Sleeve gastrectomy versus Roux-en-Y-gastric bypass in patients with body mass index over 50 kg/m2: international multicentre cohort
Patients with initial body mass index > 50 kg/m2 are vastly under-represented in randomized clinical trials demonstrating similar weight loss and diabetes remission rates after sleeve gastrectomy and Roux-en-Y gastric bypass.Propensity score matching 1 : 1 was used to compare outcomes regarding w...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
April 2026
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| In: |
BJS open
Year: 2026, Volume: 10, Issue: 2, Pages: 1-7 |
| ISSN: | 2474-9842 |
| DOI: | 10.1093/bjsopen/zrag028 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1093/bjsopen/zrag028
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| Author Notes: | Lars Kollmann, Ilan Rosenblum, Adisa Poljo, Pascal Probst, Markus K Muller, Piotr Kalinowski, Muhammed S Dalkılıç, Abdullah Şişik, Johanna Betzler, Mirko Otto, Stephanie Taha-Mehlitz, Beat P Müller, Daniel M Frey, Bassey Enodien, Emanuel Burri, Reinhard Stoll, Otto Kollmar, Robert Rosenberg, Florian Ponholzer, Johan Friso Lock, Sven Flemming, Erik Stenberg, Johan Ottosson, Ellen Andersson, Torsten Olbers, Ralph Peterli, Florian Seyfried and Anas Taha |
| Summary: | Patients with initial body mass index > 50 kg/m2 are vastly under-represented in randomized clinical trials demonstrating similar weight loss and diabetes remission rates after sleeve gastrectomy and Roux-en-Y gastric bypass.Propensity score matching 1 : 1 was used to compare outcomes regarding weight loss and diabetes control after sleeve gastrectomy and Roux-en-Y gastric bypass in patients with body mass index > 50 kg/m2 between 2012 and 2022 in a cohort from 13 centres in six European countries. The primary endpoint was percentage total bodyweight loss; secondary endpoints were diabetes remission rate and rate of persistent body mass index > 40 kg/m2.In total, 3976 of 8160 patients were matched and included in the analysis (1988 in each group). Median age at baseline was 40.0 (range 16-76) years in the sleeve gastrectomy group and 39.5 (15-71) years in the Roux-en-Y gastric bypass group. Median body mass index at baseline was 56.2 (range 50.0-100.0) and 54.3 (50.0-83.9) kg/m2, respectively (P < 0.001). The follow-up rate was 70.5% at 1 year and 24.4% at 5 years. Percentage total bodyweight loss at 1 and 5 years after sleeve gastrectomy was 30.2 (2.2-63.7) and 25.4 (-4.8 to 56.0)%, respectively, versus 31.2 (7.4-54.5) and 28.2 (−6.6 to 62.9)% in the Roux-en-Y gastric bypass group (P < 0.001 between groups in both time points). The prevalence of persistent body mass index > 40 kg/m2 after 1 and 5 years was 42.7 and 57.6%, respectively, after sleeve gastrectomy versus 24.5 and 39.2% after Roux-en-Y gastric bypass (P < 0.001 between groups in both time points). A 5-year follow-up, the prevalence of a pathological haemoglobin A1c level (> 6.5%) was 12.9% after sleeve gastrectomy and 11.6% after Roux-en-Y gastric bypass (P = 0.323).This study suggests that Roux-en-Y gastric bypass results in greater weight loss than sleeve gastrectomy in patients with body mass index > 50 kg/m2, whereas improvements in diabetes appear comparable between procedures. |
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| Item Description: | Im Titel ist die Zahl 2 bei "50 kg/m2" hochgestellt Online veröffentlicht: 29. April 2026 Gesehen am 11.05.2026 |
| Physical Description: | Online Resource |
| ISSN: | 2474-9842 |
| DOI: | 10.1093/bjsopen/zrag028 |