Safety and effectiveness of sleeve gastrectomy versus gastric bypass: one-year results of Tehran Obesity Treatment Study (TOTS)

Aim: We aimed to compare the effectiveness and safety of sleeve gastrectomy versus gastric bypass at one-year. Background: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most commonly performed bariatric procedures worldwide. Methods: Patients from a prospectively collected database who presented to a specialized bariatric center and underwent a primary bariatric procedure between March 2013 and April 2015 were included and compared regarding major and minor complication rates and weight loss parameters at 6 and 12 months. Results: A total of 513 patients with a mean age of 37.5±12.5, 82.6 % female and mean body mass index (BMI) of 44.1±6.3 kg/m2 were included in our analysis: 73.3% underwent SG and 26.7% underwent RYGB. Major and minor complication rates were 7.1 and 2.6% for SG vs. 9.5 and 2.2% for the RYGB, respectively (P=NS). The operative and anesthesia time in SG patients were significantly shorter than in RYGB patients (P<0.001). SG and RYBG patients achieved similar excess weight loss at one year (75.4±20.5% vs. 71.8±26.3%, respectively, P=NS). Baseline BMI was the only predictive factor for weight loss at one year (OR: 0.901, CI: 0.827-0.982, P<0.017). Conclusion: RYGB and SG both showed similar one-year safety and effectiveness. Long-term studies are needed to complement these findings.