Abstract | INTRODUCTION: The comparative efficacy of various bariatric procedures has not been completely elucidated. We aimed to evaluate efficacy and safety of various bariatric procedures comprehensively. METHODS: We searched for randomized controlled trials investigating the efficacy of bariatric surgery. Network meta-analyses were performed to determine the percentage of excess weight loss (%EWL) and remission of diabetes mellitus (DM). RESULTS: Of 45 studies, 33 and 24 provided the data for %EWL and DM remission rates, respectively. Six months after surgery, biliopancreatic diversion with duodenal switch (BPD-DS), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) showed superior efficacy for %EWL compared to the standard-of-care (mean difference [MD], [95% confidence interval [CI]]: BPD-DS, 38.2% [7.3%, 69.1%]; RYGB, 32.1% [3.1%, 61.1%]; SG, 32.5% [5.5%, 59.5%]). However, adjustable gastric banding was not superior to standard-of-care (MD [95% CI] = - 0.2% [- 19.6%, 19.2%]). At 1 year, all bariatric procedures were superior to standard-of-care. At 3 years, RYGB and SG showed superior efficacy when compared to standard-of-care (MD [95% CI]: RYGB, 45.0% [21.8%, 68.2%]; SG, 39.2% [15.2%, 63.3%]). With respect to DM remission 3-5 years after surgery, BPD-DS, RYGB, and SG were superior to standard-of-care. Hernias, obstruction/ stricture, bleeding, and ulcers were less common in patients who underwent SG than in those who underwent RYGB. CONCLUSIONS: RYGB and SG had excellent long-term outcomes for both the %EWL and DM remission rates. Additionally, SG had a relatively lower risk of adverse events than RYGB.
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Authors | Chan Hyuk Park, Seung-Joo Nam, Hyuk Soon Choi, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Jai Hoon Yoon, Sung Hoon Jung, Yil Sik Hyun, Hang Lak Lee, Korean Research Group for Endoscopic Management of Metabolic Disorder and Obesity |
Journal | Obesity surgery
(Obes Surg)
Vol. 29
Issue 7
Pg. 2180-2190
(07 2019)
ISSN: 1708-0428 [Electronic] United States |
PMID | 31037599
(Publication Type: Journal Article, Meta-Analysis, Systematic Review)
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Topics |
- Bariatric Surgery
- Diabetes Mellitus
(surgery)
- Humans
- Obesity, Morbid
(surgery)
- Randomized Controlled Trials as Topic
- Treatment Outcome
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