Analysis of three Bariatric Surgery Techniques for the Treatment of Patients with BMI > 50 Kg/M2. Prospective and Comparative Study with a minimum follow-up of 5 years

Abstract

Roux-n-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are the most effective options for the treatment of obesity. General objective: Compare three techniques: RYGB with alimentary limb (AL) of 150 cm and biliopancreatic limb (BPL) of 50 cm, RYGB with AAL of 200 cm and ABP of 100 cm and SG in patients with body mass index (BMI) > 50 Kg/ m². Methods: A comparative and prospective study was carried out including 42 patients with BMI > 50 Kg/m², forming 3 groups: 14 RYGB patients with AL of 150 cm and BPL of 50 cm, 8 RYGB with AL of 200 cm and BPL of 100 cm and 20 SG. Minimum follow-up was 5 years. Results: Average age 38.83 ± 1.54 years. Patients with comorbidities (69.05%). There was no difference in the anthropometric parameters among three groups except for excess weight. All groups demonstrated significant decrease in initial weight after surgery (p < 0.05). All groups demonstrated a significant decrease in initial BMI postoperatively (p < 0.05). Average percentage of excess weight lost (%EWL) of 62.45 ± 2.64 % was recorded. The highest median %EWL was recorded in SG group with no significant difference between groups. Better resolution of comorbidities was demonstrated in the BPGL AAL 200 / ABP 100 group and SG group with no statistical differences among study groups. Conclusion: all three tecniques proved to be equally effective in patients with BMI > 50 Kg/m².