Comparison of mini-gastric bypass with sleeve gastrectomy in a mainly super-obese patient group: first results

Andreas Plamper, Philipp Lingohr, Jennifer Nadal, Karl P. Rheinwalt

Whereas sleeve gastrectomy (SG) in its beginnings was mainly performed to treat super-obesity, it has become as popular as gastric bypass in the treatment of obesity of any class. In contrast to this, the persisting problems of early staple line leaks and poor long-term results of SG regarding weight loss and new onset of gastroesophageal reflux have become increasingly obvious. The mini-gastric bypass (MGB) with its low complication rates and possibly better long-term results may be a good alternative to SG, especially in super-obesity. In this context, two groups of mostly super-obese patients (SG and MGB) of a single bariatric center were retrospectively analyzed and compared for perioperative and early postoperative outcomes. Between August 2007 and March 2015, 169 patients underwent MGB, while 118 patients were operated by SG. Both groups were comparable for BMI at baseline (MGB = 54.1 kg/m(2) vs. SG = 54.6 kg/m(2), p = 0.657). Mean operation time (81.7 vs. 112.1 min, p < 0.0001) as well as hospital stay was lower in the MGB-group (4.5 vs. 7.2 days, p < 0.0001). Perioperative (30 days) mortality was 0 % in MGB versus 0.8 % in SG (one patient). Perioperative complication rate was also lower in the MGB-group (3.0 vs. 9.3 %, p = 0.449). %EWL was significantly better after 1 year in MGB: 66.2 % (±13.9 %) versus 57.3 % (±19.0 %) in SG (p < 0.0001), as well as BMI which was 34.9 kg/m(2) (±4.8 kg/m(2)) in MGB versus 38.5 kg/m(2) (±8.6 kg/m(2)) in SG (p = 0.001). MGB achieved superior weight loss at 1 year and had a lower 30-day complication rate in comparison with SG for super-obese patients. Thus, MGB might be superior to SG regarding the treatment of super-obesity.