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Background: Despite the extensive literature on the outcome and impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on comorbidities and weight loss, clear evidence is still lacking. Our study aims to compare the short- and long-term efficacy and safety of the two procedures in patients with obesity. Methods: The primary endpoint of this retrospective registry study is to examine the adverse events after surgery, weight loss, and remission rate of comorbidities 12 months after surgery. Any result with a p-value of 5% corresponds to a significant outcome. Results: 27,882 patients had completed a one-year follow-up. 14,399 patients after SG and 13,483 after RYGB. The overall rate of intraoperative and postoperative complications was not significantly different between the two groups (overall p&gt;5%). The %EWL was 62.4% in the SG group vs. 69.2% in the RYGB group; p&lt;0.001. BMI reduction and mean weight loss were significantly different between the two groups in favor of SG. The RYGB group achieved significantly better remission of diabetes mellitus (T2DM; p&lt;0.001), hypertension (28.8% vs. 23.5%; p &lt; 0.001) and reflux 22.3% vs. 7.8%; p&lt;0.001). Sleep apnea remission was similar between the two groups (10.2%; p&lt;0.001). Conclusion: SG and RYGB are effective methods in the treatment of obesity. RYGB achieved better results in terms of remission of comorbidities and %EWL. However, further studies are needed to investigate the sustainability of weight loss and remission of comorbidities after both procedures.

Remission of comorbidities, weight loss, and adverse events after Sleeve Gastrectomy and Roux-en-Y gastric bypass in patients with obesity