The Comparative Effect of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on 10-Year and Lifetime Atherosclerotic Cardiovascular Disease Risk

AbstractBackgroundBariatric surgery reduces atherosclerotic cardiovascular disease (ASCVD) risk. However, the comparative effect of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on 10-year and lifetime ASCVD risk, as defined by the American College of Cardiology/American Heart Association (ACC/AHA), remains unknown.MethodsUsing the ACC/AHA ASCVD risk estimator, 10-year and lifetime ASCVD risks were calculated before and 1  year after bariatric surgery for patients aged 40–78 who underwent RYGB or SG at an academic medical center in California between 2003 and 2015. Change in risk was calculated by taking the difference between 1-year and baseline risk. Statistical analyses included the Wilcoxon signed rank test, M ann-WhitneyU test, Quade ’s test, and multiple logistic regression.ResultsThere were 536 patients (mean age 52  ± 10 years, 20% male), of whom 438 underwent RYGB and 98 underwent SG. Patients undergoing RYGB were predominately female (82% vs 71%,p = 0.021) and had higher baseline BMIs (44.4 ± 8.4 vs 41.9 ± 8.0,p 
Source: Obesity Surgery - Category: Surgery Source Type: research

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AbstractReviewed here are multiple mouse models of vertical sleeve gastrectomy (VSG) and Roux-en Y gastric bypass (RYGB) that have emerged over the past decade. These models use diverse approaches to both operative and perioperative procedures. Scrutinizing the benefits and pitfalls of each surgical model and what to expect in terms of post-operative outcomes will enhance our assessment of studies using mouse models, as well as advance our understanding of their translational potential. Two mouse models of bariatric surgery, VSG-lembert and RYGB-small pouch, demonstrate low mortality and most closely recapitulate the human...
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractThe purpose of this study was to investigate the relationship between bariatric surgery (laparoscopic sleeve gastrectomy [LSG] and laparoscopic Roux-en-Y gastric bypass [LRYGB]) and gastroesophageal reflux disease (GERD). The number of obese patients with newly onset, worsened, or improved GERD after bariatric surgery in each article were extracted. In the pooled analysis, LSG was associated with a higher risk of GERD than LRYGB (odds ratio [OR] = 5.10, 95% confidence interval [CI] 3.60 –7.23,p
Source: Obesity Surgery - Category: Surgery Source Type: research
The sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single anastomosis duodenal-ileal bypass with SG (SADI-S) are recognized bariatric procedures. A comparison has never been made between these three procedures and especially in different body mass index (BMI) categories.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
AbstractIntroductionBariatric surgery is increasingly performed. Since there are numerous surgical techniques, the effects of these on the esophageal function are still poorly understood. We aimed at assessing the effect of different techniques on esophagogastric junction (EGJ), esophageal peristalsis and reflux exposure using high-resolution manometry (HRM), and impedance-pH monitoring (MII-pH).MethodsAll obese patients underwent symptomatic questionnaires, endoscopy, HRM, and MII-pH before and 1  year after surgery. Esophageal function and EGJ were classified according to Chicago Classification V. 3.0. Intragastric ...
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
Obesity is a public health pandemic and leading contributor to morbidity and mortality. Endoscopic bariatric therapies have emerged as a viable minimally invasive treatment option to fill the therapeutic gap between conservative and surgical approaches. The ability to reliably place full-thickness sutures throughout the gastrointestinal tract has opened the door to novel endoscopic gastric restrictive procedures. A growing body of literature supports endoscopic sleeve gastroplasty as a safe, effective, and reproducible endoscopic treatment of obesity and metabolic syndrome. In addition, endoscopic sutured revision procedur...
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Source Type: research
ConclusionThe LSG and RYGB both impart dramatic meaningful loss in excess body weight. In addition, both the LSG and RYGB impart dramatic reductions in fat mass. However, both procedures induce loss of lean mass and there appears to be no difference between the two procedures in this regard despite their anatomic and physiologic differences.
Source: Obesity Surgery - Category: Surgery Source Type: research
We have read with great interest this study (1) analyzing the perioperative outcomes of Roux-en Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in super-obese patients (SO, body mass index (BMI) 50 - 59.9 kg/m2) and super-super obese patients (SSO, BMI ≥ 60 kg/m2). The authors investigated the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database and 356,621 patients met the inclusion criteria. Of these, 255,459 (71.6%) underwent SG and 101,162 (28.4%) underwent RYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study aims to assess MVPA changes during the rapid weight loss phase through self-reporting and objective measures.MethodsPhysical activity patterns were assessed as minutes per day spent doing MVPA. A walking cadence of ≥ 100 steps per minute defined MVPA. Individuals completing gastric bypass (N = 7) and sleeve gastrectomy (N = 17) procedures (21 females, 3 males, age 42.2 ± 12.6 years, body mass 121.8 ± 24.8 kg, BMI 44.0 ± 6.5) completed office visits at 12 ± 6 days pre- and 35&th...
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractBackgroundThe safety and efficacy of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) to treat obesity and associated comorbidities, including diabetes mellitus, is well established. As diabetes may add risk to the perioperative period, we sought to characterize perioperative outcomes of these surgical procedures in diabetic patients.MethodsUsing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we identified patients who underwent LSG and LRYGB between 2015 and 2017, grouping by non-diabetics (NDM), non-insulin-dependent dia...
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionEE is more prevalent after SG compared with RYGB in a pre-bariatric surgery cohort with GERD. SG is associated with significant esophageal physiologic changes conducive to GERD and its clinical consequences.
Source: Obesity Surgery - Category: Surgery Source Type: research
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