Evidence map›Paper›PMID 27287899›Full record

ArticleSurgical endoscopy2017

Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in super obese patients.

Adam C Celio, Qiang Wu, Kevin R Kasten, Mark L Manwaring, Walter J Pories, Konstantinos Spaniolas

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  6. Effect of alcohol ingestion on plasma glucose kinetics after Roux-en-Y gastric bypass surgery.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Adam C CelioDepartment of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA.
Qiang WuDepartment of Biostatistics, College of Allied Health Sciences, East Carolina University, Greenville, NC, USA.
Kevin R KastenDepartment of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA.
Mark L ManwaringDepartment of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA.
Walter J PoriesDepartment of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA.
Konstantinos SpaniolasDepartment of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA. spaniolask@ecu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe disproportionate increase in the super obese (SO) is a hidden component of the current obesity pandemic. Data on the safety and efficacy of bariatric procedures in this specific patient population are limited. Our aim is to assess the comparative effectiveness of the two most common bariatric procedures in the SO.

methodsUsing the Bariatric Outcomes Longitudinal Database from 2007 to 2012, we compared SO patients (BMI ≥ 50) undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Stepwise logistic regression modeling was used to calculate a propensity score to adjust for patient demographics and comorbidities.

resultsWe identified 50,987 SO patients who underwent RYGB (N = 42,119) or SG (N = 8868). There was no difference in adjusted overall 30-day complication rate comparing RYGB and SG patients (11.5 vs. 11.1 %, p = 0.250). RYGB patients had higher adjusted rates of 30-day mortality (0.3 vs. 0.2 %, p = 0.042), reoperation (4.0 vs. 2.4 %, p < 0.001), and readmission (6.9 vs. 5.5 %, p < 0.001) compared to SG patients. The percent of total weight loss (%TWL) was significantly higher for RYGB patients compared to SG at 3 months (14.1 vs. 13.1 %, p < 0.001), 6 months (25.2 vs. 22.4 %, p < 0.001), and 12 months (34.5 vs. 29.7 %, p < 0.001). RYGB patients had increased resolution of all measured comorbidities: diabetes mellitus (61.6 vs. 50.8 %, p < 0.001), hypertension (43.1 vs. 34.5 %, p < 0.001), gastroesophageal reflux disease (53.9 vs. 32.5 %, p < 0.001), hyperlipidemia (39.7 vs. 32.5 %, p < 0.001), and obstructive sleep apnea (42.8 vs. 40.6 %, p = 0.058) at 12 months compared to SG patients.

conclusionsThere are significant differences in comorbidity improvement and resolution as well as weight loss between RYGB and SG in the SO population. There was no difference in overall 30-day complications, but more RYGB patients required readmission and reoperation. However, RYGB was considerably more effective in controlling obesity-related comorbidities. Our results favor performance of RYGB in SO patients of appropriate risk.

Indexed as

Gastric BypassAdultComorbidityComparative Effectiveness ResearchDiabetes MellitusFemaleGastrectomyGastroesophageal RefluxHumansHyperlipidemiasHypertensionMaleObesity, MorbidPatient ReadmissionPostoperative ComplicationsReoperationBariatric surgeryBOLDGastric bypassSleeve gastrectomySuper obese

Identifiers

PMID27287899

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.