SynthesisObesity surgery2026
Ten-Year Follow-Up for Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis.
Synthesis in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLaparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most performed bariatric procedures worldwide. Trials and observational studies up to five years show RYGB yields slightly greater weight loss and better metabolic control, notably for dyslipidemia and reflux. Ten-year cohorts and recent randomized trials give perspective on durability differences, but small sample sizes and single-center designs limit their reach. No meta-analysis has yet pooled these decade-long data, leaving clinicians without clear guidance on the comparative long-term performance of SG and RYGB.
objectiveThis meta-analysis aims to compare the 10-year outcomes of SG versus RYGB in terms of weight loss and remission of comorbidities.
methodsWe performed a systematic review and meta-analysis of randomized clinical trials (RCTs) and observational cohorts with a minimum 10-year follow-up. We searched PubMed, Embase, and Cochrane through April 2025. Primary endpoints were percent total weight loss (%TWL) and percent excess weight loss (%EWL). Secondary endpoints were remission of type 2 diabetes (T2D), hypertension, and dyslipidemia. Data were pooled using a random-effects model with risk ratio (RR) and mean difference (MD). Statistical analysis were made using R v.4.3.5.
resultsRYGB produced greater long-term weight loss than SG (%TWL mean difference −2.38, 95% CI − 3.85 to − 0.92, p = 0.001; %EWL mean difference − 4.92, 95% CI − 8.67 to − 1.17, p = 0.01). Remission of T2D (RR 0.88, 95% CI 0.67 to 1.15, p = 0.36) and dyslipidemia (RR 0.84, 95% CI 0.64 to 1.09, p = 0.18) did not differ. Hypertension remission trended toward RYGB without reaching significance (RR 0.68, 95% CI 0.39 to 1.20, p = 0.19). SG showed higher rates of de-novo or worsening gastro-esophageal reflux disease and a markedly higher conversion to RYGB.
conclusionThe decadal outcomes of SG and RYGB reveal a level of parity that challenges historical procedural endorsements. Fidelity to the data indicates that ten years after surgery, there is no statistically or clinically significant difference in total weight loss or excess weight loss between the two techniques. Furthermore, the remission of major metabolic comorbidities, including type 2 diabetes and dyslipidemia, is comparable across both cohorts.
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