Eight Year Follow-Up After Gastric Bypass and Sleeve Gastrectomy in a Brazilian Cohort: Weight Trajectory and Health Outcomes.

Abstract

Introduction: Despite Sleeve Gastrectomy (SG) being the most commonly performed bariatric surgery today, studies with over 5 years of follow-up show that patients undergoing SG have inferior weight loss compared to those undergoing Roux-en-Y gastric bypass (RYGB). The aim of this study was to examine differences in weight loss and the prevalence of weight regain between SG and RYGB up to 8 years after surgery.

Methods: Retrospective study including adult patients undergoing SG or RYGB between 2015 and 2018 at a tertiary center in Brazil. We evaluate the weight trajectory and pre- and postoperative behavior of type 2 diabetes (T2D), hypertension, and dyslipidemia. Differences betwen variables were tested using Student t-test, Mann-Whitney U, Pearson's chi-square or Fisher's exact test as appropriate. The level of significance adopted was p < 0,005.

Results: Among 591 patients (40 ± 10 years; baseline body mass index 41.7 [IQR 39.1-45]; 83% women), 327 underwent RYGB (55%) and 264 SG (45%). Preoperatively, 14% had T2D, 40% hypertension, and 53% dyslipidemia. The mean total percentage of weight loss was higher in the RYGB group after 8 years: 32% compared to 19% after SG (difference 13%, p < 0.004). At 8 years, weight regain was also lower in RYGB (23%) compared to SG (39%) (p < 0.001). At 5 years postoperatively, the remission rates for T2D, hypertension, and dyslipidemia were 63%, 42%, and 51%, respectively, among the patients who remained in follow-up.

Conclusions: Patients undergoing RYGB showed greater weight loss and less weight regain 8 years after bariatric surgery compared to those undergoing SG.