“Mini” Gastric Bypass: Systematic Review of a Controversial Procedure

Background. Controversies on the utility of laparoscopic mini gastric bypass (LMGB) in weight loss and type 2 diabetes mellitus (T2DM) control still exist.Methods. We conducted a comprehensive literature search of PubMed, EMBASE, and Cochrane Library. Review Manager was used to perform the meta-analysis and the weighted mean difference (WMD) and/or odds ratio with 95% confidence interval (95% CI) were used to evaluate the overall size effect.Results. The literature search identified 16 studies for systematic review and 15 articles for meta-analysis. Compared with LAGB, LSG, and LRYGB, LMGB showed significant weight loss [WMD, −6.58 (95% CI, −9.37, −3.79),P<0.01(LAGB); 2.86 (95% CI, 1.40, 5.83),P=0.004(LSG); 10.33 (95% CI, 4.30, 16.36),P<0.01(LRYGB)] and comparable/higher T2DM remission results [86.2% versus 55.6%,P=0.06(LAGB); 89.1% versus 76.3%,P=0.004(LAGB); 93.4% versus 77.6%,P=0.006(LAGB)]; LMGB also had shorter learning curve and less operation time than LRYGB [WMD, −35.2 (95% CI, −46.94, −23.46)].Conclusions. LMGB appeared to be effective in weight loss and T2DM remission and noninferior to other bariatric surgeries. However, clinical utility of LMGB needs to be further validated by future prospective randomized controlled trials.

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WEIGHT LOSS COMPARISON AFTER SLEEVE AND ROUX-EN-Y GASTRIC BYPASS: SYSTEMATIC REVIEW

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020190001e1474 ◽

2019 ◽

Vol 32 (4) ◽

Cited By ~ 3

Author(s):

Fernando de BARROS ◽

Mayara Galisse NEGRÃO ◽

Giovana Galisse NEGRÃO

Keyword(s):

Systematic Review ◽

Clinical Trial ◽

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Mini Gastric Bypass ◽

Loss Assessment ◽

Vertical Gastrectomy ◽

Significant Difference

ABSTRACT Introduction: Bariatric surgery is currently the gold standard treatment for obesity. The two most accomplished surgeries are the Roux-en-Y gastric bypass and the sleeve gastrectomy, and controversies exist in which is better. Objective: To compare the two techniques in relation to weight loss with at least five years of follow-up. Methods: Search in Medline, PubMed, Embase, SciElo, Lilacs, Cochrane databases from 2001 (beginning of vertical gastrectomy) until 2018, using the following headings: “sleeve” or “sleeve gastrectomy” combined with “gastric bypass” or “Roux-en-Y gastric bypass”, “weight loss” and “clinical trial”. Criteria for inclusion of articles were patients aged between 18 and 65 years; clinical trial; comparison between the two techniques; minimum five-year follow-up; outcome with weight loss assessment. Results: The initial search identified 1940 articles, of which 185 publications were identified as clinical trials. One hundred and forty-one were excluded, 67 because they did not compare the two techniques, 57 not addressed weight loss and 17 were repeated articles. Thirty-four studies were retrieved for a more detailed analysis; 36 studies were excluded due to a follow-up of less than five years, and another compared the mini-gastric bypass. In total, seven studies were included in the systematic review, but there was no significant difference in three of them. Conclusion: The gastric bypass had a greater weight loss than the vertical gastrectomy in all the evaluated studies.

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