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    Ayman M. A. Osman1 MD, MRCS (Eng); Hytham H. Mohey1 M.Sc.; Ahmed M. Ghobashy1 MD
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    • Impact of Roux-en-Y gastric bypass and sleeve gastrectomy on three common co-morbidities in morbidly obese Egyptian patients: A randomized comparative study

    Ayman M. A. Osman1 MD, MRCS (Eng); Hytham H. Mohey1 M.Sc.; Ahmed M. Ghobashy1 MD
    1Department of General Surgery, Faculty of Medicine, Cairo University, Egypt.

    Objectives: Several co-morbidities may be associated with obesity. The aim of this prospective, randomized, uncontrolled study is to compare between laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) in terms of their impact on 3 common obesity-related comorbidities: hypertension, diabetes mellitus (DM) and gastroesophageal reflux disease (GERD). Methods: Over a 20-month period, 50 morbidly obese patients were randomly allocated into one of two groups (A & B). Group A patients (n=25) underwent LRYGB, whereas group B patients (n=25) underwent LSG. Patients were followed up for 6 months. Primary endpoints included percentage of excess weight loss (%EWL) and impact on 3 obesity-related co-morbidities: hypertension, DM and GERD. Results: The %EWL was significantly higher in group A at 6 months postoperatively (61.1 ± 11.95 kg/m2 ) compared to group B (57.17 ± 8.36 kg/m2 ); P=0.007. The rates of remission of hypertension were higher in group A (60%) compared to group B (25%). Complete resolution or improvement of type 2 DM was achieved in both groups. Four / 5 patients with preoperative GERD symptoms in group A (80%) had complete relief of their symptoms at 6 months, compared to 3 / 6 patients in group B (50%). Conclusion: Both LRYGB and LSG are effective in terms of short-term weight loss. However, LRYGB provides better weight loss at 6 months after surgery. Both LRYGB and LSG are associated with excellent and comparable rates of type 2 DM resolution / improvement, but the rates of remission of hypertension and relief of GERD symptoms appear to be higher after LRYGB. Keywords: Obesity; Roux-en-Y gastric bypass; sleeve gastrectomy; co-morbidities. 

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