52(M), 39(F) | 37.0±10.3 | 36.4±11.7 | 41 | 45 |
| BMI (kg/m2) | 38.5 ± 5.7 | 38.9 ± 5.4 | 39.3±3.8 | 38.5±4.2 | 32.3±2.4 | 31.8±3.0 | 44.2±5.3 | 43.6±5.3 | 41(M), 41(F) | 42(M), 40(F) | 38.0±3.4 | 37.9±4.6 | 44.5 | 42.2 |
| Major complications (n) | 1 | 0 | 5 | 1 | 0 | 0 | 11 | 2* | - | - | 152 (all complicaitons) | 51*(all complicaitons) | - | - |
| %EWL at 6 m | 62.4 | 56.3 | - | - | 74.9 | 67.3* | - | - | - | - | 84.6 | 80.5 | - | - |
| %EWL at 1 y | 80.1 | 76.7 | 84.5 | 73.9 | 86.4 | 79.6* | - | - | 72 | 64.7* | 97.2 | 86.4* | - | - |
| %EWL at 3 y | 76.5 | 65.7* | 79.8 | 68* | 92.0 | 81.93* | 72.8 | 63.3 | - | - | 93.1 | 86.8 | - | - |
| %EWL at 5 y | - | - | 76.2 | 63.2* | - | - | - | - | 68.3 | 57.4 | - | - | - | - |
| HbA1c (%) at 1 y | - | - | - | - | 5.8 | 5.9 | - | - | - | - | 5.9 | 5.7 | - | - |
| HbA1c (%) at 3 y | - | - | - | - | 5.7 | 5.9 | - | - | - | - | - | - | - | - |
| T2DM R/I rate (%) at 1 y | 81.0 | 68.8 | - | - | - | - | 67.9 | 57.7 | - | - | - | - | - | - |
| T2DM R/I rate (%) at 3 y | 63.2 | 57.1 | - | - | 92.6 | 89.3 | - | - | - | - | 93.2 | 100 | - | - |
| T2DM R/I rate (%) at 5 y | - | - | 87.5 | 88.9 | - | - | - | - | - | - | - | - | - | - |
| Conclusion | LSG is inferior to LRYGB in mid-term weight loss, but similar in safety and improvement of comorbidities. | LRYGB is superior in terms of weight loss. | LRYGB and LSG have similar effect on diabetes. | LRYGB and LSG are almost equally efficient in achieving weight loss and improvement of comorbidities. | LRYGB and LSG have similar effect on long-term weight loss | LRYGB and LSG result in similar weight loss and remission of comorbidities. | LRYGB and LSG improve glucose metabolism through different effects on pancreatic beta-cell function, insulin sensitivity, and free fatty acids. | |||||||
LRYGB: Laparoscopic Roux-en-Y gastric bypass; LSG: laparoscopic sleeve gastrectomy; BMI: body mass index; T2DM: type 2 diabetes mellitus; %EWL: excess weight loss percentage; HbA1c: glycated hemoglobin; R/I rate: resolution or improvement rate.
*
compared with LRYGB, P < 0.05.