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Background <p>Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are common bariatric procedures that are effective in treating type 2 diabetes (T2D) in patients with obesity. The addition of a silastic-ring (SR) to LRYGB may increase weight loss, reduce weight regain, and improve diabetes remission. Five and seven-year results from a prospective, randomized, parallel, two-arm, clinical trial at North Shore Hospital (Auckland, Aotearoa New Zealand) found that SR-LRYGB was superior to LSG for diabetes remission and weight loss following surgery, with acceptable complication rates. Results on longer-term outcomes are still emerging in the literature.</p> Methods <p>A 10-year analysis was conducted on 114 patients with T2D who underwent SR-LRYGB or LSG. The primary outcome was diabetes remission assessed at 10 years. Secondary outcomes included percentage total body weight loss (%TWL) and complications.</p> Results <p>Of 114 patients randomized to either SR-LRYGB or LSG, 10 years after surgery, diabetes remission was seen in 15/49 (30.6%) after SR-LRYGB and 7/40 (17.5%) after LSG (adjusted OR 3.3; 95% confidence interval (CI) 1.0, 10.6; <i>p =</i> 0.042). Percentage total body weight loss was greater after SR-LRYGB than LSG (27.2% vs. 20.2%, absolute difference 7.0% 95% CI 2.2%, 11.8%; <i>p =</i> 0.005). Late minor complication rates were 28.6% after SR-LRYGB and 19.0% after LSG (absolute difference 9.6%, <i>p</i> = 0.226). Late major complication rates were 25.0% after SR-LRYGB and 31.0% after LSG (absolute difference 6.0%, <i>p</i> = 0.535).</p> Conclusions <p>SR-LRYGB remains superior to LSG for diabetes remission and weight loss at 10 years following surgery. This study confirms long-term enhanced patient outcomes in patients undergoing SR-LRYGB when compared directly with LSG. This study adds to the mounting body of evidence that demonstrates sustained diabetes remission and weight loss in patients undergoing SR-LRYGB.</p>

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Ten‑Year Results of a Randomized Trial Comparing Banded Roux‑en‑Y Gastric Bypass to Sleeve Gastrectomy for Type 2 Diabetes and Weight Loss

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • Megan Elizabeth Grinlinton,
  • Preekesh Patel,
  • Anamitra Nair,
  • Michael Clarke,
  • Lindsay Plank,
  • Rinki Murphy,
  • Michael Booth

摘要

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are common bariatric procedures that are effective in treating type 2 diabetes (T2D) in patients with obesity. The addition of a silastic-ring (SR) to LRYGB may increase weight loss, reduce weight regain, and improve diabetes remission. Five and seven-year results from a prospective, randomized, parallel, two-arm, clinical trial at North Shore Hospital (Auckland, Aotearoa New Zealand) found that SR-LRYGB was superior to LSG for diabetes remission and weight loss following surgery, with acceptable complication rates. Results on longer-term outcomes are still emerging in the literature.

Methods

A 10-year analysis was conducted on 114 patients with T2D who underwent SR-LRYGB or LSG. The primary outcome was diabetes remission assessed at 10 years. Secondary outcomes included percentage total body weight loss (%TWL) and complications.

Results

Of 114 patients randomized to either SR-LRYGB or LSG, 10 years after surgery, diabetes remission was seen in 15/49 (30.6%) after SR-LRYGB and 7/40 (17.5%) after LSG (adjusted OR 3.3; 95% confidence interval (CI) 1.0, 10.6; p = 0.042). Percentage total body weight loss was greater after SR-LRYGB than LSG (27.2% vs. 20.2%, absolute difference 7.0% 95% CI 2.2%, 11.8%; p = 0.005). Late minor complication rates were 28.6% after SR-LRYGB and 19.0% after LSG (absolute difference 9.6%, p = 0.226). Late major complication rates were 25.0% after SR-LRYGB and 31.0% after LSG (absolute difference 6.0%, p = 0.535).

Conclusions

SR-LRYGB remains superior to LSG for diabetes remission and weight loss at 10 years following surgery. This study confirms long-term enhanced patient outcomes in patients undergoing SR-LRYGB when compared directly with LSG. This study adds to the mounting body of evidence that demonstrates sustained diabetes remission and weight loss in patients undergoing SR-LRYGB.