Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Obese Elder Patients: a Syste
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ORIGINAL CONTRIBUTIONS
Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Obese Elder Patients: a Systematic Review and Meta-analysis Chenxin Xu 1 & Tong Yan 2 & Hongtao Liu 1 & Rui Mao 1 & Yurui Peng 1 & Yanjun Liu 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose This study aimed to compare the safety and effectiveness of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in patients aged 60 years old or older. Methods The available literature was searched for eligible studies up to November 2019. The meta-analysis was performed by the RevMan 5.3 software. Results This meta-analysis involved nineteen studies. The rates of early and late complications in RYGB were much higher than those in SG. More specifically, within 30 days after surgeries, leak, urinary tract infection, obstruction, and death occurred more often in the RYGB group. The above differences may lead to higher rates of hospital readmission and return to the operating room. RYGB was superior to SG in terms of remission of hypertension and the 1-year follow-up weight loss outcome, while there were no differences in terms of remission of type 2 diabetes (T2D) and obstructive sleep apnea (OSA) as well as weight loss outcomes during 2- and 3-year follow-up. Conclusions SG was the preferable option to RYGB for patients aged 60 years old or older, as SG has been shown not inferior to RYGB in terms of effectiveness, while being safer than RYGB. Keywords Roux-en-Y gastric bypass . Sleeve gastrectomy . Bariatric surgery . Elderly obesity Chenxin Xu and Tong Yan contributed equally to this work. * Yanjun Liu [email protected] Chenxin Xu [email protected] Tong Yan [email protected] Hongtao Liu [email protected] Rui Mao [email protected] Yurui Peng [email protected] 1
The Center of Gastrointestinal and Minimally Invasive Surgery, Affiliated Hospital of Southwest Jiaotong university / The Third People’s Hospital of Chengdu, NO.82 Qinglong Road, Chengdu 610031, Sichuan Province, China
2
Department of Endocrinology and Metabolism, Affiliated Hospital of Southwest Jiaotong university / The Third People’s Hospital of Chengdu, NO.82 Qinglong Road, Chengdu 610031, Sichuan Province, China
Introduction The prevalence of obesity is increasing progressively, even in the older population [1]. The incidences of hypertension, diabetes, and metabolic syndrome are positively correlated with age and body mass index (BMI) [2]. Bariatric surgery is the only treatment option with sustainable weight loss and comorbidity resolution among patients with morbid obesity. In all of the patients with morbid obesity, the elderly individuals present a treatment challenge for bariatric surgeons. Currently, Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most commonly performed bariatric procedures worldwide. RYGB, currently considered as the golden standard, has been routinely used for the past decade [3]. Meanwhile, sleeve gastrectomy showed a steep increase, representin
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