Postoperative early major and minor complications in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) procedures: A meta-analysis and systematic review

Osland, Emma, Yunus, Rossita Mohamad, Khan, Shahjahan, Alodat, Tareq, Memon, Breda and Memon, Muhammed Ashraf (2016) Postoperative early major and minor complications in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) procedures: A meta-analysis and systematic review. Obesity Surgery, 1-12. doi:10.1007/s11695-016-2101-8


Author Osland, Emma
Yunus, Rossita Mohamad
Khan, Shahjahan
Alodat, Tareq
Memon, Breda
Memon, Muhammed Ashraf
Title Postoperative early major and minor complications in Laparoscopic Vertical Sleeve Gastrectomy (LVSG) versus Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) procedures: A meta-analysis and systematic review
Journal name Obesity Surgery   Check publisher's open access policy
ISSN 1708-0428
0960-8923
Publication date 2016-02-19
Sub-type Article (original research)
DOI 10.1007/s11695-016-2101-8
Open Access Status Not Open Access
Start page 1
End page 12
Total pages 12
Place of publication New York, United States
Publisher Springer New York LLC
Formatted abstract
Background
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage obesity-related chronic disease. The aim of this meta-analysis and systematic review was to compare the “early postoperative complication rate i.e. within 30-days” reported from randomized control trials (RCTs) comparing these two procedures.

Methods
RCTs comparing the early complication rates following LVSG and LRYGB between 2000 and 2015 were selected from PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane database. The outcome variables analyzed included 30-day mortality, major and minor complications and interventions required for their management, length of hospital stay, readmission rates, operating time, and conversions from laparoscopic to open procedures.

Results
Six RCTs involving a total of 695 patients (LVSG n = 347, LRYGB n = 348) reported on early major complications. A statistically significant reduction in relative odds of early major complications favoring the LVSG procedure was noted (p = 0.05). Five RCTs representing 633 patients (LVSG n = 317, LRYGB n = 316) reported early minor complications. A non-statically significant reduction in relative odds of 29 % favoring the LVSG procedure was observed for early minor complications (p = 0.4). However, other outcomes directly related to complications which included reoperation rates, readmission rate, and 30-day mortality rate showed comparable effect size for both surgical procedures.

Conclusions
This meta-analysis and systematic review of RCTs suggests that fewer early major and minor complications are associated with LVSG compared with LRYGB procedure. However, this does not translate into higher readmission rate, reoperation rate, or 30-day mortality for either procedure.
Keyword Bariatric surgery
Laparoscopic
Meta-analysis
Roux-en-Y gastric bypass
Sleeve gastrectomy
Systematic review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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