Roux-en-Y Gastric Bypass vs Vertical Sleeve Gastrectomy in the Remission of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Talledo J.A.; Caballero-Alvarado J.; De la Cruz Davila M.I.; Zavaleta-Corvera C. · Polski Przeglad Chirurgiczny/ Polish Journal of Surgery (2024) · DOI: 10.5604/01.3001.0054.2674

Resumen

Introduction: Obesity's associated comorbidities and treatment costs have risen significantly, highlighting the importance of early weight loss strategies. Bariatric surgeries like Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) have been effective in promoting weight loss and improving type 2 diabetes mellitus (T2DM) management. Aim: The aim was to determine whether Roux-en-Y gastric bypass is more effective than vertical sleeve gastrectomy in the remission of type 2 diabetes mellitus (T2DM). Methods: A systematic review and meta-analysis was performed. A literature search was performed in the databases Web of Science, Medline/PubMed, Embase, Scopus, and Medline/Ovid. A total of 1323 results were identified; after screening, 14 articles were selected and included in the systematic review. Primary and secondary outcomes were measured by RR with a 95% CI. Results: The primary outcome of T2DM remission was 15% in favor of VSG (RR: 1.15, [95% CI: 1.04–1.28]). For secondary outcomes, hypertension remission was 7% in favor of VSG (RR: 1.07, [95% CI: 1.00–1.16]). Remission of dyslipidemia was 16% in favor of VSG (RR: 1.16, [95% CI: 1.06–1.26]). BMI after surgery was in favor of RYGB (MD: –1.31, [95% CI: –1.98 to –0.64]). For weight loss, the results favored VSG (MD: 6.50, [95% CI: 4.99–8.01]). In relation to total cholesterol, they were 65% favorable for RYGB (MD: –0.35, [95% CI: –0.46 to –0.24]), with a value of p <0.05. For LDL values, our results were 69% favorable for RYGB (MD: –0.31, [95% CI: –0.45 to –0.16]), p <0.01 value. Conclusions: Laparoscopic sleeve gastrectomy is more effective in T2DM remission, hypertension remission, dyslipidemia remission, and weight loss compared to Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is more effective at lowering BMI, total cholesterol, LDL, and TG compared to laparoscopic sleeve gastrectomy. Some right reserved: Fundacja Polski Przegląd Chirurgiczny. Published by Index Copernicus Sp. z o. o.

Instituciones: Universidad Privada Antenor Orrego