Featured Research

from universities, journals, and other organizations

Gastric bypass surgery associated with improved health outcomes, studies find

Date:
February 22, 2011
Source:
JAMA and Archives Journals
Summary:
Gastric bypass surgery appears to lead to better long-term results including greater weight loss, resolution of diabetes and improved quality of life compared with sleeve gastrectomy and "lap-band" surgery, according to two new studies.

Gastric bypass surgery appears to lead to better long-term results including greater weight loss, resolution of diabetes and improved quality of life compared with sleeve gastrectomy and "lap-band" surgery, according to two reports in the February issue of Archives of Surgery, one of the JAMA/Archives journals.

"Obesity and type 2 diabetes mellitus are currently two of the most common chronic, debilitating diseases in Western countries," the authors write as background information in one of the articles. The most common surgical procedure for treating diabetes in the United States is the laparoscopic Roux-en-Y gastric bypass, more commonly referred to as gastric bypass surgery. In 2001, the laparoscopic adjustable gastric band, also known as lap-band, was introduced as a less invasive alternative to gastric bypass. Sleeve gastrectomy is another surgical weight-loss procedure, which involves surgical removal of a large portion of the stomach.

To evaluate differing outcomes of bariatric surgeries, Guilherme M. Campos, M.D., now of the University of Wisconsin School of Medicine and Public Health, Madison, formerly of the University of California, San Francisco, and colleagues examined 100 morbidly obese patients (having a body mass index greater than 40) who underwent lap-band surgery. These patients were matched by sex, race, age and initial body mass index (BMI) with 100 patients who underwent gastric bypass surgery.

All weight loss outcomes were significantly greater for patients who underwent gastric bypass. Average excess weight loss for this group was 64 percent, compared to 36 percent for lap-band patients. Additionally, 86 patients in the gastric bypass group successfully lost more than 40 percent of their excess weight compared with 29 (31 percent) of lap-band patients.

Each group had 34 patients with type 2 diabetes mellitus. Resolution or improvement of type 2 diabetes was significantly better after gastric bypass (26 patients or 76 percent) compared to lap-band (17 patients or 50 percent). At the one-year follow-up, six of eight gastric bypass patients (75 percent) who were using insulin had discontinued its use, while only one patient of six (17 percent) in the lap-bad group had done so.

The overall rate of complications was similar in both groups, with 11 patients (12 percent) in the lap-band group and 14 patients (15 percent) in the gastric bypass group experiencing complications. Early complications (within the first 30 days post-surgery) were higher in the gastric bypass group (11 patients or 11 percent) than the lap-band group (2 patients or 2 percent), however the rate of re-operation was higher in lap-band patients (12 patients or 13 percent) compared to gastric bypass patients (2 patients or 2 percent). No deaths occurred in either group.

"Our study shows that laparoscopic Roux-en-Y gastric bypass, when performed in high-volume centers by expert surgeons, has a similar rate of overall complications and lower rate of re-operations than laparoscopic adjustable gastric band," the authors conclude. "Because it achieves greater weight loss, increased resolution of diabetes, and better improvement in quality of life, we conclude that, in the setting we studied, laparoscopic Roux-en-Y gastric bypass has a better risk-benefit profile than laparoscopic adjustable gastric band."

In a second report, Wei-Jei Lee, M.D., Ph.D., of the Min-Sheng General Hospital, Taiwan, Republic of China, and colleagues conducted a double-blind randomized controlled trial of 60 moderately obese patients (BMI between 25 and 35) between the ages of 30 and 60, who had poorly controlled type 2 diabetes after conventional treatment. Between September 2007 and June 2008, half of the patients were randomized to undergo gastric bypass with duodenum exclusion (bypassing the first 12 inches of the small intestine) and half were randomized to have a sleeve gastrectomy without duodenum exclusion.

Overall, 42 patients (70 percent) had remission of type 2 diabetes 12 months after surgery. However, this resolution was significantly greater for gastric bypass patients (28 patients or 93 percent) than sleeve gastrectomy patients (14 patients or 47 percent). Both groups also had significant weight loss at the one- and three-month post-surgery follow-up, but gastric bypass patients had better weight loss results at the six- and 12-month follow-ups.

In addition to greater weight loss, patients who underwent gastric-bypass achieved a lower waist circumference and had lower glucose HbA1c and blood lipid levels than patients in the sleeve gastrectomy group. Late complications occurred in two patients (3 percent), one patient in each group, and required hospitalization for treatment, but no major adverse events were observed.

"Although more clinical trials are needed, this study and other previous studies have strongly recommended that laparoscopic gastric bypass as a metabolic surgery should be included in the armament of diabetes mellitus treatments in less obese populations (BMI of 25-35) and in the morbidly obese population (BMI greater than 35)," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. W.-J. Lee, K. Chong, K.-H. Ser, Y.-C. Lee, S.-C. Chen, J.-C. Chen, M.-H. Tsai, L.-M. Chuang. Gastric Bypass vs Sleeve Gastrectomy for Type 2 Diabetes Mellitus: A Randomized Controlled Trial. Archives of Surgery, 2011; 146 (2): 143 DOI: 10.1001/archsurg.2010.326
  2. G. M. Campos, C. Rabl, G. R. Roll, S. Peeva, K. Prado, J. Smith, E. Vittinghoff. Better Weight Loss, Resolution of Diabetes, and Quality of Life for Laparoscopic Gastric Bypass vs Banding: Results of a 2-Cohort Pair-Matched Study. Archives of Surgery, 2011; 146 (2): 149 DOI: 10.1001/archsurg.2010.316

Cite This Page:

JAMA and Archives Journals. "Gastric bypass surgery associated with improved health outcomes, studies find." ScienceDaily. ScienceDaily, 22 February 2011. <www.sciencedaily.com/releases/2011/02/110221163054.htm>.
JAMA and Archives Journals. (2011, February 22). Gastric bypass surgery associated with improved health outcomes, studies find. ScienceDaily. Retrieved October 2, 2014 from www.sciencedaily.com/releases/2011/02/110221163054.htm
JAMA and Archives Journals. "Gastric bypass surgery associated with improved health outcomes, studies find." ScienceDaily. www.sciencedaily.com/releases/2011/02/110221163054.htm (accessed October 2, 2014).

Share This



More Health & Medicine News

Thursday, October 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com
Robotic Hair Restoration

Robotic Hair Restoration

Ivanhoe (Oct. 1, 2014) A new robotic procedure is changing the way we transplant hair. The ARTAS robot leaves no linear scarring and provides more natural results. Video provided by Ivanhoe
Powered by NewsLook.com
Insertable Cardiac Monitor

Insertable Cardiac Monitor

Ivanhoe (Oct. 1, 2014) A heart monitor the size of a paperclip that can save your life. The “Reveal Linq” allows a doctor to monitor patients with A-Fib on a continuous basis for up to 3 years! Video provided by Ivanhoe
Powered by NewsLook.com
Attacking Superbugs

Attacking Superbugs

Ivanhoe (Oct. 1, 2014) Two weapons hospitals can use to attack superbugs. Scientists in Ireland created a new gel resistant to superbugs, and a robot that can disinfect a room in minutes. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins