Lee WJ et al. (2005) Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg 242: 20–28
Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a technically difficult procedure and the safety of laparoscopic mini-gastric bypass (LMGB) still remains unclear; therefore, both warrant further investigation. In a prospective, randomized, controlled, clinical trial Lee et al. compared the safety and effectiveness of LRYGB and LMGB in the treatment of morbid obesity.
Overall, 80 patients were enrolled in the study, who had at least a 5-year history of obesity and BMI >40 kg/m2 (or >35 kg/m2 with comorbidities). They were randomized to either LRYGB (40 patients) or LMGB (40 patients). Surgery was successfully completed in 100% and 97.5% of patients in the LMGB and LRYGB, groups, respectively. The LRYGB group experienced a longer hospital stay and larger cumulative doses of analgesic medication compared with the LMGB group. Six minor and two major complications, relating to anastomotic leakage, occurred in the LRYGB group, compared with only three minor complications in the LMGB group. In addition, weight loss was significantly greater in the LMGB group at 1 year (64.9%) compared with LRYGB (58.7%); however, there was no statistical difference between the two groups at 2 years of follow-up.
The authors further note that 56% of patients who were diagnosed with metabolic syndrome before either form of surgery were completely cured within a year. The authors conclude that LMGB is an acceptable alternative treatment to LRYGB and has proven to be a simple and safe procedure for the treatment of morbid obesity.
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Lofthouse, M. Laparoscopic mini-gastric bypass is simple and safe. Nat Rev Endocrinol 1, 6 (2005). https://doi.org/10.1038/ncpendmet0003