At 10 Years, Roux-en-Y Gastric Bypass Superior for Patient Excess BMI Loss

MONDAY, Feb. 24, 2025 (HealthDay News) — The long-term outcomes of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) may differ in intention-to-treat (ITT) and per protocol (PP) populations, according to a study published online Feb. 19 in JAMA Surgery.

Marko Kraljević, M.D., from the University Hospital of Basel in Switzerland, and colleagues compared long-term weight and metabolic outcomes, reoperation rates, and quality of life for patients at 10 years and beyond in the Swiss Multicenter Bypass or Sleeve Study randomized clinical trial. A total of 217 patients were enrolled and randomly assigned to SG or RYGB (107 and 110, respectively).

The researchers found that in the ITT population, the mean percentage excess body mass index loss (percentEBMIL) was not significantly different between SG and RYGB (60.6 and 65.2, respectively). Compared with RYGB, patients who underwent SG had significantly higher conversion rates due to insufficient weight reduction or reflux (29.9 versus 5.5 percent). After 10 years, in the PP population, patients undergoing RYGB had significantly higher mean percentEBMIL compared with those undergoing SG (65.9 versus 56.1 percent). However, the groups did not significantly differ in terms of mean percentage total weight loss (27.7 and 25.5 percent for RYGB and SG, respectively). Significantly more de novo gastroesophageal reflux occurred in SG versus RYGB patients.

“For the ITT analysis, no significant difference in percentEBMIL was found after 10 years comparing SG and RYGB. However, the PP analysis revealed superior weight loss in patients who underwent RYGB compared to SG,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical device industries.

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