Laparoscopic Roux-en-Y Versus Mini-Gastric Bypass for the Treatment of Morbid Obesity: A Prospective Randomized Controlled Clinical Trial
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In Brief Objectives: This prospective, randomized trial compared the safety and effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGBP) and laparoscopic mini-gastric bypass (LMGBP) in the treatment of morbid obesity. Summary Background Data: LRYGBP has been the gold standard for the treatment of morbid obesity. While LMGBP has been reported to be a simple and effective treatment, data from a randomized trial are lacking. Methods: Eighty patients who met the NIH criteria were recruited and randomized to receive either LRYGBP (n = 40) or LMGBP (n = 40). The minimum postoperative follow-up was 2 years (mean, 31.3 months). Perioperative data were assessed. Late complication, excess weight loss, BMI, quality of life, and comorbidities were determined. Changes in quality of life were assessed using the Gastro-Intestinal Quality of Life Index (GIQLI). Results: There was one conversion (2.5%) in the LRYGBP group. Operation time was shorter in LMGBP group (205 versus 148, P < 0.05). There was no mortality in each group. The operative morbidity rate was higher in the LRYGBP group (20% versus 7.5%, P < 0.05). The late complications rate was the same in the 2 groups (7.5%) with no reoperation. The percentage of excess weight loss was 58.7% and 60.0% at 1 and 2 years, respectively, in the LPYGBP group, and 64.9% and 64.4% in the LMGBP group. The residual excess weight <50% at 2 years postoperatively was achieved in 75% of patients in the LRYGBP group and 95% in the LMGBP group (P < 0.05). A significant improvement of obesity-related clinical parameters and complete resolution of metabolic syndrome in both groups were noted. Both gastrointestinal quality of life increased significantly without any significant difference between the groups. Conclusion: Both LRYGBP and LMGBP are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. LMGBP is a simpler and safer procedure that has no disadvantage compared with LRYGBP at 2 years of follow-up. This randomized prospective study evaluated the surgical morbidity and results 2 years after laparoscopic Roux-en-Y gastric bypass (LRYGBP) and laparoscopic mini-gastric bypass (LMGBP) to treat morbid obesity. LMGBP was simpler and safer with lower surgical morbidity than LRYGBP (7.5% versus 20.0%, P < 0.05). Both procedures were effective in weight reduction and resolution of metabolic syndrome in patients with morbid obesity and provided similar quality of life.
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Quality of life and resolution of comorbidities were similar between OAGB and RYGB.
“Quality of life and resolution of comorbidities was similar.”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [113]
OAGB was associated with marginally reduced odds for in-hospital morbidity compared with RYGB (OR 0.38, 95% CI 0.13 to 1.14).
“OAGB was associated with marginally reduced odds for in-hospital morbidity (OR 0.38, 95% CI 0.13 to 1.14) and late complications (0.76, 95% CI 0.33 to 1.77) at the expense of less pronounced EWL (WMD 13%, 95% CI 2% to 29%; very low certainty) (Supplementary Table S22).”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [113]
OAGB was associated with marginally reduced odds for late complications compared with RYGB (OR 0.76, 95% CI 0.33 to 1.77).
“OAGB was associated with marginally reduced odds for in-hospital morbidity (OR 0.38, 95% CI 0.13 to 1.14) and late complications (0.76, 95% CI 0.33 to 1.77) at the expense of less pronounced EWL (WMD 13%, 95% CI 2% to 29%; very low certainty) (Supplementary Table S22).”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [113]
OAGB was associated with less pronounced excess weight loss compared with RYGB (WMD 13%, 95% CI 2% to 29%; very low certainty).
“OAGB was associated with marginally reduced odds for in-hospital morbidity (OR 0.38, 95% CI 0.13 to 1.14) and late complications (0.76, 95% CI 0.33 to 1.77) at the expense of less pronounced EWL (WMD 13%, 95% CI 2% to 29%; very low certainty) (Supplementary Table S22).”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [113]
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- Authors
- Lee, W.-J., Yu, P.-J., Wang, W., Chen, T.-C., Wei, P.-L., & Huang, M.-T.
- Affiliations
- En Chu Kong Hospital (TW)
- National Taiwan University (TW)
- Corresponding author
- Lee, Wei-Jei
- Wang, Weu
- Chen, Tai-Chi
- Wei, Po-Li
- Huang, Ming-Te
- Venue
- Annals of Surgery
- Published
- 2005-07
- Volume
- 242
- Issue
- 1
- Pages
- 20-28
- ISSN
- 0003-4932 (ISSN-L)
- PMC
- PMC1357700
- OpenAlex
- W2086051776
- Cited by
- 479
- References
- 42
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 22 · 2023: 23 · 2022: 32 · 2021: 33 · 2020: 28 · 2019: 37 · 2018: 45 · 2017: 35 · 2016: 29 · 2015: 31 · 2014: 25 · 2013: 15 · 2012: 12
- FWCI
- 15.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- morbid obesity, bariatric surgery, excess weight loss, metabolic syndrome, gastrointestinal quality of life, surgical morbidity, conversion to open surgery, operative time, long-term outcomes, quality of life, obesity-related comorbidities
- MeSH terms
- Adult, Anastomosis, Roux-en-Y, Female, Humans, Male, Obesity, Morbid, Postoperative Pain, Laparoscopy, Postoperative Complications, Probability, Prospective Studies, Quality of Life, Reference Values, Severity of Illness Index, Gastric Bypass, Weight Loss, Body Mass Index, Treatment Outcome, Patient Satisfaction, Risk Assessment, Minimally Invasive Surgical Procedures
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