Retrospective longitudinal and comparative observational study between gastric bypass surgery and sleeve gastrectomy: 5-year post-operative follow-up

BACKGROUND: Among the 2.0 billion overweight individuals in the world, Brazil ranks fifth in the number of obese people, therefore requiring treatment options for obesity. AIM: The aim of this study was to compare the percentage of total body weight loss (%TWL), change in body mass index (BMI), percentage of excess weight loss (%EWL), incidence of reflux esophagitis, and occurrence of Barrett's esophagus in obese patients undergoing gastric bypass (Roux-en-Y gastric bypass [RYGB]) and sleeve gastrectomy (SG), both techniques by videolaparoscopy. METHODS: The study included 100 consecutive patients who underwent RYGB and SG techniques, totaling 200 patients, and were followed up for 60 months, from June 2013 to July 2018. RESULTS: The frequency of gastroesophageal reflux disease (GERD) was lower in RYGB patients (p<0.05). At 60 months, the %EWL was 77.4±13.3 kg (RYGB) versus 80.5±17.5 kg (SG) (p<0.05). The BMI data were statistically significantly different between groups after 5 years (28.5±3.9 kg/m2 in RYGB and 31.9±5.3 kg/m2 in SG groups, p<0.05). During the follow-up, the RYGB showed higher %EWL compared to the SG (at 60 months, 80.1% vs. 59.1%, respectively, p<0.05). The %TWL was 30% for the RYGB and 19.7% for the SG (p<0.05). The RYGB had a lower frequency of reflux esophagitis and Barrett's esophagus. CONCLUSIONS: The RYGB technique showed greater absolute weight loss, %TWL, BMI reduction, and %EWL in higher obesity classes compared to the SG technique. Additionally, RYGB had a lower frequency of reflux esophagitis and Barrett's esophagus.