Sitzung

72 - Freie Mitteilung
Bariatry & hernia I
16. Mai 2019, 17:30 - 19:00, Bellavista 3+4, 6. OG

Abstract

7
Proximal versus very-very-long-limb roux-en-Y gastric bypass: Long-term outcome with a follow-up of up to 15 years
J. Süsstrunk1, I. Lazaridis2, M. Hauser2, M. Kraljevic2, T. Köstler1, U. Zingg1, T. Delko2, Presenter: J. Süsstrunk1 (1Schlieren, 2Basel)

Ziel
Laparoscopic Roux-en-Y gastric bypass (RYGB) is considered as the gold standard in the treatment of morbid obesity. A number of different types of RYGB are widely used, however, data on long-term outcomes comparing the different RYGB techniques are scarce. This study reports the results after Very-Very-Long-Limb RYGB (VVLL-RYGB) and proximal RYGB (PRYGB) with a follow-up time of up to 15 years.
Methoden
Pre-, intra- and postoperative as well as follow-up data of all patients undergoing bariatric procedures have been collected in a database. All patients undergoing VVLL or proximal RYGB between 2000 and 2012 were analysed. The minimal follow-up time was 5 years.
Resultate
A total of 382 patients underwent RYGB. 230 patients received VVLL-RYGB and 152 patients PRYGB. Mean age was 40.4 +/- 10.6 years, 69.6% were female. Mean preoperative body mass index (BMI) was 44.9 +/- 7.1 kg/m2 and type 2 diabetes mellitus was present in 21.7%. Mean follow-up time was 6.2 +/- 3.1 years. In VVLL-RYGB BMI reduction and excessive weight loss (EWL), respectively, were: 15.3 +/- 6.7 kg/m2 and 79.1 +/- 37.1%, at 5 years follow-up, 15.4 +/- 6.0 kg/m2 and 88.9 +/- 41.1% at 8 years, 16.1 +/- 5.7 kg/m2 and 76.9 +/- 22.9% at 10 years, 17.9 +/- 4.9 kg/m2 and 83.2 +/- 16.5% at 13 years. In PRYGB BMI reduction and EWL, respectively, were: 11.8 +/- 4.8 kg/m2 and 74.5 +/- 32.4% at 5 years, 14.2 +/- 5.9 kg/m2 and 72.5 +/- 15.3% at 8 years. With exception of BMI reduction 5 years postoperatively (p<0.01) no significant differences were detected between groups. Overall, type 2 diabetes resolved in 90.1% of patients during the first 5 years postoperatively. There were 19 revisional procedures in the VVLL group compared to 8 in the PRYGB group.
Schlussfolgerung
RYGB leads to a sustainable long-term weight loss and reduction of co-morbidities. In terms of BMI reduction and EWL, both procedures were comparable with a slight advantage for the VVLL-RYGB after 5 years.
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