Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial

摘要: Importance Sleeve gastrectomy is increasingly used in the treatment of morbid obesity, but its long-term outcome vs standard Roux-en-Y gastric bypass procedure unknown. Objective To determine whether there are differences between sleeve and terms weight loss, changes comorbidities, increase quality life, adverse events. Design, Setting, Participants The Swiss Multicenter Bypass or Study (SM-BOSS), a 2-group randomized trial, was conducted from January 2007 until November 2011 (last follow-up March 2017). Of 3971 morbidly obese patients evaluated for bariatric surgery at 4 centers, 217 were enrolled randomly assigned to with 5-year period. Interventions Patients undergo laparoscopic (n = 107) 110). Main Outcomes Measures primary end point expressed as percentage excess body mass index (BMI) loss. Exploratory points comorbidities Results Among (mean age, 45.5 years; 72% women; mean BMI, 43.9) 205 (94.5%) completed trial. Excess BMI loss not significantly different 5 years: gastrectomy, 61.1%, bypass, 68.3% (absolute difference, −7.18%; 95% CI, −14.30% −0.06%;P = .22 after adjustment multiple comparisons). Gastric reflux remission observed more frequently (60.4%) than (25.0%). worsened (more symptoms therapy) often (31.8%) (6.3%). number reoperations interventions 16/101 (15.8%) 23/104 (22.1%) bypass. Conclusions Relevance no significant difference years surgery. Trial Registration clinicaltrials.gov Identifier:NCT00356213