Division of Digestive Surgery, University Hospitals of Geneva, Genève 14, Switzerland.
Obesity (Silver Spring). 2022 Mar;30(3):614-627. doi: 10.1002/oby.23338. Epub 2022 Feb 8.
This study aimed to determine which bariatric procedure allows patients to obtain the best weight-loss outcomes and a remission of type 2 diabetes.
Databases were searched for randomized-controlled trials comparing Roux-en-Y gastric bypass (RYGB) with sleeve gastrectomy (SG) or one-anastomosis gastric bypass (OAGB). The mean difference (MD) or the relative risk was determined.
Twenty-five randomized-controlled trials were analyzed. Excess weight loss (EWL, percentage) was greater for RYGB patients at 3 years (MD: 11.93, p < 0.00001) and 5 years (MD: 13.11, p = 0.0004). Higher excess BMI loss (percentage) was found in RYGB at 1 year (MD: 11.66, p = 0.01). Total weight loss (percentage) was greater for RYGB patients after 3 months (MD: 2.41, p = 0.02), 6 months (MD: 3.83, p < 0.00001), 1 year (MD: 6.35, p < 0.00001), and 5 years (MD: 3.90, p = 0.005). No difference in terms of remission of type 2 diabetes was seen between RYGB and SG. EWL was significantly more important after OAGB than after RYGB after 1 year (MD: -10.82, p = 0.003).
RYGB is more efficient than SG in the midterm. OAGB offers greater EWL than RYGB after 1 year, but further evidence is needed to confirm this result.
本研究旨在确定哪种减重手术能使患者获得最佳的减重效果并缓解 2 型糖尿病。
检索比较 Roux-en-Y 胃旁路术（RYGB）与袖状胃切除术（SG）或单吻合胃旁路术（OAGB）的随机对照试验数据库。确定均数差（MD）或相对风险。
分析了 25 项随机对照试验。RYGB 患者的超重减轻率（EWL，百分比）在 3 年（MD：11.93，p<0.00001）和 5 年（MD：13.11，p=0.0004）时更高。RYGB 在 1 年时的多余 BMI 减轻率（百分比）更高（MD：11.66，p=0.01）。RYGB 患者在 3 个月（MD：2.41，p=0.02）、6 个月（MD：3.83，p<0.00001）、1 年（MD：6.35，p<0.00001）和 5 年（MD：3.90，p=0.005）时的总减重（百分比）更大。RYGB 和 SG 在缓解 2 型糖尿病方面没有差异。OAGB 在 1 年后的 EWL 明显比 RYGB 更重要（MD：-10.82，p=0.003）。
RYGB 在中期比 SG 更有效。OAGB 在 1 年后的 EWL 比 RYGB 更大，但需要更多证据来证实这一结果。
